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Flashcards in Rx Deck (117)
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1

epinephrine

Class: Adrenergics
catecholamines
A1&A2&B1&B2&B3 agonist
sympathetic stimulation = inc heart rate, contractility, BP and CO
low doses: B preferred
uses: cardiac arrest, cardiogenic shock, severe hypotension, anaphylaxis, respiratory distress, urticaria, keep anesthetic "local"
side effect: hyperglycemic effect, tachycardia, arrhythmia, MI
~adrenaline

2

norepinephrine

Class: Adrenergics
catecholamines
A1&A2>B1 agonist
stimulates peripheral vasoconstriction and inc BP
use: shock, severe hyoptension
side effect: MI due to increased cardiac work

3

isoproterenol

Class: Adrenergics
catecholamines
B1 & B2 agonist
inc HR, contractility and cardiac output
use: bradycardia, asthma, bronchitis, and emphysema.
side effects: tachycardia, MI

4

dopamine

Class: Adrenergics
catecholamines
low dose: D1&D2&B1 agonist
high dose: A1&A2 agonist (act as vasopressor)
increase contractility and HR
use: cardiogenic shock, CHF
*causes renal vasodialtion
side effect: arrhythmias

5

dobutamine

Class: Adrenergics
catecholamines
B1 agonist
uses: cardiogenic shock, congestive heart failure
(increases contractility w/o increase HR) increases cardiac output
side effect: arrhythmias, hypotension

6

phenylephrine

adrenergic Agonists/ sympathomimetics
direct agents
A1>A2
vasopressor
uses: rhinitis, decongestion, SVT, hypotension, shock
*big vasoconstriction= increase systemic resistance= inc BP=vagal stimulation= slows heart rate
side effect: rebound mucous swelling

7

midodrine

Agonists/ sympathomimetics
direct agents
A1
uses: hypotension, retinal exams (dilates pupils)

8

brimonidine    

presynaptic anti-adrenergic
direct, Agonist A2
causes dec NE and suppresses sympathetic
uses: glaucoma (decreases aqueous humor formation)

9

clonidine

presynaptic anti-adrenergic
direct, Agonist A2
causes dec NE and suppresses sympathetic
uses: HTN, (inhibits sympathetic outflow)
side effect: sedation
(CNS active)

10

oxymetazoline (Afrin)

Agonists/ sympathomimetics
direct agents
A1 & A2
use: decongestion

11

albuterol/salmeterol/terbutaline (proventil/ventolin)

adrenergic Agonists/ sympathomimetics
direct agents
B2
causes bronchiodilation
use: asthma, COPD
side effects: tachycardia, tremor

12

fenoldopam 

adrenergic Agonists/ sympathomimetics
direct agents
D1
use: severe HTN
rapid renal and splanchnic vasodilating effects

13

amphetamine

adrenergic Agonists/ sympathomimetics
Indirect acting agents
mechanism: inhibits MAO, releases endogenous NE from storage vesicles= inc NE binding to adrenergic receptors
CNS excitation (can cross BBB)
stimulant: increases heart rate and blood pressure and decreases appetite

14

ephedrine

adrenergic Agonists/ sympathomimetics
Mixed agent
Indirect acting: inc NE release from neuron and binding to adrenergic receptor
DIRECTLY stimulates A1&B2
use: asthma, nasal decongestion, hypotension
side effect: HTN

15

phenoxybenzamine

adrenergic Antagonists/ adrenergic receptor blockers
A1 & A2,
noncompetitive, binds irreversibly
use: HTN
side effect: reflex tachycardia, increased insulin

16

phentolamine

Antagonists/ adrenergic receptor blockers
A1 & A2, competitive
causes: dilation of smooth muscle and dec BP
Uses: HTN
side effects: reflex tachycardia and arrhythmias

17

prazosin 

Antagonists/ adrenergic receptor blockers
A1 selective
competitive
causes blood vessel vasodilation and dec BP
use: HTN (does not cause tachycardia)
side effect: hypotension and dizziness
"minipress"

18

tamsulosin

Antagonists/ adrenergic receptor blockers
A1a selective (GU tract)
use: benign prostatic hypertrophy and bladder obstruction
side effect: floppy iris syndrome

19

terazosin

Antagonists/ adrenergic receptor blockers
A1a selective (GU tract)
use: benign prostatic hypertrophy, HTN

20

pindolol

Antagonists/ adrenergic receptor blockers
B1 & B2, weak
intrinsic sympathomimetic activity (less effect on resting HR)
use: HTN
side effect: bronchoconstriction

21

propranolol

Antagonists/ adrenergic receptor blockers,
Antiarrhythmic: class 2
B1 & B2, strong
effect: prolongs AV conduct and refract; decreases HR and contractility
use: angina pectoris, HTN, MI, SVT, ventricular arrhythmia, tachycardia, Afib, Aflutter
side effect: bronchoconstriction, heart failure

22

metoprolol

Antagonists/ adrenergic receptor blockers
Antiarrhythmic: class 2
B1 selective
(-) inotropy, (-) chronotropy
use: HTN, MI, SVT, CP, tachycardias, IHD, CHF
less likely to cause bronchoconstriction
side effect: bradycardia, enters brain (CNS sedation)

23

labetalol

Antagonists/ adrenergic receptor blockers
causes vasodilation
Mixed: A1 & B
use: HTN, angina pectoris, CHF
side effects: hypotension, fatigue, bradycardia

24

carvedilol

Antagonists/ adrenergic receptor blockers
Mixed: A1 & B
use: HTN, angina pectoris, tachycardia, CHF
(inc ejection fraction)

25

guanethidine

Antagonists/ block adrenergic neuronal function (peripheral pre-synaptic)
decreases NE in synaptic cleft
use: severe HTN, renal HTN
side effects: hypotension, fluid retention, impaired ejaculate, diarrhea, nerve toxicity
**not used anymore

26

hexamethonium (C6)

nonspecific Antagonist
adrenergic and nicotinic cholinergic receptors (nAChnR)
blocks all stimulation of pre-ganglionic neurons
stops release of NE and ACh
use: HTN
side effects: severe
not used clinically

27

atropine

anticholinergic
nonselective muscarinic Antagonist

use: bradycardia, vagal hyperactivity, bronchospasms, over-secretions
(treats DUMBBLSS)

side effect: "hot as a hare, dry as a bone, red as a beet, blind as a bat, and mad as a hatter"
flush, blurred vision, dec secretions, hyperthermia, delirium, hallucinations
big CNS effects

28

cocaine

adrenergic agonist; indirect sympathomimetic
block catecholamine reuptake by membrane transporter (NET)
increases NE in synapse
use: causes vasoconstriction, local anesthesia
side effect: MI

29

(+) inotropic drug

increase heart contractility

30

(+) chronotropic drug

increase heart rate