Class 6 Deck 2 Flashcards
Inamrinone is what type of drug? and what does it do?
- P.D.E. Inhibitors
- increase SV and CO and Decreases SVR and PVR after CABG
How does inamrinone compare to dobutamine?
-More effective with less complications when separating from CPB
How does inamrinone compare to Epi?
-With poor LV function, it is as effective Epi, but they to work better together
What are the adverse reaction of inamrinone?
- Thromocytopenia
- ↑ LFTs
- Arrhythmias
- Intrapulmmonary shunting
- Decreased PaO2
What is milrinone? and how does it compare to inamrinone?
- P.D.E. Inhibitors (inotropic and vasodilator)
- 15-20x more potent than inamrinone w/o the thrombocytopenia
What is the antidote for Beta-blocker OD?
Glucagon
Glucagon use is limited by what?
- N/V
- ↑ blood sugar
- ↑ coronary and pulmonary vascular resistance
Where is BNP synthesized and where is it stored? When is it released?
- Synthesized in atrium = released when over distended
- Stored in brain = excreted with venous congestion
What 7 things does BNP do?
- Sodium excretion
- Suppress RAA Axis
- Lower sympathetic tone
- Lower vagal threshold
- Diuresis
- Vasodilate
- Inhibit vasopressin
How does neseritide work and when is it used?
- Stimulates cGMP = vascular smooth muscle relax
- Used in decompensated CHF
What is digoxin and what does it do to the heart?
- Cardiac glycoside
- Positive inotrope (Ca binds to Troponin)
- Negative dromotrope
- Negative chromotrope
What is digoxins mechanism of action?
- Inhibits Na-K ATPase which increases intracellular Na and Ca
- Increase LV shortening and EF
What are the uses for digoxin?
- Mild to moderate heart failure (w/diuretic and ACEI)
- Control chronic AFib
What are the 3 indirect actions digoxin has on the CV system?
- Vagomimetic effect (Slow HR w/ ↓ conduction of AV node)
- Baroreceptor sensitization
- Toxic effect on CNS (↑ sympathetic outflow)
What blood level is digoxin considered toxic?
> 3
- If treating CHF <3
- If treating AFib treat to results
