CV Drugs

Question 1

What are the classes of drugs that have effects on the heart?

Answer 1

Anticholinergics
Antiarrhythmics
Vasopressors/Iontropes

Question 2

What are two types of Vasopressors/Iontropes?

Answer 2

Adrenergic agonists

Vasopressin

Question 3

What is the ultimate goal of CV drugs?

Answer 3

Oxygen delivery to the tissues

Question 4

DO2

Answer 4

Oxygen Delivery to Tissues

Question 5

What is DO2 dependent on?

Answer 5

Cardiac Output

Blood O2 content (CaO2)

Question 6

CaO2

Answer 6

Blood O2 content

Question 7

What is the equation for DO2?

Answer 7

CO x CaO2

Question 8

What is the equation for CO?

Answer 8

Heart Rate X Stroke Volume

Question 9

What are the targets for CV drugs?

Answer 9

Heart Rate
Contractility
Afterload/Preload

Question 10

What drugs affect Heart rate?

Answer 10

Anticholinergics

Antiarrhythmics

Question 11

What are drugs that effect Contractility?

Answer 11

Inotropes

Question 12

What are drugs that effect Afterload/Preload?

Answer 12

Pressors

Question 13

What is the definition of Anticholinergics?

Answer 13

Competitive antagonists at the muscarinic Ach receptors

Question 14

What drugs antagonize Nicotinic Ach receptors?

Answer 14

Neuromuscular Blockers

Question 15

What kind of drugs decrease parasympathetic tone?

Answer 15

parasympatholytics

Question 16

What is the effect of Anticholinergics?

Answer 16

Decreases Parasympathetic tone

Increased firing of the SA node (chronotropy) and conduction speed through the AV node (dromotopy)

Question 17

Where are M1 receptors located?

Answer 17

CNS

Stomach

Question 18

Where are M2 receptors located?

Answer 18

Heart
CNS
airway smooth muscle

Question 19

What do M2 receptors cause?

Answer 19

bradycardia

Question 20

Where are M3 receptors located?

Answer 20

CNS
salivary glands
airway smooth muscle

Question 21

Where are M4 receptors located?

Answer 21

CNS

Heart

Question 22

Where are M5 receptors located?

Answer 22

CNS

Question 23

What do M3 receptors cause?

Answer 23

Salivation
bronchodilation
vasodilation

Question 24

When are anticholinergics indicated?

Answer 24

Bradycardia secondary to increased vagal tone

Question 25

What increases vagal tone?

Answer 25

``` Intubation vomiting manipulation of ophthalmic GI Hepatobiliary structures Opioids Brachycephalic conformation ```

Question 26

What are the side effects of anticholinergics?

Answer 26

``` Increased viscosity of saliva Ileus and colic decreased LES pressure sedation bronchodilation mydriasis ```

Question 27

When is atropine contraindicated?

Answer 27

glaucoma

Question 28

What species are the used of anticholinergics cause for concern?

Answer 28

Horses | Ruminants

Question 29

What are the CNS side effects of anticholinergics?

Answer 29

Sedation

Question 30

What are the respiratory side effects of anticholinergics?

Answer 30

bronchodilation

Question 31

What are the Ophthalmic side effects of anticholinergics?

Answer 31

mydriasis

Question 32

Paradoxical Bradycardia

Answer 32

due to blockade of presynaptic inhibitory M1 receptors on vagus inhibition of inhibitory receptors leads to increased Ach release

Question 33

What is a Class 1B Anti arrhythmic?

Answer 33

Lidocaine

Question 34

What are Class II Anti-arrhythmics?

Answer 34

Beta Blockers

Question 35

When are beta blockers used?

Answer 35

severe sinus or supraventricular tachycardia

Question 36

When do you use Beta Blockers in anesthesia?

Answer 36

tachycardia associated with pheochromocytoma

Question 37

What is the most common beta blocker used?

Answer 37

Esmolol

Question 38

What happens when alpha 1 and alpha 2 receptors are activated?

Answer 38

vasoconstriction

Question 39

What does Beta 1 on the heart cause?

Answer 39

Increased Inotropy and chronotropy

Question 40

What does beta 2 on the blood vessels and bronchi cause?

Answer 40

Vasodilation and bronchodilation

Question 41

What does alpha overstimulation cause?

Answer 41

Vasoconstriction Decreased perfusion increased cardiac workload

Question 42

What does beta 1 overstimulation cause?

Answer 42

tachyarrhythmia | increased myocardial O2 demand

Question 43

What does beta 2 overstimulation cause?

Answer 43

vasodilation | decreased pre load

Question 44

What drugs act on mixed receptors?

Answer 44

Dopamine Ephedrine Norepinephrine Epinephrine

Question 45

What drug acts primarily on alpha receptors?

Answer 45

Phenylephrine

Question 46

What drugs act primarily on beta receptors?

Answer 46

Dobutamine | Isoproterenol

Question 47

What drug acts on non-adrenergic receptors?

Answer 47

Vasopressin

Question 48

What receptors does Dopamine act on with low doses?

Answer 48

Dopamine receptors

Question 49

What receptors does Dopamine act on with medium doses?

Answer 49

Beta receptors

Question 50

What receptors does Dopamine act on with high doses?

Answer 50

Beta and alpha receptors

Question 51

What can ephedrine cause?

Answer 51

Reflex bradycardia | CNS stimulation

Question 52

What is norepinephrine indicated in?

Answer 52

refractory shock or non-responsive hypotension

Question 53

What is epinephrine indicated in?

Answer 53

CPR | Anaphylactic shock

Question 54

What kind of agonist is Phenylephrine?

Answer 54

Alpha 1

Question 55

What does phenylephrine cause?

Answer 55

Splenic contraction

Question 56

What is phenylephrine used to treat?

Answer 56

nephrosplenic entrapment

Question 57

What receptor does Dobutamine act on?

Answer 57

Beta 1

Question 58

What does Dobutamine cause?

Answer 58

Increased inotropy | minimal effects on chronotropy

Question 59

What receptor does Isoproterenol act on?

Answer 59

Beta 1 and B2

Question 60

What is Isoproterenol used for?

Answer 60

treatment of 3rd degree AV block and bronchodilation

Question 61

Vasopressin

Answer 61

Antidiuretic hormone

Question 62

When is Vasopressin indicated?

Answer 62

Refractory shock | non-responsive hypotension

Question 63

What does Vasopressin cause?

Answer 63

Vasoconstriction | Tissue Ischemia

Question 64

What is the first thing to do for hypotension?

Answer 64

evaluate patient and turn down the vaporizer if the patient is too deep If the patient is too light ass mac-sparing drug then turn down the vaporizer

Question 65

What are other strategies for hypotension?

Answer 65

Give crystalloid fluid bolus Treat the suspected underlying cause consider CV drug therapy

Question 66

How do you treat Vasodilation?

Answer 66

Give Vasopressor

Question 67

How do you treat decreased contractility?

Answer 67

Give Inotrope