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Module 3: CPR > Drugs > Flashcards

Drugs Flashcards

1
Q

Amiodarone:
Give the:

Category

Indications

Contraindications

A

Category: Antiarrhythmic

Indications:
Recurrent Ventricular Fib.
Recurrent and hemodynamically unstable Ventricular Tachycardia
Ventricular and Supraventricular arrhythmias

Contraindications:
Prolonged QT
SA or AV node dysfunction
lung disease

(Class 3)

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2
Q

Midodrine

What receptors does it bind to?

What are its effects?

A

ALPHA 1 agonist

increases BP until it causes a vagal discharge slowing HR

Treats paroxysmal superventricular tachycardia

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3
Q

Pindolol

What receptors does it bind to?

What are its effects?

A

Beta-Blocker
(beta1 and beta2 antagonist)

Partial beta1 and beta2 agonist

Lowers BP
Modestly lowers HR

Used to Treat:
Hypertension
arrhythmias
migraine
prevents worstening of bradycardia

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4
Q

Fenoldopam

What receptors does it bind to?

What are its effects?

A

peripherial D1 agonist

No CNS effect

Dialates renal arterioles

short-term mgmt of severe hypertension

NET EFFECT:

Reduces BP

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5
Q

Procainimide:
Give the:

Category

Indications

Contraindications

A

Category: Antiarrhythmic

Indications: Atrial Fib.
Sustained ventricular tachycardia

Contraindications:
Arthritis

(Class Ia)

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6
Q

Verapemil:
Give the:

Category

Indications

Contraindications

A

Category: Antiarrhythmic

Indications:
Hypertension
Angina
Supraventricular Arrhythmia

Contraindications:
Severe L ventricular dysfunction
hypotension
Sick sinus syndrome
2nd and 3rd degree AV block
WPW

(Class IV)

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7
Q

What are some Class Ic antiarrhythmetic agents? What effect do they have on cardiac electrical activity?

A

Flecainide, encainide, propafenone

no effect on repolarization period or QT interval legnth

Strongly decreases phase 0 upstroke rate

Strongly decreases conduction velocity

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8
Q

Atenolol:
Give the:

Category

Indications

Contraindications

A

Category: Beta-Blocker

Indications:
Hypertension
Angina
Ventricular/Supraventricular Tach.
Acute MI
Patients with pulmonary disease
Chronic Heart Failure

Contraindications:
Asthma
Sinus bradycardia
cardiogenic shock
hypotension
pheochromocytoma
Acutely decompensated coronary heart disease

(Beta1 Selective)

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9
Q

Midodrine:
Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
Orthostatic hypotension

Contraindications:
Severe heart disease
Renal disease
urinary retension
Pheochromocytoma
Thyrotoxicosis

(alpha1 agonist)

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10
Q

Adenosine:
Give the:

Category

Indications

Contraindications

A

Category: Antiarrhythmic

Indications:
Paroxysmal Supraventricular Tachycardia (PSVT)

Contraindications:
Severe hypotension
Sick sinus syndrome
2nd and 3rd degree heart block
Asthma
Drug induced tachycardia

(alpha1 mediated adenylyl cyclase inhibitor)

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11
Q

What are some class Ia antiarrhythmic drugs? What effect do they have on cardiac electrical activity?

A

Quinidine

Procainamide

Slow phase 0 upstroke and conduction

Increase repolarization duration

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12
Q

Bretylium:
Give the:

Category

Indications

Contraindications

A

Category: Antiarrhythmic

Indications:
Ventricular Fib.
Ventricular Tachycardia that won’t respond to other drugs

Contraindications:
None noted

(Class III)

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13
Q

What is the mechanism of Class II antiarrhythmic drugs?
Give examples

A

Sympatholytic.

Reduce beta andrenergec effects in the heart. (Beta-Blockers)

Examples:
Propanolol
Atenolol
Pendolol
Labetilol
Carvedilol

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14
Q

What is the mechanism of Class IV antiarrhythmic drugs?
Give examples

A

Blockade of the cardiac calcium current.

