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Anesthesiology > Cardiovascular Drugs > Flashcards

Cardiovascular Drugs Flashcards

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1
Q

What are the primary effects of inhalant anesthetics on the CV system?

A

Vasodilation and inotropy at higher doses

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2
Q

What are the primary effects of propofol/alfaxalone/thiopenal on the CV system?

A

Negative inotropy and vasodilation especially at higher doses

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3
Q

What are the primary effects of opioids on the CV system?

A

Bradycardia; can be profound

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4
Q

What are the synthetic agonist of adrenergic receptors?

A

Isoproteronol, ephedrine, dobutamine, and phenylephrine

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5
Q

What are the endogenous agonist of adrenergic receptors?

A

Epinephrine, norepinephrine, and dopamine

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6
Q

What are the post-synaptic effects of alpha-1/2 receptors?

A 
Vasoconstriction
Minimal Inotropy (alpha-1)
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7
Q

What are the effects of beta-1 receptors?

A

Inotropy, chronotropy, lusitropy, dromotropy

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8
Q

What is lusitropy and dromotropy?

A

Lusitropy- relaxation

Dromotropy- conduction velocity of the AV node

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9
Q

What are the effects of beta-2 receptors?

A

Some inotropy, vasodilation

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10
Q

What is the endogenous agonist of cholinergic receptors?

A

Acetylcholine

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11
Q

What are the effects of muscarinic receptors?

A

M1- increased gut motility
M2- increased cardiac parasympathetic tone
M3- salivation/vasodilation

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12
Q

What are synthetic cholinergic agonists?

A

Bethanechol and pilocarpine

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13
Q

What is the first drug that is usually used for surgical bradycardia?

A

Atropine

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14
Q

What are some other things you can do to correct bradycardia before giving atropine?

A

Stop or reduce any bradycardia inducing drugs.

Inhalants, opioids, etc

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15
Q

What are most bradycardias due to?

A

Excessive vagal tone

Brachiocephalics, visceral manipulation, ocular pressure, drugs

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16
Q

What is sometimes induced when atropine is given and will it resolve?

A

2nd degree AV block, typically will resolve fairly quickly

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17
Q

What can be given if a bradycardia isn’t due to vagal tone?

A

Give a beta-agonist

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18
Q

What is isoproterenol good for?

A

Increasing HR while decreasing BP with an non-vagal bradycardia

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19
Q

What are causes of low BP?

A

Low HR/SV/CO
Low blood volume
Vasodilation with no reflex tachycardia

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20
Q

What are some ways to increase SVR?

A

Alpha agonists

Phenylephrine, norepi, or ephedrine

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21
Q

What are some ways to increase SV and CO?

A

Beta agonists

Dopamine, dobutamine, ephedrine

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22
Q

What are effects of alpha agonists?

A

Alpha-1/2: vasoconstriction, decrease CO/SV at high doses

Alpha-1: mild inotropy

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23
Q

What is phenylephrine used for in horses?

A

As a nasal spray to reduce nasal edema

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24
Q

What are some effects of ephedrine?

Study These Flashcards
A

Bronchodilation, promotion of release of NE from terminals

25
Should ephedrine be used in "sick" animals?
No, more appropriate of elevating BP in healthy animals
26
What is an indication for using dopamine?
Increase BP and HR
27
Does dopamine case vasoconstriction or dilation?
Vasodilation- esp in kidneys, mesentary, and coronary vessels
28
Is dobutamine or dopamine more appropriate for horses, dogs, and cats?
Horses- dobutamine
29
What are the effects of dobutamine?
Intropy>chronotropy Low doses produce desired effect in horses
30
Are the BP effects of dopamine dose dependent in small animals?
Yes
31
Are the BP effects of dopamine dose dependent in horses?
No, no change in BP until very high doses
32
What are the effects of dobutamine in small animals?
Dose dependent increase in CO but no increase in BP except at high doses
33
What are the effects of phenylephrine in small animals?
Dose dependent increases in BP, no change in CO, increased SVR in high doses
34
What are the effects of dobutamine in horses?
Rapid increase of BP at low doses with increased CO
35
What is a major issue with using norepinephrine?
Profound vasoconstriction- must maintain organ perfusion
36
When is norepinephrine usually used?
Serious hypotension esp with sepsis and shock
37
What is the pathophysiology of hypotension in septic patients?
Circulating vasodilatory mediators
38
What is norepiephrine sometimes combined with?
Dobutamine
39
When should epinephrine be used over norepinephrine?
Cardiac arrest, acute anaphylaxis, tachycardia, or bronchoconstricion
40
What receptors are more affected by epinephrine at low doses?
Beta adrenergic
41
What receptors are more affected by epinephrine at high doses?
Alpha adrenergic
42
What is vasopressin?
Antiduretic hormone (ADH)
43
When is vasopressin used?
In catecholamine resistant hypotension with shock/sepsis
44
What is a major concern with vasopressin?
Potent vasoconstriction- must maintain organ perfusion
45
What is a side effect of atropine/glycopyrrolate that contraindicates its use in cardiac patients?
Increased myocardial O2 consumption
46
What can beta agonists lead to?
Tachycardias with ventricular arrhythmias
47
What can alpha agonists lead to?
Hypertension- can be profound
48
What can vasoconstrictors lead to?
Tissue necrosis esp if injected outside of the vein
49
When are ventricular arrhythmias most common?
During the peri-anesthetic period and are usually not due to cardiac pathology
50
When should ventricular arrhythmias be treated
If they result in poor CO/BP- typically will be sustained and rapid
51
What drug is used to treat ventricular arrhythmias?
Lidocaine IV
52
What is the MOA of lidocaine?
Na channel blocker- stabilization of neuronal membranes NOT a negative inotrope
53
What are some good side effects of lidocaine?
- Reduction of MAC and anesthetic requriements - Improves bowel motility - Useful for pain neuropathies - Some free radical scavenging
54
T/F: Lidocaine is neurotoxic especially at excessive doses
True It can also cause cardiovascular collapse at 3x toxic dose
55
What condition may cause primary hypertension?
Renal disease or catecholamine producing tumors Typically managed with Ca channel blockers or ACE inhibitors
56
What drugs are used to manage the cardiac effects of hyperthyroidism?
Beta blockers
57
What are drugs used to treat hypertension?
Arterial dilators- hydralazine Venous (capacitence) dilators- nitroprusside Mixed dilators- alpha antagonists, prazosin, ACE inhibitors
58
When is nitropursside used?
Acute hypertensive emergencies (short acting infusion)

Anesthesiology (27 decks)

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