Medications Flashcards
EPINEPHRINE
INCREASES Systemic vascular resistance Systolic & Diastolic blood pressure Electrical activity in the Myocardium Coronary & cerebral blood flow Strength of myocardial contraction Myocardial oxygen requirements Automaticity Peripheral Vasoconstriction Coronary perfusion pressure
Receptor- Stimulation
a= alpha , B=beta
A1 = vasoconstriction
a2=Peripheral Vasodilation
B1= increases heart rate & myocardial contractility
B2= relaxation of bronchial, uterine, GI Smooth muscle.
Modulates fat metabolism & drives K+ into the cell
Stimulates the release of RENIN
USES OF EPINEPHRINE
Indicated in VFib, Pulseless VTach, Asystole , PEA
Can be used for severe Brady , Hypotension or cardiac arrest
VASOPRESSIN : Levephed ( Nonepinephine)
For Hypotension
Can increase heart rate
De
Contractions of blood vessels both peripheral and central
Can cause decrease secretion
I
ATROPINE: inhibit ACETYLCHOLINE cause increase heart rate Decrease secretions AFib - Flutty
Used in symptomatic or relative bradycardia
Caution in 2 nd degree heart blocks
ADRENERGIC
Dopamine
Dopitamine
Epinephrine
ANTI-CHOLINERGIC
Atropine, Scopolamine
Indications
Bradycardic
Mode of action
Increase heart rate , increase CO
Inhibit Parasympathetic nerve , impulse by selectivity binding acetylcholine to it receptor nerve cells
VASODILATORS
NITROGLYCERIN, SODIUM, NITROPRUSSIDE
Used for Hypertension Angina
ACTION
Decrease BP, Increase tissue Perfusion, Relaxation of vessels
ANTICOAGULANTS
1. Heparin ( Reverse Agent is PROTAMINE)
2 Coumadin
Used
DVT, PE, Stroke, PCIACTION Many different caution depends on drug 1. Coumadin ( vitamin K antagonist) 2. Heparin ( activate antithrombin 3. Lovenox( Direct Factor Xa inhibitors Argatroban direct Thrombin inhibit reversed & Repolarization of excitable membranes
NITRATES
Nitropaste, Nytroglycein
Lower BP by Enhancing NO activity at Endothelial Level
Causes Vasodilation of smooth muscle in vascular wall
Decrease in Preload which results in decrease BP Which Reduces LV work and decrease Oxygen demand
Indications
Hypertension: ( systemic
Angina: ( coronary artery relaxation to increase flow
ANTIRRHYTHMIC
- Digoxin
- Amiodarone,
- Procainamide
Used Treat arrhythmia such as: VT,VFIB a fib, A flutter
Action
Suppress abnormal rhythms of the heart
CALCIUM CHANNEL BLOCKERS : inhibit movement of calcium Ions cross membranes of cardiac & arterial muscle cells Result in depression of Impulse formation in cardiac cells
Negative dromotropic, negative Inotropic
Dilation of coronary arteries & arterioles
Decreased cardiac work
1. Verapamil (Calan
Breaks coronary, vasospasm, breaks PSVT
2. Dltiazam( cardizem)
Angina & atrial
3. Nifedipine( procardia)
Vasodilation = lowered BP
Used for hypertension A fib / flutter tachycardia
Action Decrease HR Smooth muscle Relaxation ( vasodilation) for IC Indications Angina long term management Hypertension SVT Particularly those related to DIGOXIN slow / No Reflow situations
BETA BLOCKERS: Mechanism of action : PROPRANOLOL (inderal), ATENOLOL ( Tenormin), Labetalol ( Normodyne, Trandate)
1. Decrease the myocardial demand for oxygen
2. BETA 1 selective blockade
Negative Chronotropic
Negative Inotropic
These actions decrease Myocardial demand & decrease the Workload of the Heart
Beta blockers indications
Angina : long term management
Arrhythmias
Hypertension
HOCM
Prevention of reinfarction in clinically stable patients when started 1-4 was after MI
Bradycardia and heart blockers with bradycardia
Cardiogenic shock , CHF, Bronchial Asthma or spams
ACE INHIBITORS : Action
Blocke Angiotensin Converting Enzyme in the lungs from converting Angiotensin I , Activated the KIDNEYS to Renin is released from the Kidneys to Angiotensin II Which is a VASOCONSTRICTOR
Results in Anti- Hypertension properties
Indications
Hypertension
Treat mood CHF, Stable patients within 24hrs of AMI to improve survival
Ex: Captopril
Enalapril
Lisinopril
QuinacrineAnti- Arrythmics Classes
1: Class Ia : Procanamide prolongs action potential
2: Ib Lidocaine: shortens action potential
3 Ic Flecanide Na channel blocker slows conduction
4: II Propranolol beta blocker
5: III Amiodarone blocks Potassium Chanel and prolongs Repolarization
Amiodarone
150mg IVP VT Patients that feel palpitations or are alive
300mg IVT FOR VFIB patients
Pulseless VFib or patients that are dead
SYMPATHETIC = ADRENERGIC
Affect the atria & the ventricle Increase HR Conduction & irritability "Fight or Fight " Increase Blood Sugar Responds to immediate treat or stress Epinephrine, Norepinephrine
Drugs that stimulate the Sympathetic nervous system
ADRENERGIC
ADRENERGIC agonists
Sympathominetics
Catecholamines
CATECHOLAMINES
Substance which produce a sympathominetics response are either
Natural or Endogenous =
Epinephrine norepinephrine
Or synthetic or exogenous =
Isoproternol, DobutaminePARASYMPATHETIC = Choligenic
Affect the atria
Decrease HR and Conductivity
Control body process Eating Resting Sleeping Digestion
ADENOSINE
Slows conduction through AV node
Interrupts AV node re entry
MAGNESIUM
Co factor in numerous enzymatic
Decrease mg associated with Dysrhythmics can precipitate VFIB
May reduce post MI Ventricular Dysrhythmias
Treatment of choice for Torsades de pointes
MORPHINE SULPHATE
Increase venous capacitance Decrease SVR Decrease Pulmonary Congestion Decrease myocardial oxygen demand Given for Pain, Anxiety, Pulmonary edema
AMRINONE
Rapid acting Inotrope
For severe CHF refractory vasodilator and conventional Inotropics
IIb / IIIa INHIBITORS
GLYCOPROTEINS IIb/ IIIa Inhibitors recommend for a patients with no ST segment elevation MI OR High risk Unstable Angina
Platelets aggregation is the final common pathway bod formation of a platlet drug
FIBRINOGEN and VON WILLEBRAND FACTOR links the Platelets together by binding to GP IIb/ IIIa molecules on adjacent platelets aggregate into a hemostatic plug