Slows conduction in regions where the AP upstroke is Ca++ dependant (SA and AV nodes).

Examples:
Verapamil
Diltiazem

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15
Q

What is the mechanism of Class I antiarrhythmic drugs?
What drugs are in each class?

A

Na+ channel blockade:

1A- prolong AP duration:
Quinidine
Procainamide

1B- shorten AP duration:
Lidocaine

1C- minimal effect on APD:
Flecainide

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16
Q

Dobutamine
Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
Heart failure
cardiac stress testing

Contraindications:
none noted

(beta1 agonist, inotropic)

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17
Q

Phenoxybenzamine
Give the:

Category

Indications

Contraindications

A

Category: Alpha Blocker

Indications: Hypertension (usually Phechromocytoma)
Hypoplastic L hear

Contraindications: History of MI
angina
Coronary artery disease

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18
Q

Phentolamine

What receptors does it bind to?

What are its effects?

A

Alpha 1 Competitive antagonist

prevents NE and Epi activity

reduces peripheral resistance

increases heart rate

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19
Q

Cocaine:
Category

Indications

Contraindications

A

Category: Indirect Sympathomimetics

Indications:
nasal surgery

Contraindications:
it’s really bad for you
(none noted)

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20
Q

What are some class 1b antiarrhythmic drugs? What effect do they have on cardiac electrical activity?

A

Lidocaine

tocainide

Phenytoin

Doesn’t increase QT interval

slows phase 0 upstroke rate in abnormal tissue (not in normal tissue)

increases repolarization duration

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21
Q

Tansulosin
Give the:

Category

Indications

Contraindications

A

Category: alpha-blocker

Indications: Benign Prostate Hypertension

No noted contraindications

(alpha1 selective)

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22
Q

What are the two types of sympathomimetic drugs?

A

Direct acting

Indirect acting

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23
Q

Epinephrine:
Give the:

Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
Anaphylaxis
Glaucoma
Asthma

Contraindications:
Non-selective beta blocker use

(agonist of alpha and beta receptors)

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24
Q

Tamsulosin

What receptors does it bind to?

What are its effects?

A

Competitive alpha1 antagonist

More selective for prostatic smooth muscle than vascular smooth muscle

Used for treatment of Benign Prostate Hyperplasia (BPH)

