Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex Anesthesia > Review Exam ANS Pharmacology > Flashcards

Review Exam ANS Pharmacology Flashcards

1
Q

Rank Drugs from Highest to Lowest affinity for Alph-1 R:

Dopamine, Isoproterenol, Dobutamine, Norepinephrine, phenylephrine, Epinephrine, Ephedrine

A
  1. Norepinephrine
  2. Phenylephrine
  3. Epinephrine
  4. Dopamine
  5. Ephedrine
  6. Dobutamine
  7. Isoproterenol

N P E D E D I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hemodynamic effects of HIGH DOSE NE include?

A

Decreased Cardiac Output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of catecholamine is NE?

A

Natural occurring catecholamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What receptors does NE have an affinity for?

A

Dose-dependent A1, A2, B1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Receptor affinity for LOW dose NE?

A

B1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Low dose NE Effects?

A

B1- Increased Contractility, CO, BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Receptor affinity for HIGH dose NE?

A

A1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

High dose NE effects?

A 
Increase SVR
Decreased HR (BBR)

*masks B1 effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

NE is an ideal drug for?

A

LOW SVR states

-Sepsis or Post CPB HoTN d/t LOW after load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Avoid NE in which settings?

A

Cardiogenic Shock

-Increases MVO2 & SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What risk can peripheral administration of NE cause?

A

Extravasation of NE can cause tissue necrosis

should be administered via CL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you Tx NE extravasation at peripheral site?

A

PhenTolAmine – 2.5 - 10 mg in 10mL diluent
-vasodilates affected region

OR

Stellate Ganglion Block on affected side
-counteracts vasoconstriction by increasing BF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Key Drug interactions for NE

A 
MAO inhibitors (MAOi)
Tricyclic antidepressants (TCA)

MAOi – decreased NE clearance –> excessive SNS stimulation

TCA- reduced NE reuptake –> Excessive SNS stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Infusion rate: Low Dose Epi

A

0.01 - 0.03 mcg/kg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Infusion rate: Intermediate Dose Epi

A

0.03 - 0.15 mcg/kg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Infusion rate: High Dose Epi

A

> 0.15 mcg/kg/min

17
Q

Effects of Low Dose Epi

A

Dominating receptor: Non-selective Beta

  • B1 –> increase HR + contractility
  • B2–> vasodilation skeletal muscles

net effect:
increased CO, decreased SVR, slight decrease BP, wide PP

18
Q

Effects of Intermediate Dose Epi

A

Mixed beta & alpha effects

19
Q

Effects of High Dose Epi

A

Dominating receptor: Alpha

Increased SVR

20
Q

Common side effects of High Dose Epi

A

SVT

*limits usefulness of high dose epi

21
Q

Rank affinity of dopamine vs. Beta vs. Alpha at adrenergic receptors?

A

DA > Beta > Alpha

22
Q

Infusion rate: Low Dose Dopamine

A

Renal: 1 -2 mcg/kg/min

23
Q

Infusion rate: Intermediate Dose Dopamine

A

Cardiac: 2-10 mcg/kg/min

24
Q

Infusion rate: High Dose Dopamine

A

Vasopressor: 10-20 mcg/kg/min

25
Q

Effects of LOW Dose Dopamine

A

DA1 (post) Vasc, DA2 (pre) Renal

DA1- vasodilation in renal
DA2-inhibits NE release from presynaptic NT

Net effect: Increased RBF, UOP

26
Q

Effects of Intermediate Dose Dopamine

A

Beta receptor dominate

  • Increased: HR, contractility, CO
  • same: BP
27
Q

Which dopamine dose (low, intermediate, high) for CHF?

A

Intermediate

28
Q

Effects of High Dose Dopamine

A

Alpha receptor dominates
Alpha > beta & DA

Resembles High dose NE

29
Q

Isoproterenol and CPP

A

decreases CPP

Isoproterenol- decreases SVR
- SVR decrease can drop DBP–> impair CPP

30
Q

CPP calculation?

A

CPP = AoDB - LVEDP (APEX)

AoDB- Aortic Diastolic BP

CPP = DBP - LVEDP (Edwards)
Range: 60-80 mmHg

31
Q

Isoproterenol and Sepsis

A

AVOID in Sepsis

Isoproterenol causes:

  • severe dysrhythmias
  • tachycardia
  • Vasodilates nonessential vascular beds (muscle/skin)
32
Q

Clinical uses for Isoproterenol?

A
  • Chemical PM
  • Heart transplant
  • Bronchoconstriction
  • Cor Pulmonale
33
Q

2 organic key components in Catecholamines

A
  1. Catechol Nucleus (benzene ring w/ hydroxyl group 3,4

2. Amine side chain

34
Q

Organic size rank of Catecholamines (largest to smallest)

A

Dobutamine > Isoproterenol > Epi > NE > Dopa

35
Q

How many Benzene rings does Dobutamine have?

A

Dobutamine is the ONLY one that has TWO benzene rings

Apex Anesthesia (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions