Norepinephrine and Epinephrine Flashcards

1
Q

Epinephrine

A

Increases:

  • -HR
  • -SV
  • -CO
  • -arrhythmias
  • -Coronary Blood flow
  • -Systolic arteriole pressure
  • -Mean arterial pressure
  • -Mean pulmonary blood pressure

Widens Pulse pressure!!
(ESPECIALLY low dose given subcutaneously)

*at low doses, may DECREASE BP
(so on time curve, pressure goes up initially, but as drug concentration declines the pressure goes below normal!)

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2
Q

Norepinephrine

A

Increases:

  • -SV
  • -arrhythmias
  • -coronary blood flow
  • -Systolic arteriole pressure
  • -diastolic arteriole pressure
  • -mean arteriole pressure
  • -Mean pulmonary pressure
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3
Q

Similarities

A

Increase:

  • -SV
  • *arrhythmias
  • -Coronary blood flow
  • -systolic arterial pressure
  • -mean arterial and pulmonary pressures
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4
Q

Differences

A
  • -HR
  • -CO

–Pulse pressure

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5
Q

Why difference in HR and CO?

A

Parasympathetic tone predominates in the heart

NE affects mainly alpha receptors, causing more intense vasoconstriction than E and causing major increase in Mean arterial pressure, thus stimulating vagus

Increased BP–>vagus parasympathetic activation on heart, decreasing HR and CO

(If atropine given before NE, then increase in HR and CO)

E does not increase mean arterial pressure much, and thus doesn’t stimulate vagus

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6
Q

Why difference in Pulse pressure?

A

NE works more intensely on alpha receptors, increasing both systolic and diastolic pressures

E works on both beta receptors especially. Systolic pressure increases greatly b/c of increased SV etc., but diastolic doesn’t increase or even goes down b/c doesn’t work as much on alpha and does activate strongly the beta-2 receptors, causing vasodilation.

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7
Q

Epinephrine affects B1 receptors of…

Cardiac effects

A

SA node and AV node

not really ventricular tissue

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8
Q

Epinephrine Vascular effects

A

Vasodilation:
–skeletal muscle

Vasoconstriction:

  • -cutaneous
  • -renal (so incr renin secretion & dec BF)

Increases:

  • -pulmonary pressures (arteries and veins)
  • -Coronary BF
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9
Q

Epinephrine administration

A

IV, inhaled, IM, subcutaneous (allergies)

NOT oral

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10
Q

Epinephrine adverse effects

A

Cerebral hemorrhage (esp w/ non-selective BB)

Ventricular arrhythmias

Angina

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11
Q

Epinephrine utility

A

emergency relief of anaphylaxis

vasoconstrictor w/ local anasthetics

Restoring cardiac rhythm in pts w/ cardiac arrest

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