Side effect: Floppy Iris Syndrome

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25
What are some Class II antiarrhythmetic agents? What effect do they have on cardiac electrical activity?
Beta-Blockers Propranolol- non-selective Atenolol- B1 selective Pindolol-B1 selective with vasodilation (B2 partial agonist) block adrenergic receptors
26
**Guanethidine** What receptors does it bind to? What are its effects?
Blocks Action Potential induced release of NE *slowly* displaced NE from storage vesicles which leads to depletion of NE (NE gets oxidized by MAO) Used to treat: hypertension Doesn't cross BBB, so no CNS side effects
27
Dopamine What receptors does it bind to? What are its effects?
D1, D2, B1 Renal and Mesenteric Vasodilation Increases heart contractility, velocity, automaticity NET EFFECTS: Increased HR, BP, PR | (high doses A1, A2 also)
28
Lidocaine: Give the: Category Indications Contraindications
**Category:** Antiarrhythmic **Indications:** Ventricular tachycardia with remote MI Premature ventricular complexes Ventricular Fib. Digitalis induced ventricular arrhythmia **Contraindications:** SA or AV nodal conduction disease | (Class Ib)
29
What is adenosine used for? How is it metaboilzed?
Shortens AP generation, hyperpolarizes, slows normal automaticity by binding purinergic GPCRs. Used for PSVT via bolus IV injection. Metabolized by vascular tissue by the time it reaches the heart.
30
**Terazosin** What receptors does it bind to? What are the effects?
Alpha1 selective antagonist anti-hypertensive Proven for men with Benign Prostatic Hyperplasia (BPH)
31
Amphetamine: Category Indications Contraindications
**Category:** Indirect Sympathomimetics **Indications:** Narcolepsy Obesity ADD/ADHD **Contraindications:** Advanced arterosclerosis hypertension glaucoma symptomatic cardiovascular disease hyperthyroidism
32
Isoproterenol: Give the: Category Indications Contraindications
**Category:** Sympathomimetics **Indications:** AV block **Contraindications:** Myocardial ischemia | (beta1, beta2 agonist)
33
Ephedrine What receptors does it bind to? What are its effects?
Indirect acting Displaces NE in presynaptic vessicles May directly stimulate A1, A2, B2 receptors Bronchodilation increase HR
34
What are the signs of Atropine toxicity?
Hot as a hare Dry as a bone Red as a beet Blind as a bat Mad as a hatter
35
Isoproterenol What receptors does it bind to? What are its effects?
Beta 1 and Beta 2 (agonist) Vasodialation in skeletal muscle Relaxation of broncheal and GI smooth muscle Small increase in glucose release NET EFFECTS: Increase HR Decrease PR then compensatory Increase Decrease in mean BP
36
Labetalol: Give the: Category Indications Contraindications
**Category:** Beta-Blocker **Indications:** Hypertension Heart failure **Contraindications:** Coronary heart disease asthma heart block bradycardia cardiogenic shock | (non-selective and partial alpha1 blocker)
37
**Propranolol** What receptors does it bind to? What are its effects?
Beta1 and Beta2 antagonist (Beta Blocker) Lowers HR and BP Reduces Renin Used for: Hypertension Migraines Angina Pectoris Arrhythmias
38
Ibutilide: Give the: Category Indications Contraindications
**Category:** Antiarrhythmic **Indications:** Atrial Fib. or Atrial Flutter (of recent onset) **Contraindications:** not noted | (Class III)
39
Diltiazem: Give the: Category Indications Contraindications
**Category:** Antiarrhythmic **Indications:** Hypertension Angina Supraventricular Arrhythmia **Contraindications:** hypotension Sick sinus syndrome 2nd and 3rd degree AV block WPW Acute MI with pulmonary congestion | (Class IV)
40
Pindolol: Give the: Category Indications Contraindications
**Category:** Beta-Blocker **Indications:** Hypertension Angina **Contraindications:** Pheochromocytoma Diabetes Mellitus asthma bradycardia cardiogenic shock hypotension hyperthyroidism | (non-selective and partial agonist effect)
41
Terazosin: Give the: Category Indications Contraindications
**Category:** alpha blocker **Indications:** Hypertension Urinary Retention No contraindications noted | (alpha1 selective)
42
What are some Class III antiarrhythmetic agents? What effect do they have on cardiac electrical activity?
Amioderone (also class I, II, IV)- can be used for almost any arrhythmia Sotalol (also class II) -treats severe Ventricular arrhythmias. for patients who can't tollerate Amioderone's sideeffects. Prevents atrial flutter and fibrillation maintains NSR.
43
**Atenolol** What receptors does it bind to? What are its effects?
Beta-Blocker beta1 \> beta2 Lowers HR and BP Reduces Renin Safer for patients with asthma (no bronchoconstriction) Used for treatment of: Hypertension Angina Pectoris Arrhythmias
44
