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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
Q

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

A

Beta-Blockers

Propranolol- non-selective

Atenolol- B1 selective

Pindolol-B1 selective with vasodilation (B2 partial agonist)

block adrenergic receptors

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26
Q

Guanethidine

What receptors does it bind to?

What are its effects?

A

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

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27
Q

Dopamine

What receptors does it bind to?

What are its effects?

A

D1, D2, B1

Renal and Mesenteric Vasodilation
Increases heart contractility, velocity, automaticity

NET EFFECTS:

Increased HR, BP, PR

(high doses A1, A2 also)

28
Q

Lidocaine:
Give the:

Category

Indications

Contraindications

A

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
Q

What is adenosine used for? How is it metaboilzed?

A

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
Q

Terazosin

What receptors does it bind to?

What are the effects?

A

Alpha1 selective antagonist

anti-hypertensive

Proven for men with Benign Prostatic Hyperplasia (BPH)

31
Q

Amphetamine:
Category

Indications

Contraindications

A

Category: Indirect Sympathomimetics

Indications:
Narcolepsy
Obesity
ADD/ADHD

Contraindications:
Advanced arterosclerosis
hypertension
glaucoma
symptomatic cardiovascular disease
hyperthyroidism

32
Q

Isoproterenol:
Give the:

Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
AV block

Contraindications:
Myocardial ischemia

(beta1, beta2 agonist)

33
Q

Ephedrine

What receptors does it bind to?

What are its effects?

A

Indirect acting

Displaces NE in presynaptic vessicles

May directly stimulate A1, A2, B2 receptors

Bronchodilation

increase HR

34
Q

What are the signs of Atropine toxicity?

A

Hot as a hare

Dry as a bone

Red as a beet

Blind as a bat

Mad as a hatter

35
Q

Isoproterenol

What receptors does it bind to?

What are its effects?

A

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
Q

Labetalol:
Give the:

Category

Indications

Contraindications

A

Category: Beta-Blocker

Indications:
Hypertension
Heart failure

Contraindications:
Coronary heart disease
asthma
heart block
bradycardia
cardiogenic shock

(non-selective and partial alpha1 blocker)

37
Q

Propranolol

What receptors does it bind to?

What are its effects?

A

Beta1 and Beta2 antagonist
(Beta Blocker)

Lowers HR and BP

Reduces Renin

Used for:
Hypertension
Migraines
Angina Pectoris
Arrhythmias

38
Q

Ibutilide:
Give the:

Category

Indications

Contraindications

A

Category: Antiarrhythmic

Indications:
Atrial Fib. or Atrial Flutter
(of recent onset)

Contraindications:
not noted

(Class III)

39
Q

Diltiazem:
Give the:

Category

Indications

Contraindications

A

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
Q

Pindolol:
Give the:

Category

Indications

Contraindications

A

Category: Beta-Blocker

Indications:
Hypertension
Angina

Contraindications:
Pheochromocytoma
Diabetes Mellitus
asthma
bradycardia
cardiogenic shock
hypotension
hyperthyroidism

(non-selective and partial agonist effect)

41
Q

Terazosin:
Give the:

Category

Indications

Contraindications

A

Category: alpha blocker

Indications: Hypertension
Urinary Retention

No contraindications noted

(alpha1 selective)

42
Q

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

A

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
Q

Atenolol

What receptors does it bind to?

What are its effects?

A

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
Q

Prazosin:
Give the:

Category

Indications

Contraindications

A

Category: alpha-blocker

Indications:
Hypertension
Urinary retention
PTSD
Scorpion Stings

Contraindications:
none noted

(alpha1 selective)

45
Q

Albuterol

What receptors does it bind to?

What are its effects?

A

B2 Agonist

Activates adenylyl cyclase resulting in bronchodialation

46
Q

Dobutamine

What receptors does it bind to?

What are its effects?

