Norepinephrine and Epinephrine Flashcards Preview

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Flashcards in Norepinephrine and Epinephrine Deck (11)
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1

Epinephrine

Increases:
--HR
--SV
--CO
--arrhythmias
--Coronary Blood flow

--Systolic arteriole pressure
--Mean arterial pressure
--Mean pulmonary blood pressure

Widens Pulse pressure!!
(ESPECIALLY low dose given subcutaneously)

*at low doses, may DECREASE BP
(so on time curve, pressure goes up initially, but as drug concentration declines the pressure goes below normal!)

2

Norepinephrine

Increases:
--SV
--arrhythmias
--coronary blood flow

--Systolic arteriole pressure
--diastolic arteriole pressure
--mean arteriole pressure
--Mean pulmonary pressure

3

Similarities

Increase:
--SV
**arrhythmias
--Coronary blood flow

--systolic arterial pressure
--mean arterial and pulmonary pressures

4

Differences

--HR
--CO

--Pulse pressure

5

Why difference in HR and CO?

Parasympathetic tone predominates in the heart

NE affects mainly alpha receptors, causing more intense vasoconstriction than E and causing major increase in Mean arterial pressure, thus stimulating vagus

Increased BP-->vagus parasympathetic activation on heart, decreasing HR and CO

(If atropine given before NE, then increase in HR and CO)

E does not increase mean arterial pressure much, and thus doesn't stimulate vagus

6

Why difference in Pulse pressure?

NE works more intensely on alpha receptors, increasing both systolic and diastolic pressures

E works on both beta receptors especially. Systolic pressure increases greatly b/c of increased SV etc., but diastolic doesn't increase or even goes down b/c doesn't work as much on alpha and does activate strongly the beta-2 receptors, causing vasodilation.

7

Epinephrine affects B1 receptors of...
(Cardiac effects)

SA node and AV node
(not really ventricular tissue)

8

Epinephrine Vascular effects

Vasodilation:
--skeletal muscle

Vasoconstriction:
--cutaneous
--renal (so incr renin secretion & dec BF)

Increases:
--pulmonary pressures (arteries and veins)
--Coronary BF

9

Epinephrine administration

IV, inhaled, IM, subcutaneous (allergies)
NOT oral

10

Epinephrine adverse effects

Cerebral hemorrhage (esp w/ non-selective BB)

Ventricular arrhythmias

Angina

11

Epinephrine utility

emergency relief of anaphylaxis

vasoconstrictor w/ local anasthetics

Restoring cardiac rhythm in pts w/ cardiac arrest