CVICU Drugs Packet from the unit

Question 1

What four drugs will you see on the unit that increase contractility?

Answer 1

dobutamine
dopamine
milrinone
digitalis

Question 2

what do dobutamine, dopamine, milrinone, and digitalis have in common?

Answer 2

they all increase contractility

Question 3

Which 4 type of drugs reduce preload?

Answer 3

Nitrates
ACE inhibitors
Angiotensin II Receptor Blockers (ARBs)
Morphine

Question 4

which vasoconstrictors will you commonly see on the unit?

Answer 4

neosynephrine
lveophed
epinephrine
vasopressin
dopamine

Question 5

When does dopamine act as a vasoconstrictor?

Answer 5

when used in HIGH doses

Question 6

what arterial dilators will you commonly see on the unit?

Answer 6

calcium channel blockers
antihypertensives
ace inhibitors
arbs
milrinone
nipride

Question 7

how do arterial dilators decrease blood pressure?

Answer 7

by reducing after load

Question 8

what happens when you stimulate alpha receptors?

Answer 8

vascular smooth muscle contraction

Question 9

what happens when you block alpha receptors?

Answer 9

decrease in blood pressure, relaxation of vascular smooth muscles

Question 10

what happens when you stimulate beta receptors?

Answer 10

increase in heart rate and bronchodilation

Question 11

Which drug acts on beta receptors to bronchodilator?

Answer 11

albuterol

Question 12

what happens when you block beta receptors?

Answer 12

decrease in HR
mild bronchoconstriction
mild decrease in BP

Question 13

which drugs should you use caution in patients with COPD and why?

Answer 13

beta receptor blockers because of bronchoconstriction

Question 14

what are 3 examples of drugs that release catecholamines?

Answer 14

epi, norepi, dopamine

Question 15

catecholamines are released as part of the…

Answer 15

fight or flight response

Question 16

where are catecholamines produced in the body?

Answer 16

primarily the adrenal medulla

Question 17

what does the release of catecholamines do to the body?

Answer 17

increase cardiac output
increase in blood pressure
increase in heart rate
increase in blood sugar

Question 18

catecholamines are a type of…

Answer 18

neurotransmitter

Question 19

where are alpha 1 receptors located in the body?

Answer 19

vascular smooth muscle

Question 20

what are alpha receptors responsible for?

Answer 20

they determine both arteriolar resistance and venous capacitance, and thus BP

Question 21

what is venous capacitance?

Answer 21

volume of blood contained in the venous system at a given pressure

Question 22

where are alpha 2 receptors located?

Answer 22

in the brain and the periphery

Question 23

what is amiodarone?

Answer 23

class III anti arrhythmic

Question 24

how does amiodarone work?

Answer 24

inhibits potassium ion fluxes during phase II and III of the action potential

Question 25

Amiodarone delays polarization by...

Answer 25

prolonging the QT interval and the refractory period in cardiac tissue

Question 26

when is amiodarone used?

Answer 26

pulseless v tach or v fib stable or unstable arterial/ventricular arrhythmias to convert and manage a fib

Question 27

amiodarone works as a powerful vaso__

Answer 27

dilator

Question 28

what must you use when hanging amiodarone?

Answer 28

inline filter

Question 29

how is an amiodarone drip infused?

Answer 29

loading dose of 150mg over 10 minutes then maintenance drip of 1mg/min over 6 hrs then 0.5mg/min over 18 hrs

Question 30

what should be done if a patient is on an amiodarone drip and has breakthrough arrhythmias?

Answer 30

give supplemental loading dose of 150 mg over 10 mins

Question 31

how is amiodarone given for lethal v tach or v fib?

Answer 31

300 mg IVP

Question 32

what are 4 serious adverse reactions of amiodarone?

Answer 32

thyroid dysfunction vision loss interstitial pneumonitis bradycardia

Question 33

what is an important ingredient of amiodarone?

Answer 33

it is by weight, 37% iodine

Question 34

excess iodine intake may precipitate...

Answer 34

hyper/hypothyroidism goiter thyroid autoimmunity

Question 35

what are 3 beta blockers commonly used in the Cvicu?

Answer 35

metoprolol, atenolol, propanolol

Question 36

what is the mechanism of action of beta blockers?

Answer 36

competitively inhibits catecholamines from binding to beta receptors

Question 37

what are 2 main functions of beta blockers?

Answer 37

reduce myocardial oxygen demand and increase coronary artery perfusion

Question 38

how do beta blockers reduce myocardial oxygen demand and increase coronary artery perfusion?

Answer 38

by decreasing heart rate and contractility, and reducing left ventricular wall stress by prolonging diastole