Vasopressors/ Sympathomimetics Flashcards

1
Q

vasopressors are NOT a replacement for

A

Adequate volume
Blood
TOO MUCH ANESTHESIA

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2
Q

ephedrine class

A

Mixed - acting synthetic non-catecholamine sympathomimetic

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3
Q

ephedrine indirect effects

A

Ephedrine at Alpha-1 and Beta-1 receptors displaces norepinephrine presynaptic vesicles

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4
Q

what occurs when norepinephrine is released

A

activates the postsynaptic receptors to cause arterial and venous vasoconstriction and increased myocardial contraction

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5
Q

ephedrine direct effect

A

directly stimulates β- 2

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6
Q

ephedrine effects

A

Increased heart rate, cardiac output , and some SVR increase

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7
Q

what is ephedrine good for

A

bradycardia and hypotension

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8
Q

α-1 receptors

A

walls of blood vessels
urinary retention
mydriasis (pupil dilation)
ejaculation

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9
Q

α-2 receptors

A

pre-synaptic neuron

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10
Q

β-1 effects

A

heart and kidneys

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11
Q

β-2 receptors

A

smooth muscle relaxation

lungs, vessels, GI tract, bladder, uterus, liver

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12
Q

β-3 receptors

A

adipose tissue, bladder

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13
Q

ephedrine uses

A

increases BP/HR, CO and contractility, PONV, bronchodilator effect

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14
Q

ephedrine in OB

A

can cause fetal tachycardia and acidosis which was associated with lower umbilical artery pH at delivery

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15
Q

ephedrine contraindicaitons (med and condition)

A

MAO inhibitors

pheochromocytoma

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16
Q

ephedrine should be used in caution in patients with

A

coronary artery disease

17
Q

which drug can cause tachyphylaxis

A

ephedrine

18
Q

ephedrine dose

A

5-10 mg to increase BP/HR

19
Q

ephedrine dose for antiemetic effect

A

25 mg IM before the end of surgery

20
Q

1 cc ephedrine + 9 cc NS =

A

5 mg/cc

21
Q

phenylephrine mechanism of action

A

Directly stimulates alpha-1 receptors, minimal effect on alpha-2 or Beta receptors

22
Q

phenylephrine uses

A

hypotension, decreased CO in patients with LV dysfunction

23
Q

phenylephrine causes

A

constriction of cutaneous, mesenteric, splenic and renal vessels

24
Q

what is the vasopressor of choice in OB

A

phenylephrine

25
Q

how does phenylephrine increase blood pressure and what does it cause?

A

causes vasoconstriction to increase BP, reflex decrease in HR, increase in coronary blood flow

26
Q

phenylephrine dose

A

50-100 mcg titration to effect

27
Q

.1 cc phenylephrine + 9.9 cc NS =

A

100 mcg/cc

28
Q

which drug will not cause a decrease in uterine blood flow

A

ephedrine wont decrease uterine blood flow

29
Q

which vasopressor possesses some antiemetic property

A

ephedrine

30
Q

which vasopressor is good for hypotension from regional anesthestsia

A

ephedrine

31
Q

which vasopressor can cause fetal tachycardia and acidosis

A

ephedrine (this is why phenylephrine is preferred)

32
Q

which vasopressor is now preferred in OB

A

phenylephrine

33
Q

which vasopressor has faster onset and shorter duration of action

A

phenylephrine

34
Q

which vasopressor maintains fetal pH

A

phenylephrine