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AS - N928 Basic Principles of Anesthesia > Blood Pressure Management > Flashcards

Blood Pressure Management Flashcards

(56 cards)

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1
Q

What events cause hypotension and/or bradycardia?

A
  • Induction
  • Deep anesthesia
  • Insufflation
  • Vagal response
  • Blood loss
  • Prolonged duration (insensible loss)
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2
Q

Hypotension and/or bradycardia treatments

A

IDENTIFY CAUSE

HR related → anticholinergic
Preload → fluids and/or products
Vasodilation → decrease anesthetic or vasoconstrictor
Cardiac depressant → increase contractility

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3
Q

Phenylephrine MOA

A

Direct α1 agonist

↑SVR & reflex bradycardia

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4
Q

Phenylephrine Dose

A

Bolus 40-100 mcg

Infusion 20-300 mcg/min OR 0.15-0.75 mcg/kg/min

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5
Q

Phenylephrine Onset

A

< 1 minute

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6
Q

Phenylephrine DOA

A

15-20 minutes

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7
Q

Ephedrine MOA

A

Mixed α/β direct & indirect agonist

1° ↑contractility (BP & HR)

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8
Q

Ephedrine Dose

A

Bolus 5-10 mg

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9
Q

Ephedrine Onset

A

< 1 minute

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10
Q

Ephedrine DOA

A

15-60 minutes

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11
Q

Vasopressin MOA

A

α1 potent vasoconstriction

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12
Q

Vasopressin Dose

A

Bolus 1 unit

Infusion 0.04-0.1u/min

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13
Q

Vasopressin Onset

A

1-5 minutes

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14
Q

Vasopressin DOA

A

10-30 minutes

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15
Q

Norepinephrine MOA

A

Mixed α/β direct agonist (α > β)

↑SVR & tachyarrhythmias

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16
Q

Norepinephrine Dose

A

Infusion 1-30 mcg/min OR 0.01-0.2 mcg/kg/min

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17
Q

Norepinephrine Onset

A

< 1 minutes

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18
Q

Norepinephrine DOA

A

10-60 minutes

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19
Q

Epinephrine MOA

A

Mixed α/β direct agonist
Low dose β
High dose α

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20
Q

Epinephrine Dose

A

Bolus 10-100 mcg

Infusion 1-20 mcg/min OR 0.01-0.3 mcg/kg/min

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21
Q

Epinephrine Onset

A

< 1 minute

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22
Q

Epinephrine DOA

A

5-10 minutes

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23
Q

Glycopyrrolate MOA

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A

Blocks muscarinic receptor to oppose PSNS

  • No CNS effects (does not cross blood-brain barrier)
  • Less ↑HR as compared to Atropine
24
Q

Glycopyrrolate Dose

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A

Bolus 0.1-0.4 mg

25
Glycopyrrolate Onset
2 minutes
26
Glycopyrrolate DOA
2-4 hours
27
Atropine MOA
Blocks muscarinic receptors to oppose PSNS | - Crosses the blood-brain barrier & placenta
28
Atropine Dose
Bolus 0.1-0.5 mg | ACLS 1 mg
29
Atropine Onset
1-2 minutes
30
Atropine DOA
1-2 hours
31
What events cause hypertension and/or tachycardia?
- Induction/intubation - Light anesthesia - Insufflation - Surgical stimulation - Blood loss
32
Hypertension and/or tachycardia treatment
β blockers Ca2+ channel blockers α2 agonist
33
Esmolol MOA
Cardioselective β blocker β1 >> β2 HR >> BP Plasma esterase metabolism Does NOT cross blood-brain barrier
34
Esmolol Dose
Bolus 10 mg incremental doses | Infusion 100-300 mcg/kg/min
35
Esmolol Onset
60 seconds
36
Esmolol DOA
10-15 minutes
37
Metoprolol MOA
Cardioselective β blocker β1 >> β2 | HR > BP
38
Metoprolol Dose
1 mg incremental doses
39
Metoprolol Onset
< 5 minutes
40
Metoprolol DOA
5-8 hours
41
Labetalol MOA
Non-selective β blocker | BP >> HR
42
Labetalol Dose
5 mg incremental doses
43
Labetalol Onset
< 5 minutes
44
Labetalol DOA
2-6 hours
45
Nicardipine MOA
Ca2+ channel blocker 1° blocks arterial L-type channels - Reflex tachycardia - No effect on ICP (ideal for neuro patients)
46
Nicardipine Dose
Bolus 100-200 mcg | Infusion 5-15 mg/hr or 5 mcg/kg/min
47
Nicardipine Onset
10-20 minutes
48
Nicardipine DOA
8 hours
49
Clevidipine MOA
Ca2+ channel blocker 1° blocks arterial L-type channels - Reflex tachycardia - Rebound HTN when discontinue
50
Clevidipine Dose
Bolus 1 mg Infusion 1-2 mg/hr double every 90 seconds Max 21 mg/hr (up to 32 mg/hr short duration)
51
Clevidipine Onset
< 30 seconds
52
Clevidipine DOA
< 1 minutes
53
Hydralazine MOA
Direct acting NO arterial vasodilator - Reflex tachycardia - ↓DBP > SBP - Tachyphylaxis/tolerance
54
Hydralazine Dose
2.5-10 mg
55
Hydralazine Onset
10-20 minutes
56
Hydralazine DOA
6 hours

AS - N928 Basic Principles of Anesthesia (18 decks)

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