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Flashcards in Drips Deck (14)
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Tell me about Milrinone.

Milrinone is an inotrope and a selective phosphodiesterase inhibitor in cardiac and vascular tissue, resulting in vasodilation and inotropic effects with little chronotropic activity.

Milrinone inhibits cAMP found in cardiac and vascular muscle.

Milrinone increased intravenous at ionized calcium and contractile force in cardiac muscle.

1

Tell me about Amiodarone

Amiodarone is a class III antiarrhythmic agent which inhibits adrenergic stimulation (alpha- and beta-blocking properties), effects the lengthening of the cardiac action potential and blocks myocardial potassium channels leading to slowed conduction and prolonged refractory periods.

Amiodarone prolongs conduction in the AV node and thus decreases the ventricular rate!!!

Amiodarone is a negative inotrope and a negative dromotrope.

2

Tell me about Phenylephrine!

Phenylephrine is a synthetic sympathomimetic, that is a potent, direct-acting alpha-adrenergic agonist with virtually no beta-adrenergic activity; produces systemic arterial vasoconstriction. Such increases in systemic vascular resistance result in dose dependent increases in systolic and diastolic blood pressure and reductions in heart rate and cardiac output especially in patients with heart failure.

3

Tell me about Levophed!

Levophed is a sympathomimetic amine that stimulates beta1-adrenergic receptors and alpha-adrenergic receptors causing increased contractility and heart rate as well as vasoconstriction, thereby increasing systemic blood pressure and coronary blood flow; clinically, alpha effects (vasoconstriction) are greater than beta effects (inotropic and chronotropic effects)

4

Tell me about Vasopressin!

Vaso is the anitdiuretic hormone analog, that causes direct vasoconstriction without inotropic or chronotropic effects.
Vaso increases cyclic adenosine monophosphate (cAMP) which increases water permeability at the renal tubule resulting in decreased urine volume and increased osmolality; causes peristalsis by directly stimulating the smooth muscle in the GI tract.

5

Tell me about Sodium Nitroprusside!

SNP is an anti hypertensive vasodilator; causes peripheral vasodilation by direct action on venous and arteriolar smooth muscle, thus reducing peripheral resistance; will increase cardiac output by decreasing afterload; reduces aortal and left ventricular impedance. Improves CO in HF.

6

Tell me about Epinephrine!

Epi is a sympathomimetic catecholamine that stimulates alpha-, beta1-, and beta2-adrenergic receptors resulting in relaxation of smooth muscle of the bronchial tree, cardiac stimulation (increasing myocardial oxygen consumption), and dilation of skeletal muscle vasculature; small doses can cause vasodilation via beta2-vascular receptors; large doses may produce constriction of skeletal and vascular smooth muscle

7

Tell me about Nitroglycerin!

Nitro is an anti angina med and a vasodilator. Nitroglycerin forms free radical nitric oxide. In smooth muscle, nitric oxide activates guanylate cyclase which increases (cGMP) leading to dephosphorylation of myosin light chains and smooth muscle relaxation.

Nitro produces a vasodilator effect on the peripheral veins and arteries with more prominent effects on the veins.

Nitro primarily reduces cardiac oxygen demand by decreasing preload (left ventricular end-diastolic pressure); may modestly reduce afterload; dilates coronary arteries and improves collateral flow to ischemic regions.

8

Tell me about Dobutamine!

Dobutamine is a synthetic catecholamine with adrenergic agonist action that has inotropic effects in decompensated systolic HF.
Dobutamine stimulates beta1-adrenergic receptors, causing increased contractility and heart rate, with little effect on beta2- or alpha-receptors.

Increases SV, decreases cardiac filling pressures, proportionally decreases SVR - thus the MAP doesn't increase!

9

Tell me about Propofol!

Propofol is a short-acting, lipophilic intravenous general anesthetic.

Propofol causes global CNS depression, presumably through agonism of GABAA receptors and perhaps reduced glutamatergic activity through NMDA receptor blockade.

10

Tell me about Fentanyl!

Fentanyl is a anilidopiperidine opioid.
Fentanyl binds with stereospecific receptors at many sites within the CNS, increases pain threshold, alters pain reception, inhibits ascending pain pathways.

11

Tell me about Precedex / Dexmedetomidine!!!!!

Dexmedetomidine is an alpha 2 adrenegic agonist sedative.
Dexmedetomidine is an elective alpha2-adrenoceptor agonist with anesthetic and sedative properties thought to be due to activation of G-proteins by alpha2a-adrenoceptors in the brainstem resulting in inhibition of norepinephrine release;
peripheral alpha2b-adrenoceptors are activated at high doses or with rapid I.V. administration resulting in vasoconstriction.

12

Tell me about the Dopamine!

Dopamine is an adrenergic agonist with inotropic effects.
Dopamine stimulates both adrenergic and dopaminergic receptors;
-lower doses are mainly dopaminergic stimulating and produce renal and mesenteric vasodilation,
-intermediate doses also are both dopaminergic and beta1-adrenergic stimulating and produce cardiac stimulation and renal vasodilation;
-large doses stimulate alpha-adrenergic receptors and are used as pressors.

13

Tell me about Atropine!

Atropine is a antimuscarinic - it causes a blockade of muscarinic receptors at the cardiac SA node, and is parasympatholytic and anticholinergic.
Atropine inhibits smooth muscle and glands innervated by postganglionic cholinergic nerves, and produces a complete vagal blockade.