Drugs Flashcards
Epinephrine affinity
B1 and B2 then alpha at higher doses
Epinephrine indications
anaphylactic shock
complete heart block
cardiac arrest
Prolonged Anestetic actions
Adverse affects of Epinephrine
HTN, cerebral hemmorage and arrhythmias
Low dose effect (graph of epi)
up: pulse (B1)
Down: peripheral resistance (B2)
Increase in sys (B1)
Decrease in diastolic (B2)
Epinephrine Reversal
Higher dose epi= pressor
Given w/ alpha antagonist =decrease in pressure. Due to unopposed beta activity.
NE affinity
Alpha 1 and alpha 2 > B1
NE lacks affinity for
B2
NE acts how
Potent vasoconstrictor.
Increases CO.
HR may decrease slightly due to baroreceptor reflex.
NE indications
Hypotension , shock
AEs of NE
High risk of HTN
NE trace
Lowers heart rate: (baroreceptors)
Up: Peripheral resistance (unopposed alpha 1 effect)
Overall increase in MAP
Dopamine affinity
Low (D1): vasodilation in renal , mesenteric, and coronary beds.
Moderate (B1):
High (Alpha)
Dopamine indications
shock and heart failure
Dopamine AEs
Similar to NE… .HTN
Phenylephrine affinity
alpha 1 –vasoconstriction
Phenylephrine indications
hypotension/shock
nasal congestion
mydriasis
Phenylephrine AEs
reflex Brady cardia due to vasoconstriction . Has no direct effects on heart, so use when you don’t want to induce tacky
Clonidine affinity
Alpha 2 agonist in CNS . Decreases SNS outflow from CNS and decreases NE release.
Clonidine indications
HTN, addiction , post menopausal hot flashes
Brimonidine affinity
Alpha 2 agonist -topical use to treat glaucoma.
Dobutamine affinity
B1 (B2>alpha)- increases contractile strength . . more than in increases rate
Indications: cariogenic shock and heart failure
Isoproterenol affinity
Nonselective beta agonist
Isoproterenol indications
infrequently used for complete heart block. Cardiac arrest.
Isoproterenol AEs
Arrythmia
Albuterol, Metaproterenol, terbutaline
B2 agonist
Albuterol, Metaproterenol, terbutaline indications
bronchodilation asthma , COPD,, can also be used to relax the uterus to inhibit premature labor.
Isoproternol trace
Pulse: increase (B1 + baro-reflex)
PR: decrease (B2)
MAP: inchanged(diastolic decrease and systolic increase)
Initital vasopressor of choice with septic shock, cardogenic shock, and hypovolemic shock
NE
Initial vasopressor when tachyarrythmias preclude use of NE
Phenylephrine
Alternative to NE in septic shock in highly selected patients (compromised systolic function or bradycardia and a low risk of tachyarrthmias).
Dopamine
Initial agent of choice with low CO and maintained blood pressure.
Dobutamine
Mirabegron mechanism
relaxes bladder detrusor muscle .
Ephedrine mechanism
alpha , B1 and B2 affinity . . .
Increases NE release . CNS stimulant
AMphetamine
increase NE and DA from storage vesicles.
Cocoaine
blocks NE and Epi reuptake also blocks DAT and SERT
MDMA
increases serotonin release. Blocks NET, DAT, SERT release.
Phenoxybenzamine vs Phentolamine
Phenoxy: long acting . Irreversible. Can cause hypotension or relfextachy .
Phentolamine : short acting . Competitive. Can cause hypotension or reflex tacky
Alpha 1 blocker for HTN
prazosin
A 1 blocker for HTN and BPH
Terazosin
A 1 blocker for BPH only
Tamsulosin
