inotropes + vasodilators

Question 1

Epinephrine (adrenaline)

Answer 1

Classify as catecholamine, sympathetic stimulator

increase force of contraction, increase HR, vasoconstrict

Increases myocardial work, and myocardial oxygen demand

Question 2

Norepinephrine, Levophed

Answer 2

classification- Catecholamine, sympathetic stimulator
Profound a1 vasoconstrictor, very mild effects on HR and force of contraction

given via IV (NO USE AS A BOLUS)

Increases myocardial work, and myocardial oxygen demand (creates a ischemia problem)

Question 3

Phenylephrine, Neo-Synephrine

Answer 3

Catecholamine, sympathetic stimulator
short acting vasocontristor (potent a1 ) no beta effects
potent OTC (Cold meds) 
used for procedural sedation 
(ALTERNATIVE TO NOREPEINEPHRINE) 
Via IV infusion or Bolus

Question 4

Dopamine

Answer 4

Catecholamine, sympathetic stimulator
effects are Dose dependent. Increases renal perfusion, than Beta1, Alpha 1, than just vasoconstriction
given via iV

Question 5

Dobutamine, Dobutrex

Answer 5

Synthetic catecholamine, sympathetic stimulator
B1 effects- increases contraction
no vascular effects-
improves C.O without increase in afterload

continues IV infusion
(often use as a combination therapy)

Increases myocardial work, and myocardial oxygen demand ( may cause arrythmias)

Question 6

MIlirone

Answer 6

Phosphdiesterase inhibitor
increase prolong effect of cAMP.
increase myocardial contraction and VASODILATION (decrease in BP)

IV infusion- used with other drugs (NEVER SOLO )
can cause arrythmias and decrease BP too much

Question 7

Vasopressin

Answer 7

Endogenous hormone
Vasopressin Increases fluid retention in kidneys. At high doses vasoconstricts Released by Pituitary gland as Anti-Diuretic hormone
NO INOTROPIC EFFECTS
increase in BP - preload

given via IV infusion 
used for 
- heart failure 
-septic shock 
-diabetes insipidus

Question 8

Atropine

Answer 8

Anti-cholinergic (blocks Vagal stimulation) to the SA and AV node---- (+) chronotrope  = increase in HR 
no Inotrope effects 
Used for 
- cardiac resuscitation effort 
-bradycardia 
-PEA (pulseless electrical activity) 
(USED DURING INTUBATION IF VAGAL STIMULATION RISK) 
given by Bolus (IV)
dry mouth 
pupil dilation 
urinary retention

Question 9

Nitroglycerine

Answer 9

Vasodilator (acute)
vasodilates both systemically and coronary arteries
used for
-acute MI
-ischemic heart failure
-angina
increases blod flow resulting while decreasing afterload

Question 10

Sodium Nitroprusside (nipride)

Answer 10

Vasodilator (acute) 
profound Systemic vasodilator only
given via IV 
Nipride binds to oxyhemoglobin= nitric oxide 
rapid decrease in BP can cause 
dizziness 
dysrhythmias 
hypotension 
affect coronary perfusion

Question 11

Neprilysin inhibitors

Answer 11

is an enzyme that reverse some of our natural vasodilator and diuretic activity
Vasodilator - decrease BP
makes you pee- decrease in circulating volume

Question 12

ACE inhibitors

Answer 12

main drug to use for antagonizing system- blocks the conversion of angiotensin I into II

two drugs 
-captopril 
-Ramipril 
taken daily 
May decrease BP too much if PT persistent cough