Pharm Test 1 Flashcards
Aspirin MOA
Small Doses block thomboxane A2 (platelet aggregate and vasoconstrictor) (used for MI)
Decreased platelet aggregation
Amiodarone Class
Anti-arrhythmic agent
Amiodarone MOA
Multiple effects on Na, K, and Ca channels
Prolongs action potential, refractory period
Ventricular automaticity (K)
Slows membrane depolarization and impulse conduction (Na)
Negative chronotropic activity in nodal tissue (antisympathetic activity)
Dilates coronary artery, Ca channel and alpha-adrenergic blocking action
Channels Amiodarone effects
Na, K, Ca
Lidocaine Indications
Suppression of ventricular arrhythmias (vtac, vfib, pvcs)
Prophylaxis against recurrence after conversion from vtac or vfib
Pain management after IO insertion in conscious patients
Lidocaine MOA
Decrease automaticity by slowing rate of spontaneous phase 4 depolarization. Terminates re-entry by decreasing conduction in re-entrant pathways. Increases vfib threshold.
Sodium Bicarb Incompatibilities
Incompatible with other drug infusions
Why does Nitro dilate coronary arteries?
To stop infarct from happening
Nitroglycerin MOA
Smooth muscle relaxant (vascular, uterine, bronchial, intestinal)
Reduces workload on heart by causing blood pooling (decreased preload)
Arteriolar vasodilation (decreased afterload)
Coronary Artery vasodilation
Increase blood flow to myocardium
Decrease myocardial 02 demand
Atropine MOA
Blocks acetylcholine at muscarinic receptor sites in smooth muscle, secretory glands and CNS.
Blocks parasympathetic response, sympathetic takes over.
Increase cardiac output and drying of secretions
Clinical MOA of Atropine
CV: Increased heart rate, increased conduction velocity, increased force of contraction, increase cardiac output
Resp: Decreased mucus production, bronchodilation
GI: Decrease GI secretion and motility
GU: Decrease urinary bladder tone
Misc: Mydriasis (pupillary dilation), decreased sweat production
Atropine and beta blockers
Not effective with beta blockers
Used for organophosphate poisoning
Atropine
Etomidate Class
Sedative/hypnotic agent
Etomidate MOA
Produces hypnosis rapidly causing CNS depression and anesthesia. No analgesic effect.
Is Sodium Bicarb for other med acidicy?
No
Furosemide MOA
Inhibits electrolyte reabsorption in the ascending loop of henle. Promotes excretion of Na, K, Cloride. Vasodilation increases venous capacitance and decreases afterload
Diuresis.
Wolff Parkinson White Syndrome complications
Can’t give adenosine or verapamil
Swoop from P wave to QRS
Wolff Parkinson White Syndrome
Verapamil Indications
SVT
A-Fib and A flutter with rapid ventricular response
Verapamil Adverse Reactions
Extreme Bradycardia Asystole AV Block Hypotension CHF
Verapamil dosage and delivery
Adult: 2.5 - 5 mg slow IV push (2-3min) Rebolus every 15-30 min with 5 - 10mg until max of 30 mg
Diphenhydramine Class
Antihistamine, anticholinergic
Diphenhydramine MOA
Blocks cellular histamine receptors (does not prevent histamine release) results in decreased capillary permeability and decreased vasodilation, prevent bronchospasm
Some Anticholinergic effects
Diphenhydramine Indications
Anaphylaxis (2nd line)
Phenothiazine reactions (extrapyramidal symptoms)
Antiemetic
Dopamine Class
Sympathomimetic
Dopamine MOA with 1-2 mcg/kg/min
Acts on dopaminergic receptors to stimulate cerebral, renal, mesenteric vasculature to dilate. HR & BP usually unchanged
Dopamine MOA with 2-10 mcg/kg/min
B1 stimulant action is primary effect. Increased cardiac output and only modest increase in systemic vascular resistance
Dopamine MOA with 10-20 mcg/kg/min
a-adrenergic effects predominate resulting in renal, mesenteric and peripheral arterial and venous vasoconstriction with marked increase in systemic vascular resistance, pulmonary vascular resistance and further increase preload
Dopamine MOA with >20 mcg/kg/min
Produces hemodynamic effects similar to norepinephrine; may increase HR and O2 demand to undesirable limits
