Brainscape's Knowledge GenomeTM

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


See full index

A1 > Vasopressors > Flashcards

Vasopressors Flashcards

1
Q

End organ damage occurs when map is below 50 for ___

A

1 minute

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

End organ damage occurs when MAP is below 65 for ____

A

13-28 minutes

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

What is the difference between autonomic and somatic ANS?

A

Somatic does not involve ganglia, ACH goes directly to the nicotinic receptor

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

Sympathetic innervation of the adrenal medulla

A

ACH binds to the nicotinic receptor on the adrenal medulla (instead of the post ganglionic neuron), then epinepherine is released into the blood to bind on to adrenergic receptors

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

Sympathetic innervation

A

ACH binds to the nicotinic receptor on the post ganglionic neuron which releases norepinepherine to bind to adrenergic receptors

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

Parasympathetic innervation

A

ACH binds to the nicotinic receptor on the post ganglionic neuron which releases ACH to bind to muscuranic receptors

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

Sympathetic nervous system origin

A

T1-L2
Preganglia near spinal cord
Postganglia secrete norepinepherine

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

What converts dopamine to norepinephrine?

A

Beta Hydroxylase

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

What releases NE from the synaptic vessel?

A

Action potential

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

Signal termination of NE

A

Reuptake
Metabolism by MAO and COMT
Dilution by diffusion

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

Location of adrenergic receptors

A

A1- periphery
A2- Presynaptic in the PNS, postsynaptic in the CNS
B1- heart
B2- smooth muscle

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

A1 receptor works by __

A

Increase intracellular Ca++
Smooth muscle contraction
Peripheral vasoconstriction
Bronchoconstriction
- insulin
+glycogenolysis
+gluconeogenesis
Mydriasis
GI relaxation

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

A2 works in the presynaptic PNS by ____

A

Decreases Ca++ into cell
Limits release of NE

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

A2 in the postsynaptic CNS

A

Sedation
Decreases BP
Decreases sympathetic outflow
Platelet aggregation

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

B-1 works to __

A

Increases chronotropy
Increases dromotropy
Increases inotropy

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

Parasympathetic nervous system origins

A

Craniosacral origin Cranial nerves (3,7,9,10)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ACH

A

Activates BOTH arms of ANS
Ca++ mediated action potential
Formed by choline and acetyltransferase
Deactivated by acetylcholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

SNS effect on GI system and bladder

A

Decreases motility
Constricts sphincter
Relaxes smooth muscle in bladder, but contracts sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

PNS effect on GI and bladder

A

Increases motility, relaxes sphincter
Contracts bladder smooth muscle, relaxes sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Down regulation

A

Long process of destruction of receptors
Extended exposure to agonists will reduce the number of receptors
Tachyphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Up regulation

A

Chronic depletion of catecholamines or beta blockers will increase the amount of receptors but not their sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tachyphylaxis

A

Decreased effectiveness due to chronic exposure
Happens with down regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Receptor uncoupling

A

Rapid inability of the receptor to bind to the G protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sequestration

A

Slowly move receptors inside the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pheocromocytoma

A

Uncontrolled release of catecholamines due to adrenal gland dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Uses of sympathomimetics

A

Positive inotropy
Elevate blood pressure
Treat bronchospasms
Manage anaphylaxis
Arrhythmia management
Addition to LA to slow systemic absorbtion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Types of sympathomimetics

A

Naturally occurring catecholamines (direct)
Synthetic catecholamines
Synthetic non catecholamines (direct and indirect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are sympathomimetics derived from?

A

B Phenylethlamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Catecholamines vs synthetic non catecholamines chemical structure

A

Sympathomimetics (synthetic non catecholamines) do not have the hydroxyl group in the 3 and 4 position of benzene ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Indirect acting

A

Synthetic non catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Direct acting

A

synthetic non catecholamines
catecholamines

32
Q

How are catecholamines metabolized or rided?

A

COMT-
MAO- present in liver, kidneys, gi tract
Reuptake

33
Q

How are synthetic non catecholamines metabolized?

A

MAO only
NO COMT

34
Q

How are phenylepherine and catecholamines metabolized?

A

Sulfoconjugation reactions- SULT1A3 and SULT1A4
Via sulfate?

35
Q

Vasoconstrictor non cardiac effects

A

Bronchodilation
Glycogenolysis
Increased insulin
Increased renin
Increased CNS stimulation
Increased pituitary hormone

36
Q

Vasoconstrictor contraindications

A

LV failure can be worsened
RV failure can be exacerbated
Poor renal blood flow can be decreased more
Hypovolemia can be masked

37
Q

What are the natural catecholamines

A

Epi
Dopamine
Norepi

38
Q

What receptor does Epi work on?