Prazosin: Give the: Category Indications Contraindications
**Category:** alpha-blocker **Indications:** Hypertension Urinary retention PTSD Scorpion Stings **Contraindications:** none noted | (alpha1 selective)
45
Albuterol What receptors does it bind to? What are its effects?
B2 Agonist Activates adenylyl cyclase resulting in bronchodialation
46
Dobutamine What receptors does it bind to? What are its effects?
Synthetic catecholamine Binds to B1 Increases myocardial contractility Very slight increase in HR, PR, BP or automaticity
47
Carvedilol: Give the: Category Indications Contraindications
**Category:** Beta-Blocker **Indications:** Hypertension Chronic heart failure **Contraindications:** pheochromocytoma diabetes asthma heart block bradycardia cardiogenic shock | (non-selective and alpha1 selective blocker)
48
**Labetalol** (carvedilol) What receptors does it bind to? What are its effects?
Mixed antagonists: Selective alpha1 and nonselective beta blocker Lowers BP with limited HR increase Used to treat: Heart failure Hypertension
48
Propanolol: Give the: Category Indications Contraindications
**Category:** Beta-Blocker **Indications:** Hypertension Angina Ventricular Tach. MI Supraventricular Arrhythmias **Contraindications:** Pheochromocytoma Diabetes Mellitus asthma bradycardia cardiogenic shock hypotension | (non-selective)
50
Quinidine: Give the: Category Indications Contraindications
**Category:** Antiarrhythmic **Indications:** Atrial fib. atrial flutter Ventricular arrhythmia supraventricular arrhythmia **Contraindications:** Prolonged QT Diarrhea | (Class Ia)
51
Phenylephrine: Give the: Category Indications Contraindications
**Category:** Sympathomimetics **Indications:** pupilary dilation nasal congestion **Contraindications:** none noted | (agonist of alpha receptors)
52
What is the mechanism of Class III antiarrhythmic drugs? Give examples.
Most block the rabid component of the delayed rectifier potassium current, IKr prolonged APD Examples: Sotilol Amiodarone Ibutilide Bretylium
53
Oxymetazoline: Give the: Category Indications Contraindications
**Category:** Sympathomimetics **Indications:** hypotension nasal congestion **Contraindications:** hypertension | (alpha1 agonist, partial alpha2 agonist)
54
Albuterol: Give the: Category Indications Contraindications
**Category:** Sympathomimetics **Indications:** acute asthma **Contraindications:** none noted | (beta2 agonist)
55
Phentolamine Give the: Category Indications Contraindications
**Category:** alpha-blocker **Indications:** Hypertension (usually for pheochromocytoma) Hypoplastic L heart **Contraindications:** History of: MI angina coronary artery disease
56
**Prazosin** What receptors does it bind to? What are the effects?
Very selective Alpha1 adrenergic receptor antagonist Relaxes smooth muscle of the prostate Metabolized in the liver | (alpha1\>\>alpha2)
57
Dopamine Category Indications Contraindications
**Category:** Sympathomimetics **Indications:** Shock heart failure **Contraindications:** none noted | (beta1 agonist, Inotropic and chronotropic)
58
What are some Class IV antiarrhythmetic agents? What effect do they have on cardiac electrical activity?
Verapamil Calcium channel blockers preferentially act on nodal tissues
59
Atropine: Give the: Category Indications Contraindications
**Category:** Anticholinergic **Indications:** Organophosphate poisoning Bradycardia Used for dilation in eye exam **Contraindications:** Glaucoma Pyloric stenosis Prostatic hypertrophy
60
61
Norepinephrine: Give the: Category Indications Contraindications
**Category:** Sympathomimetics (non-selective alpha agonist and beta1 to an extent) **Indications:** hypotension severe shock **Contraindications:** none noted
62
Ephedrine: Category Indications Contraindications
**Category:** Indirect Sympathomimetics **Indications:** Nasal decongestant urinary incontinance hypotension **Contraindications:** Diabetes hypertension prostatic hypertrophy MAOI use NE reuptake inhibitors
63
Phenoxybenzamine What receptors does it bind to? What are its effects?
Alpha 1 and 2 non-competetive, irreversable, antagonist Inhibits reuptake of released NE Treatment of Catecholamine toxicity | (also blocks serotonin, histamine, and ACh receptors)
64
Phenylephrine/Oxymetazoline What receptors does it bind to? What are its effects?
A1 agonist Vasoconstrictor Increases BP Used IV for acute hypotension Decongestant
65
Clonidine/Brimonidine What receptors does it bind to? What are its effects?
Alpha 2 agonist Inhibits Adenylyl Cyclase Inhibit NE release Vasoconstriction masked by central sympatholytic effect NET EFFECT: lowers blood pressure

Module 3: CPR (10 decks)

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