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CV Pharmacology- Parker > Cardiovascular stimulants > Flashcards

Cardiovascular stimulants Flashcards

1
Q

List the cardiovascular stimulants

A

Epinephrine (E), NE, Ephedrine (F), Phenylephrine, Isoproterenol, Dobutamine (DO), Dopamine (DA).. Go East by NorthEast to Find a Phenylly Isolated DO DAd

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2
Q

CV stimulants can be direct acting, indirect acting, or mixed. What does direct acting mean?

A

Means the drug actually stimulates post-synaptic receptors

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3
Q

What does indirect acting mean?

A

Means the drug increases the availability of E, NE

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4
Q

What does mixed acting mean?

A

Means the drug acts both ways

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5
Q

Which type of drug (direct, indirect, or mixed) is affected by Reserpine?

A

Indirect acting drugs are effected by Reserpine because Reserpine wipes out NE before it gets into its transport vesicle

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6
Q

What effects is IV epinephrine going to have?

A

Increase pulse pressure, increase inotropic and chronotropic effects

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7
Q

So, epinephrine increases HR and contractility and decreases TPR thus raising systolic and lowering diastolic. How?

A

Epi increases systolic pressure by stimulating B1 receptors in the heart. This leads to increased HR/contractility. Epi also stimulates beta 2 receptors in skeletal muscle which vasodilate. This leads to decreased diastolic

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8
Q

What would a small dose of Epi do?

A

decrease BP cuz beta 2 receptors have a higher affinity for epi than do alpha receptors

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9
Q

What happens to the relaxation rate of the heart when epi is given?

A

Relaxation rate increases (lucitropic) so that the heart can pump faster

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10
Q

CV concern when giving epi?

A

PVCs

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11
Q

Epinephrine has many effects on vasculature. What vessels does epinephrine work on?

A

small arterioles and precapillary sphincters

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12
Q

what does epi do to cutaneous BF?

A

decreases

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13
Q

what does epi do to skeletal muscle BF?

A

increases

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14
Q

what does epi do to renal BF

A

decreases because remember there are Beta 1 receptors in the JGA so you get renal vasoconstriction and decreased RBF

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15
Q

what does epi do to pulmonary pressures?

A

increases which can lead to pulmonary edema

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16
Q

what does epi do to coronary BF?

A

increases

17
Q

when you give epi subQ, what is the first thing that happens?

A

local vasoconstriction

18
Q

Clinical utility of epinepherine?

A

emergency relief of anaphylaxis, vasoconstrictor with local anesthetics, restores cardiac rhythm in pts with cardiac arrest

19
Q

epi toxicity?

A

CVA: cerebral hemorrhage, ventricular arrhythmias, angina

20
Q

what does norepinephrine do?

A

bigtime increase in BP. NE is alpha 1’s thang! it jumps on that alpha 1 and activates the shit out of it giving you profuse vasoconstriction

21
Q

NE is given IV, what should you be concerned about?

A

Necrosis at injection site

22
Q

Dopamine is a dose dependent drug. What happens if you give a low dose?

A

D1 receptor predominant, vasodilation; also improves GFR in pts with deminished renal perfusion

23
Q

Dopamine is a dose dependent drug. What happens if you give a moderate dose?

A

D1 & Beta 1 receptor agonism; increased CO via positive inotropic effect and vasodilation

24
Q

Dopamine is a dose dependent drug. What happens if you give a high dose?

A

alpha 1 agonism promotes vasoconstriction

25
Q

What does dobutamine do?

A

increases CO via increasing contractility

26
Q

What is dobutamine’s half life?

A

Bout 2 minutes

27
Q

When is dobutamine used?

A

For short term treatment of cardiac decompensation (heart surgery, CHF, MI)

28
Q

What does isoproterenol do?

A

increases HR and contractility and decreases diastolic BP

29
Q

How does isoproterenol do the things it does?

A

It only activates beta receptors. When it activates beta 1 receptors in the heart, this leads to increased HR and CO. When it activates beta 2 receptors in the skeletal muscle vasculature, it vasodilates

30
Q

What does phenylephrine do?

A

it is a direct acting alpha 1 agonist that stimulates alpha 1 to increase BP via vasoconstriction

31
Q

What does ephedrine do?

A

increases TPR, BP, CO, and HR

32
Q

How does ephedrine work?

A

Mixed acting; it activates alpha 1,2 and beta 1,2 receptors itself but it also stimulates the production of NE

33
Q

Why is ephedrine controlled?

A

Cuz if you have ephedrine and a trash can, you can make meth

34
Q

Which CV stimulant has positive effects on renal perfusion?

A

Dopamine

35
Q

Which CV stimulant is a racemic mixture?

A

Dobutamine

36
Q

Which CV stimulant(s) effects are measured by measuring urine output?

A

Dopamine and dobutamine

CV Pharmacology- Parker (14 decks)

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