A

A1, B1, B2
“all of them”
Most potent A1 activator
2-10x more potent than norepi

39
Q

NE

A

Catecholamine
Increases systolic, diastolic, and MAP
Maintains BP by adjusting SVR

40
Q

Epi at moderate doses

A

4mcg/min
B1 effects

41
Q

Epi at high doses

A

10mcg/min
A1 masks all other receptors
Reflex bradycardia can occur
No significant effect on cerebral arteries

42
Q

Racemic epi

A

Levo and dextrorotatory isomers
Used for croup and airway edema
Treatment lasts for 30-60 minutes
2 hours later can experience rebound edema

43
Q

Epi side effects

A

Little CNS effect
Hyperglycemia
mydriasis
Platelet aggregation
Sweating
Headache nausea
Skin tissue damage

44
Q

NE side effects

A

Renal injury
Mesenteric infart
Gangrene of digits

45
Q

NE receptors it affects

A

A1
B1 small and overshadowed by A1

46
Q

NE effect on CO

A

Increase but may decrease at higher doses due to reflex bradycardia
Refractory hypotension

47
Q

Dopamine receptor sites

A

Endogenous catecholamine
D at low doses
Beta at moderate doses 5mcg/kg/min
Alpha at high doses 10-20mcg/kg/min

48
Q

Endogenous dopamine in the CNS

A

Low- schizophrenia
High- manic

49
Q

Ephederine

A

Synthetic non catecholamine
Indirect and direct but mostly indirect
A1 and B receptors to increase inotropy
Venoconstriction is greater than arterioconstriction
Increases Sys and diastolic BP
Can lead to tachyphylaxis
Increase uterine blood flow
Smooth muscle relaxant

50
Q

How does ephederine compare to epinepherine

A

Ephderine is less intense but lasts longer

51
Q

Ephedrine SE

A

Insomnia/ headache/ psychosis
Palpatations/ HTN/ tremor
Cocaine and amphetamines will exaggerate HTN due to the reuptake blockade

52
Q

Phenyl

A

Synthetic non catecholamine
A1 agonist
Inreases preload more than afterload
Can improve coronary perfusion pressure without increasing chronotropy
Ok for pregnancies

53
Q

Other used for phenyl

A

Priapism
Mydriatic
Decongestant

54
Q

Phenyl SE

A

Reflex Bradycardia
Decreases renal and schplanic blood flow
Increases PA resistance and PAP

55
Q

Phenyl dose and onset

A

50-200mcg
Onset 1-2 minutes
Duration- 5-10 minutes

56
Q

Phenyl vs NE

A

Phenyl less effective but longer lasting

57
Q

Onset of Epi, NE, Ephed, and Phenyl

A

Immediate
Immediate
1-3 minutes
1-3 minutes

58
Q

Duration of Epi, NE, Ephed, and Phenyl

A

5-15
5-15
15-20
15-20

59
Q

Synthetic catecholamines

A

Isoproterenol
Dobutamine

60
Q

Synthetic non catecholamines

A

Ephedrine
Phenylepherine

61
Q

Vasoconstrictor SE

A

Dysrhythmias
Reflex bradycardia
Antihypertensives may decrease pressor response to indirect acting drugs
OR they may increase to direct acting drugs

62
Q

Vasoconstrictors and TCA / MAOI

A

TCA and MAOI can stop the breakdown and lead to a higher pressor effect
Exaggerated response with indirect acting
Worse in first 1-2 weeks of therapy (then a down regulation occurs)
Ok to continue perioperatively
Use decreased dose of direct activing drugs

63
Q

Weight loss products

A

May contain ephedra
Stop atleast 24h prior to surgery
Can lead to tachyphylaxis and perioperative cardiovascular collapse

64
Q

Phentolamine

A

A1 and A2 antagonist
Treatment for necrosis from epi, NE, and dopamine
5-10mg injected at site
Peripheral vasodilator

65
Q

DDAVP vs vaso

A

DDAVP no pressor affect 1200:0
Vaso 100:100 ADH:pressor effect

66
Q

Posterior pituitary hormones

A

Vasopressin 100:100
Oxytocin (Pictocin) 1:1
adh/pressor effect

67
Q

When to use vaso

A

Advanced vasodilitory shock
For pt who are resistance
Effects of vaso are preserved in hypoxia and severe acidosis

68
Q

Vaso receptors

A

V1intense arterial constriction
V2 renal collecting ducts increase reabsorption of water

69
Q

Vasopressin advantages of epi

A

Vaso does not increase myocardial O2 consumption
Vaso has no effect on heart
Epi may not work well in acidic and hypoxic patients

70
Q

How does oxytocin work

A

Increases Ca++ in myometrium to increase uterine contraction strength
Oxytocin receptors increase in pregnancy
Used for uterine contractions and to reduce post partum hemorrhaging

71
Q

Vasopressors and cocaine

A

Cocaine stops the reuptake
Enhances pressor effect

72
Q

Ephederine dose

A

2.5-25mg IV or
25-50mg PO

73
Q

Epi at low doses

A

1-2mcg/min
B-2
Decreases SVR but holds BP

74
Q

Epi works by __ and for ___

A

Asthma, anaphylaxis, cardiac arrest, bleeding, LA to stop absorbtion
Increases lipolysis
Increases glycogenolysis
Decreases insulin
Stimulated renin and decreases renal blood flow

75
Q

B2 works by __

A

Smooth muscle relaxation
Peripheral vasodilation
Decreases BP
+ insulin
+ glycogenolysis
+ gluconeogenesis
Decreases GI mobility

A1 (124 decks)

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