February 3, 2016 - Pharmacology Flashcards Preview

COURSE 3 > February 3, 2016 - Pharmacology > Flashcards

Flashcards in February 3, 2016 - Pharmacology Deck (20):
1

Terminology for Cardiac Drugs

Inotropes = Contractility

Vasopressors = SVR

Chronotropes = HR

 

These can be positive or negative too. For example, beta-blockers are negative chronotropes.

2

Inotropes

Deal with contractility.

3

Vasopressors

Deal with SVR

4

Chronotropes

Deal with HR

5

Receptors of the Nervous System

Muscarinic (ACh) in the Parasympathetic

Adrenergic (a & B) in the Sympathetic

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Role of Parasympathetic

"Rest and Digest"

Decreases HR and SVR

7

Role of Sympathetic

"Fight or Flight"

Increase HR, SVR, and bronchiolar dilation

8

Alpha-1 Receptors

Located on vascular smooth muscle and a little bit in the heart.

Activation leads to increased contractility of the heart, increased HR, and greatly increased SVR.

9

Alpha-2 Receptors

Located selectively where vasodilation may be beneficial during shock, such as the brain.

Activation leads to selective decrease in SVR.

10

Beta-1 Receptors

Located in the heart.

Leads to greatly increased contractility and greatly increased HR.

11

Beta-2 Receptors

Located in smooth muscle of vessels and bronchi.

Activation leads to decreased SVR and bronchial dilation.

12

Receptor Table

A image thumb
13

Epinephrine

Endogenous release from the adrenal medulla.

Activates a-1, a-2, B-1, B-2 receptors.

Results in increased cardiac output, and greatly increased SVR.

14

Epinephrine Dosing

For cardiac arrest, the IV bolus is 1 mg of 1:10,000

For anaphylaxis, the IM dose is 0.3 mg of 1:1000

15

Dopamine

Natural catecholamine which is a precursor to norepinephrine.

Increases both CO and SVR.

Effects are dose-related. At lower doses it is more of a beta-effect, and at higher doses it exhibits more of an alpha effect.

Used only as a bridge to buy time to get to the cath lab. Increasing SVR is not good in the long-term for MI. Very easy to give. Will actually make an MI worse, but will keep the patient from dying.

16

Atropine

An anticholinergic agent. It is a competitive inhibitor of muscarinic receptors.

Blocks the parasympathetic system to increase HR without increasing SVR or CO.

17

Norepinephrine

An alpha-1 receptor agonist with minimal beta-1 activity.

Greatly increases SVR and keeps CO relatively neutral.

 

Can be used for uncontrolled bleeding.

18

Dobutamine

Beta-1 receptor agonist with minimal beta-2 or alpha activity.

Greatly increases CO with a slight decrease in SVR.

 

Be careful. In heart failure, the cardiac output may increase but it may not increase above the point where the SVR drops, and the problem may be made worse. This can be supplemented with norepinephrine which will keep CO the same, but will greatly increase SVR.

19

Medication Graph

A image thumb
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