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Pharmacology > Pharmacology from Manual of Clinical Perfusion > Flashcards

Pharmacology from Manual of Clinical Perfusion Flashcards

1
Q

Inhalation Agents

A

Nitrous Oxide
Fluothane
Ethrane
Forane

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2
Q

Nitrous Oxide

A 
produces analgesia (inability to feel pain) but not loss of consciousness 
-not used alone, more as an induction agent with more potent agents
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3
Q

Fluothane (Halothane)

A
  • control hypertension during surgery
  • reduces sympathetic activity such as HR
  • dilates the vessels of the skin and skeletal muscles
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4
Q

Ethrane (Enflurane)

A

used to control hypertension during surgery

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5
Q

Forane (Isoflurane)

A
  • widely used with the heart lung machine due to lack fo cardiac problems associated with agent
  • BP drops, CO and HR usually increased
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6
Q

Anticoagulants

A 
Sodium Heparin 
Coumadin/Warfarin
Thrombate III/Antithrombin 
CPD (Citrate Phosphate Dextrose) 
CPDA-1 (Citrate Phosphate Dextrose Adenine)
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7
Q

Sodium Heparin

A

indication: to anticoagulate the blood prior to going on bypass or when anticoagulation is desired Blood stored with heparin can be kept for 48 hrs
action: stops anticoagulation by potentiating antithrombin III and inhibiting the action of activated Factors IX and XI. Half life is 1-2 hrs

Site of action: antithrombin III

dosage: 300-400 units per kilogram before bypass injected into right atrium or by way of a central line

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8
Q

Coumadin/Warfarin

A

indications: reduces the risk of harmful clots, used prophylactically after cardiac valve surgery
action: antagonizes vitamin K, therefore inhibiting synthesis of Factors II, VII, IX, X

site of action: hepatic synthesis of coagulation Factors II, VII, IX, X

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9
Q

Thrombate III/Antithrombin

A

indications: antithrombin III deficiency in connection w/ surgery
action: inactivates thrombin and activated forms of clotting factors IX, X, XI, and XII which results in coagulation inhibition

site of action: clotting factors of blood

dosage: individualized (desired - baseline AT-III level)x kg/ 1.4

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10
Q

CPD

Citrate Phosphate Dextrose

A

indications: anticoagulate and preserve blood in blood banks
actions: citrate binds calcium blocking clotting in all pathways. provides and helps maintain energy of RBCs

site of action: calcium ions in plasma and RBCs

dosage: premixed in collection bags

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11
Q

CPDA-1

Citrate Phosphate Dextrose Adenine

A

indications: anticoagulate and preserve blood in blood banks
actions: citrate binds calcium blocking clotting in all pathways. provides and helps maintain energy of RBCs. Adenine keeps ATP levels higher and prolongs life of RBC. Blood can be stored for 35 days when CPDA-1 used

site of action: calcium ions in plasma and RBCs

dosage: premixed in all collection bags, 63 ml per 450 ml of blood

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12
Q

Anticoagulant Antagonists

A

Protamine Sulfate

Phytonadione

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13
Q

Protamine Sulfate

A

indications: to reverse heparin after bypass surgery
action: in presence of heparin forms inert salt to neutralize both drugs. If given with no heparin present, acts as an anticoagulant. Increased incidents of anaphylactic reactions to drug have been reported in people with a history of prior exposure, vasectomy, NPH insulin use and fish allergies

site of action: combines with Heparin

dosage: usually given 1.3 mh per 100 units of heparin present

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14
Q

Phytonadione

A

indications: treatment of coagulation deficiencies due to lack of vitamin K
action: presence necessary for synthesis of clotting factors II, VII, IX, X

site of action: liver

dosage: 2.5 to 25 mg IM or SC

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15
Q

Platelet Inhibiting drugs

A 
Aspirin 
Persantine 
ReoPro 
Plavix 
Ticlid
Integrillin 
Aggrenox
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16
Q

Aspirin

A

indications: prophylactic treatment of platelet hyperaggregability in conditions such as CHD
action: platelet function inhibitor by blocking enzyme function

site of action: cyclooxygenase enzyme

dosage: 325-650 mg PO every day

17
Q

Persantine/Dipryridamole

A

indications: prophylactic treatment after prosthetic cardiac valve placement for reduction of embolization risk
action: reduces uptake of adenosine. synergistic effect with aspirin on platelet inhibition

site of action: platelet membrane, inhibits phosphodiesterase activity

dosage: 50 mg PO three times a day

18
Q

ReoPro

A

indication: adjunct to PTCA in patients at risk for abrupt closure
action: inhibition of platelet function

site of action: binds to glycoprotein receptor of platelet

19
Q

Plavix

A

Indications: indicated for the reduction of thrombotic events including recent MI, recent stroke, or established peripheral arterial disease and acute coronary syndrome

action: inhibition of platelet aggregation

site of action: glycoprotein GPIIb/IIIa complex

20
Q

Ticlid

A

indication: reduces risk of thrombotic events in patients who are aspirin intolerant
actions: inhibits platelet activity

site of action: platelets

21
Q

Integrillin

A

indications: used to treat its with severe chest pain or small heart attacks and for those undergoing certain heart procedures
action: inhibition of platelet aggregation

site of action: glycoprotein GPIIb/IIIa complex

22
Q

Aggrenox

Aspirin/Extended-Release Dipyridamole

A

indications: anti platelet combination used to prevent strokes in patients who have had transient ischemia or ischemic stroke due to blood clots
action: platelet function inhibitor by blocking enzyme function

site of action: cyclooxyrgenase enzyme and Thromboxane A2

23
Q

Finbrinolytics and Thrombolytics

A

Streptokinase
Urokinase
Alteplase, recombinant

24
Q

Streptokinase

A

indications: destruction of thrombosis in coronary arteries, pulmonary system and other areas
action: catalyzes conversion of plasminogen to plasmin which destroys fibrin

site of action: plasminogen

25
Q

Urokinase

A

indications: breaks down coronary artery thrombosis and pulmonary embolism
action: converts plasminogen to plasmin

site of action: plasminogen

26
Q

Activase (t-PA)

Alteplase, recombinant

A

indications: breaks down coronary artery clots in acute myocardial infarctions
action: local conversion of plasminogen to plasmin

site of action: plasminogen in clots

27
Q

Fibrinolytic Inhibitors

A

DDAVP/Desmopressin acetate
Trasylol/Aprotinin Injection
Amicar

28
Q

DDAVP

Desmopressin acetate

A

indications: to improve coagulation by increasing factor VIII
action: synthetic antidiuretic hormone that increases Factor VIII levels

site of action: factor VIII storage sites in plasma

29
Q

Trasylol

A

indications: prophylactic use to reduce perioperative blood loss and the need for transfusion in coronary artery bypass graft surgery
action: inhibits fibrinolysis and turnover of coagulation factors;decreases bleeding although exact mechanism is unclear

site of action: protease inhibitor, inhibits plasmin and Kallikrein. preserves adhesive glycoproteins in platelet membranes making them resistant to damage during CPB

dosage: do not administer with any other drugs in the same line. All intravenous doses should be through a central line

30
Q

Amicar

A

indications: to reduce bleeding caus by systemic hyperfibrinolysis
action: inhibits plasminogen activators to prevent conversion to plasmin and antiplasmin activity

site of action: plasminogen activator substances

Pharmacology (3 decks)

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