A

Synthetic catecholamine

Binds to B1

Increases myocardial contractility

Very slight increase in HR, PR, BP or automaticity

47
Q

Carvedilol:
Give the:

Category

Indications

Contraindications

A

Category: Beta-Blocker

Indications:
Hypertension
Chronic heart failure

Contraindications:
pheochromocytoma
diabetes
asthma
heart block
bradycardia
cardiogenic shock

(non-selective and alpha1 selective blocker)

48
Q

Labetalol
(carvedilol)

What receptors does it bind to?

What are its effects?

A

Mixed antagonists:

Selective alpha1 and nonselective beta blocker

Lowers BP with limited HR increase

Used to treat:
Heart failure
Hypertension

48
Q

Propanolol:
Give the:

Category

Indications

Contraindications

A

Category: Beta-Blocker

Indications:
Hypertension
Angina
Ventricular Tach.
MI
Supraventricular Arrhythmias

Contraindications:
Pheochromocytoma
Diabetes Mellitus
asthma
bradycardia
cardiogenic shock
hypotension

(non-selective)

50
Q

Quinidine:
Give the:
Category
Indications
Contraindications

A

Category: Antiarrhythmic

Indications:
Atrial fib.
atrial flutter
Ventricular arrhythmia
supraventricular arrhythmia

Contraindications:
Prolonged QT
Diarrhea

(Class Ia)

51
Q

Phenylephrine:
Give the:

Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
pupilary dilation
nasal congestion

Contraindications:
none noted

(agonist of alpha receptors)

52
Q

What is the mechanism of Class III antiarrhythmic drugs?
Give examples.

A

Most block the rabid component of the delayed rectifier potassium current, IKr

prolonged APD

Examples:
Sotilol
Amiodarone
Ibutilide
Bretylium

53
Q

Oxymetazoline:
Give the:

Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
hypotension
nasal congestion

Contraindications:
hypertension

(alpha1 agonist, partial alpha2 agonist)

54
Q

Albuterol:
Give the:

Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
acute asthma

Contraindications:
none noted

(beta2 agonist)

55
Q

Phentolamine
Give the:

Category

Indications

Contraindications

A

Category: alpha-blocker

Indications: Hypertension (usually for pheochromocytoma)
Hypoplastic L heart

Contraindications: History of:
MI
angina
coronary artery disease

56
Q

Prazosin

What receptors does it bind to?

What are the effects?

A

Very selective Alpha1 adrenergic receptor antagonist

Relaxes smooth muscle of the prostate

Metabolized in the liver

(alpha1>>alpha2)

57
Q

Dopamine
Category

Indications

Contraindications

A

Category: Sympathomimetics

Indications:
Shock
heart failure

Contraindications:
none noted

(beta1 agonist, Inotropic and chronotropic)

58
Q

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

A

Verapamil

Calcium channel blockers

preferentially act on nodal tissues

59
Q

Atropine:
Give the:

Category

Indications

Contraindications

A

Category: Anticholinergic

Indications:
Organophosphate poisoning
Bradycardia
Used for dilation in eye exam

Contraindications:
Glaucoma
Pyloric stenosis
Prostatic hypertrophy

60
Q
A
61
Q

Norepinephrine:
Give the:

Category

Indications

Contraindications

A

Category: Sympathomimetics
(non-selective alpha agonist
and beta1 to an extent)

Indications:
hypotension
severe shock

Contraindications:
none noted

62
Q

Ephedrine:
Category

Indications

Contraindications

A

Category: Indirect Sympathomimetics

Indications:
Nasal decongestant
urinary incontinance
hypotension

Contraindications:
Diabetes
hypertension
prostatic hypertrophy
MAOI use
NE reuptake inhibitors

63
Q

Phenoxybenzamine

What receptors does it bind to?

What are its effects?

A

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
Q

Phenylephrine/Oxymetazoline

What receptors does it bind to?

What are its effects?

A

A1 agonist

Vasoconstrictor

Increases BP

Used IV for acute hypotension

Decongestant

65
Q

Clonidine/Brimonidine

What receptors does it bind to?

What are its effects?

A

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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