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Flashcards in Pharm: ANS Deck (27)
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1

Epinephrine

MOA: alpha and beta receptor agonist

Use:
resuscitation from cardiac arrest, which both (+) inotropic and (+) chronotropic effects plus vasoconstriction

Anaphylactic shock to raise blood pressure by constricting arterioles

Adverse Effects: tachycardia, hypertensive crisis

2

What are 3 contraindication for all sympathomimetic drugs?

Patients that use:
Cocaine and tricyclic antidepressants
MAO inhibitors
Thyroid hormones

3

Reserpine

MOA: inhibits vesicular monoamine transporter (VMAT) in presynaptic neurons preventing NE formation.

Use:
Not used anymore but tested on boards

Adverse Effects: depression

4

Norepinephrine

MOA: alpha-1, alpha-2, Beta-1 agonist (little beta-2 effect)

Use: resuscitation of cardiac arrest, hypotensive states

Adverse Effects: tachycardia, hypertensive crisis

5

Isoproterenol

MOA: Beta-1 and Beta-2 agonist

Use: AV block, bradycardia (emergency situations in anticipation for pacemaker placement)

6

Fenoldopam

MOA: D1 agonist

Use: severe hypertension (dilates coronary arteries to prevent heart attack)

7

Dopamine

MOA: dose dependent (low to high) D1 agonist, beta-1 agonist, alpha-1 agonist

Use: hypertension, D1 receptor activation dilates renal arteries to increase GFR, dilates coronary arteries

8

Dobutamine

MOA: selective Beta-1 agonist (slight alpha-1)

Use: Heart failure (increases Cardiac output without increasing heart rate)

Adverse Effects: because of its slight alpha-1 specificity, too much use can lead to intense vasoconstriction

9

Phenylephrine

MOA: alpha-1 agonist

Use: hypotensive emergency to preserve cerebral and coronary blood flow, maintain blood pressure during anesthesia

10

Methoxamine

MOA: alpha-1 agonist

Use: hypotensive emergency to preserve cerebral and coronary blood flow, maintain blood pressure during anesthesia

11

Midodrine

MOA: alpha-1 agonist

Use: postural hypotension

12

Clonidine

MOA: alpha-2 agonist

Use: hypertension

Adverse Effects: Dry mouth, sedation, Dose-related withdrawal syndrome

13

alpha-methyldopa

MOA: alpha-2 agonist

Use: pregnancy-related hypertension

Adverse Effects: hepatotoxicity, hemolytic anemia, seation, Dose-related withdrawal syndrome

14

Prazosin

MOA: alpha-1 antagonist

Use: hypertension

Adverse Effects: 1st dose hypotension (pts should take it before bed to avoid orthostatic hypotension and fainting)

15

Doxazosin

MOA: alpha-1 antagonist

Use: hypertension

Adverse Effects: 1st dose hypotension (pts should take it before bed to avoid orthostatic hypotension and fainting)

16

Terazosin

MOA: alpha-1 antagonist

Use: BPH (induces apoptosis in the prostate)

Adverse Effects: 1st dose hypotension, syncope

17

Phenoxybenzamine

MOA: irreversible non-selective alpha blocker

Use: pheochromocytoma

Adverse Effects: reflex tachycardia (due to alpha-1 blockage leading to vasodilation), tachycardia (due to alpha-1 blockage leading to increased NE release binding beta-1)

18

Phentolamine

MOA: reversible non-selective alpha blocker

Use: prevents hypertension during surgical excision of pheochromocytoma, Dx of pheochromocytoma

Adverse Effects: reflex tachycardia (due to alpha-1 blockage leading to vasodilation), tachycardia (due to alpha-1 blockage leading to increased NE release binding beta-1)

19

Propranolol

MOA: non-selective Beta blocker

Use: Hypertension, Angina pectoris, Arrhythmias, Myocardial infarction, Acute treatment of MI, Secondary prevention following MI, Aortic dissection, Hypertrophic cardiomyopathy (CHF), Dumb

Adverse Effects: insomnia, nightmares, hallucinations, bronchoconstriction

20

Timolol

MOA: non-selective Beta blocker

Use: Hypertension, Angina pectoris, Arrhythmias, Myocardial infarction, Acute treatment of MI, Secondary prevention following MI, Aortic dissection, Hypertrophic cardiomyopathy (CHF), Dumb

Adverse Effects: insomnia, nightmares, hallucinations, bronchoconstriction

21

Pindolol

MOA: non-selective Beta blocker (has intrinsic sympathomimetic activity and can act as partial agonist, so can provide low level of cardiac stimulation)

Use: Hypertension, Angina pectoris, Arrhythmias, Myocardial infarction, Acute treatment of MI, Secondary prevention following MI, Aortic dissection, Hypertrophic cardiomyopathy (CHF), Dumb

Adverse Effects: insomnia, nightmares, hallucinations, bronchoconstriction

22

Atenolol

MOA: beta-1 blocker

Use: angina, tachycardia, (not very lipophilic so doesn't cross BBB easily)

Adverse Effects: bradycardia, AV block, Raynaud phenomenon, rebound excitation if discontinued

23

Metoprolol

MOA: beta-1 blocker

Use: angina, tachycardia

Adverse Effects: bradycardia, AV block, Raynaud phenomenon, rebound excitation if discontinued

24

Esmolol

MOA: beta-1 blocker (very short 1/2 life)

Use: hypertensive emergency, acute arrhythmia

Adverse Effects: bradycardia, AV block, rebound excitation

25

Labetolol

MOA: alpha and beta blocker

Use: hypertensive emergency

Adverse Effects: orthostatic hypotension

26

Carvediolol

MOA: alpha and beta blocker

Use: hypertensive emergency, heart failure

Adverse Effects: orthostatic hypotension

27

Mecamylamine

MOA: ACh receptor blocker

Use: hypertension in patients refractory to other antihypertensives

Adverse Effects: Parasympathoplegia and Sympathoplegia