table 18-1. plus a few random things from reading Flashcards
describe propranolol class
PURE antagonist (no sympathomimetic activity) nonselective beta blockers
propanolol IV dose
1-10mg
what is the standard drug all beta antagonist are compared
propanolol
cardiac effects of propranolol
decrease HR
decrease contractility
decrease CO
when are propranolol effects most noted
during exercise or increase sympathetic nervous system activity
what does propranolol do to fentanyl
first pass up take of fentanyl is decreased. 2-4x as much fentanyl enters the systemic circulation.
what does dibucaine reflect
the quality of the cholinesterase enzyme
if dibucaine is 70 or greater
then your cholinesterase is normal
if dibucaine is less than 20
then you have homozygous atypical cholinesterase
if dibucaine is 40-60
then you have atypical heterozygous variant.
verapamil what is it
papaverine derivative
supplied as a racemic mixture
verapamil side effects
depresses AV node
vasodilation coronary and systemic artieries
who should NOT get verapamil
HF bradycardia sinus node dysfunction av nodal block WPW- precipitate dysrhythmias not for acute MI
clinical uses of verapamil
SVT
ANGINA pectoris
symptomatic hypertrophic cardiomyopathy with out without left ventricular outflow
which drugs increase the pharmacological active unbound portion of the drug verapamil
lidocaine
diazepam
propranolol
diltiazem what does it block
blocks calcium channels of the av node
what do we use diltiazem for
svt
htn
what are diltiazem metabolites half life.
20 hours
patients with preexisting cardiac conduction abnormalities receiving verapamil or diltiazem plus beta blocker or digoxin will experience
greater degrees of AV heart blocks
how do we reverse toxicity of ccb
calcium or dopamine
dantrolene plus ccb
hyperkalemia and cardiovascular collapse
verapamil plus dantrolene equal
high potassium
calcium channel blockers and dig
increase plasma concenration
verapamil and dig
increase dig
what do beta agonist do to the slow calcium channels
beta agonist increase the number of functioning slow calcium channels in myocardial cell membranes through camp and readily counter the effects of calcium channel blockers
patients treated with beta blocker and nifedipine have what fentanyl effects
tolerate high dose fentanyl
amiodarone increases the plasma concentrations of …
quindine
procainamide
phenytoin
amiodarone depress what
vitamin K clotting factors
propafenone increases plasma concentration of what drug
warfarin
EPI receptors mechanism of action co hr dysrhythmas renal blood flow airway resistance cns stimulant mean arterial pressure peripheral vascular resistance
a b1 b2 direct moderate increase cardiac output moderate increase HR-reflex down marked increase dysrhythmias marked decrease renal blood low moderate decrease airway resistance cns stimulant mean arterial pressure minimal increase peripheral vascular resistance +-
NE receptors mechanism of action co hr dysrhythmias renal blood flow airway resistance cns stimulant mean arterial pressure peripheral vascular resistance
a b1 b2 direct minimal decrease hr minimal decrease co minimal increase dysrhythmias no change airway resistance no cns stimulant marked increase MAP marked increase peripheral vascular resistance decrease renal blood flow
dopamine
alpha beta beta direct marked increase cardiac output minimal increase hr minimal increase dysrhythmias marked increase renal blood flow minimal increase peripheral vascular resistance minimal increase mean arterial pressure
isoproterenol
beta beta direct marked increase cardiac output marked increase heart rate marked increase dysrhythmias moderate decrease peripheral vascular resistance minimal increase renal blood flow \+-map marked decrease airway resistance
dobutamine
beta1>beta2 direct marked increase cardiac output minimal increase heart rate \+-dysrhythmias nc to peripheral vascular resistance moderate increase renal blood flow minimal increase map
ephedrine CO HR dysrhythmias PVR rbf map airway cns
direct alpha indirect beta moderate increase co moderate increase hr moderate increase dysrhythmias minimal increase peripheral vascular resistance moderate decrease renal blood flow moderate increase map moderate decrease airway resistance cns stimulant
phenylephrine co hr dysrhythmias pvr rbf map airway
direct but indirect on beta minimal decrease co minimal decrease hr nc dysrhythmias marked increase in peripheral vascular disease marked decrease in renal blood flow marked increase in mean arterial pressure nc in airway resistance
