Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Top Drawer > Antihypertensives/Beta Blockers > Flashcards

Antihypertensives/Beta Blockers Flashcards

(52 cards)

Start Studying
1
Q

In anesthesia, before treating hypertension, what should you do?

A

determine why the patient is hypertensive in the first place!!!! figure out what the cause is before giving an antihypertensive/BB

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

What could be some potential causes of hypertension in a patient receiving anesthesia?

A
  • pain (give opioids)
  • hypothermia (bair hugger)
  • anxiety (give anxiolytic)
  • increased ICP (give propofol)
  • bladder distension (cath)
  • poorly controlled HTN (CAREFULLY give antihypertensive/BB)
  • lack of anesthesia (turn your gas on!!)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F: hypertension under anesthesia should always be treated with an antihypertensive or beta blocker

A

FALSE
- many times you can treat the cause of HTN and BP will decrease
- use antihypertensives sparingly

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

What is the MOA of labetalol?

A
  • NONSELECTIVE beta antagonist
  • SELECTIVE alpha1 antagonist
  • blocking beta1: decrease HR and contractility
  • blocking beta2: vasodilation
  • blocking alpha1: arteriolar vasodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the ratio of alpha to beta blockade with labetalol?

A

1 (a) to 7 (b) blockade
1:7 ratio

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

What is labetalol used used for?

A
  • acute and chronic HTN in pregnant patients
  • treat increases in BP and HR from stimulation (like intubation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is labetalol contraindicated?

A
  • bronchospastic disease
  • impaired cardiac conduction
  • underlying resting bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do we achieve BP reduction with labetalol use?

A
  • decreased PVR, which can depress cardiac contractility
  • essentially unchanged CO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T/F: Labetalol can significantly affect CO

A

false
- per Barash, CO is essentially unchanged

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

T/F: labetalol has profound affects in CBF and ICP

A

false
- only causes minimal affects in CBF and ICP

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

Labetalol Dosing

A

5-20 mg boluses IV
- less is more!!! use with caution

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

Labetalol onset and duration

A

Onset: 1-2 min
Duration: up to 6 hours

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

Why is labetalol contraindicated in bronchospastic disease?

A

a potential side effect of labetalol is bronchoconstriction

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

What is the MOA of esmolol?

A

SELECTIVE beta1 antagonist
- directly only works on the heart

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

Does esmolol have rapid or slow onset?

A

esmolol has rapid onset

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

Is esmolol short acting or long acting?

A

short acting

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

When would esmolol be used?

A
  • perioperative tachycardia
  • pretreatment during intubation/extubation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What cardiac effects do we see with esmolol?

A
  • decrease in HR, contractility, and CP
  • some decrease in BP with no rebound effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is esmolol contraindicated?

A
  • bradycardia
  • heart block
  • cardiogenic shock
  • heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Esmolol Dosing

A
  • 10 mg boluses IV
  • 50 mcg/kg/min infusion after a 0.5 mg/kg bolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Esmolol onset and duration

Study These Flashcards
A

Onset: rapid
Duration: 10-15 min

22
Q

How is esmolol metabolized?

Study These Flashcards
A

plasma esterases

23
Q

What is the reasoning behind esmolol’s short duration?

Study These Flashcards
A

metabolism by plasma esterases

24
Q

An infusion of esmolol at __________ should be started after a _________ bolus is given

Study These Flashcards
A
  • 50 mcg/kg/min infusion
  • 0.5 mg/kg bolus
25
What is the MOA of propranolol?
NONSELECTIVE beta1 and beta2 antagonist
26
Due to propranaolol's beta2 antagonist effect, what should be our concern?
- risk of bronchoconstriction - careful with use in bronchospastic disease
27
when is propranolol contraindicated?
- bronchospastic disease - AV block - bradycardia
28
When would propranolol be used?
- HTN - angina - acute MI - pheochromocytoma - anxiety/panic attacks
29
How does propranolol achieve decreased BP?
decrease in contractility, HR, and CO, therefore causing decrease in myocardial oxygen demand
30
Propranolol Dosing
1 - 3 mg IV - no more than 1 mg/min - titrated to effect
31
Propranolol onset and duration
Onset: 2-3 min Duration: up to 4-6 hours
32
What is the MOA of metoprolol?
- SELECTIVE beta1 adrenergic receptor antagonist - prevents inotropic and chonotropic responses to beta stimulation
33
When would metoprolol be used?
- rapid HR and contractility control - treatment for MI
34
Metoprolol Dosing
1-5 mg IV; up to 15 mg - best to give 1 mg at a time
35
What is the half-life of metoprolol?
3-4 hours
36
What is the action of vasopressin in the body?
- antidiuretic hormone via increasing water reabsorption in the kidneys - released by the posterior pituitary
37
When is vasopressin used?
- cardiac arrest (but removed from ACLS algorithm) - sepsis - shock - hypotension secondary to ACE inhibitors refractory to catecholamines or sympathomimetics
38
What are the sites of action of vasopressin and what are their effects?
V1: CV effects V2: renal effects V3: pituitary effects
39
Vasopressin Dosing
1-2 unit bolus
40
How is vasopressin diluted for safe administration?
10/20 units/1mL in a 10/20 mL syringe to get 1 unit/mL concentration
41
Vasopressin is a potent _____________ in what two locations?
- potent vasoconstrictor - arterial - mesenteric
42
Knowing that vasopressin is a potent vasoconstrictor, what should we consider when giving this during/after a surgery?
- vasoconstriction can potentially cause necrosis in the surgical site
43
When would hydralazine be used?
- HTN - heart failure - eclampsia
44
What is the MOA of hydralazine?
- direct systemic arterial vasodilator - blocks Ca++ release from sarcoplasmic reticulum - causes relaxation of arterial smooth muscle
45
What are the cardiac effects seen with hydralazine administration?
- decreased BP - increased HR, SV, CO
46
When is hydralazine contraindicated?
- coronary artery disease (CAD) - increased ICP
47
What effect does hydralazine potentially have on ICP?
potentialy increased ICP
48
Hydralazine Dosing
2.5-5 mg IV - titrated q 20-30 min
49
Hydralazine onset and duration
Onset: 15-30 min Duration: 4-6 hours
50
How often is hydralazine titrated?
every 20-30 minutes
51
Nitroglycerine
52
Nipride

Top Drawer (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions