Cardiovascular Drugs Flashcards Preview

Anesthesiology > Cardiovascular Drugs > Flashcards

Flashcards in Cardiovascular Drugs Deck (79):
1

What are 2 things a positive inotrope does?

- Increase cardiac output
- Increase atrial filling pressure

2

Adrenergic agonists help to maintain what?
Prevent what?

- Maintain arterial blood pressure
- Prevent tissue ischemia

3

When vasopressors are administered what occurs to heart rate?

Slows heart rate

4

Adrenergic agonists are not recommended in the face of what?

Hypovolemia

5

What are 2 examples of adrenergic agonists?

- Bronchospasm (asthma)
- Life threatening allergic reactions

6

What are 3 possible routes of administration for adrenergic agonists?
What is not an effective route?

- SQ, IV, Intra-tracheal
- Oral

7

What is are 3 examples of a drug that is an A1, A2, B1, B2 agonist?

- Epinephrine
- Norepinephrine
- Ephedrine

8

What effect does epinephrine have on heart rate?
On vascular tone?

- Increases HR
- Increases vascular tone (vasoconstriction)

9

What is the strongest vasopressor that can be administered during cardiopulmonary arrest?

Epinephrine

10

Is epinephrine the go to drug for hypotension?
Why?

- No
- Can be potent tachyogenic drug. Also potent vasoconstrictor which decreases organ profusion

11

What are 2 indications for epinephrine?

- Treat life-threatening allergic reactions
- CRI in non-responsive hypotension

12

Epinephrine decreases what?

Renal blood flow

13

Epinephrine increases what 6 things?

- Blood pressure
- Peripheral vascular resistance
- Myocardial contractile force
- Heart rate
- Cardiac output
- Bronchodilator

14

What are 4 disadvantages of epinephrine?

- Severe vasoconstriction can lead to decrease perfusion of tissues
- Increase in oxygen consumption (increased cardiac work)
- Can induce ventricular fibrillation (tachyarrhythmias)
- Increase sensitivity to tissue hypoxia

15

Epinephrine should be left for what?

Resistant hypotension or CPA

16

Does norepinephrine produce more or less severe tachycardia than epinephrine?

Less severe tachycardia

17

What is norepinephrine used for?

Significant non-responsive hypotension

18

Do you usually use norepinephrine with cardiac arrest?

No

19

What does norepinephrine decrease?

Renal blood flow

20

What are 4 things increased by norepinephrine?

- Blood pressure
- Peripheral vascular resistance
- Myocardial contractile force
- Heart rate

21

What is an example of an A1, B1, B2 agonist?

Dopamine

22

What are 2 indications for dopamine?

- Treatment of hypotension
- Increase urine output

23

What does dopamine decrease?

Partial pressure of oxygen in blood (interferes with ventilatory response)

24

What are 4 things dopamine increases?

- Myocardial contractility
- Renal blood flow
- Glomerular filtration rate
- Systemic vascular resistance (only seen with high dose)

25

How does dopamine need to be administered?

As a CRI

26

What is a low dose of dopamine?
What is seen with a low dose?

- 1-4 ug/kg/min
- Stimulates dopamine receptors

27

What are 4 results of dopamine receptor stimulation?

- Splanchnic vasodilation
- Natriuresis
- Diuresis
- Alterations in renal & GI blood flow

28

What is natriuresis?

Excretion of sodium in the urine

29

What is diuresis?

Increased discharge of urine

30

What is a medium dose of dopamine?
What are 2 things seen with a medium dose?

- 5-10 ug/kg/min
- Increase HR/contractility, mild change in vascular resistance

31

What is a high dose of dopamine?
What are 2 things seen with a high dose?

- Increase vascular resistance
- Increase contractility/HR

32

Mainly beta and only mild alpha effects are seen with which type of dopamine dose?

Medium dose

33

Dopamine receptors are stimulated with which type of dopamine dose?

Low dose

34

Significant beta and alpha effects are seen with which type of dopamine dose?

High dose

35

What type of agonist is dobutamine?

Non-specific Beta agonist

36

Which drug is a common choice for equine hypotension?

Dobutamine

37

What is dobutamine used for?

Treatment for hypotension

38

What are 2 things increased by dobutamine?

- Contractility
- HR

39

What are 4 side effects seen with dobutamine?

- Tachycardia
- Arrhythmias
- Vasodilation
- Seizures/tremors (cats at doses > 5ug/kg/min)

40

What type of an agonist is isoproterenol?

Beta agonist

41

What is the main clinical use of isoproterenol?

Treatment 3rd degree heart block

42

What are 3 effects isoproterenol has?

- Increase HR (can cause significant tachycardia)
- Potent inotrope
- Potent chronotrope

43

Is isoproterenol still commonly used?

No

44

What are 3 side effects seen with isoproterenol?

- Arrhythmias
- Tachycardia
- Hypotension

45

What type of agonist is phenylephrine?

Alpha 1 agonist

46

What are 4 clinical uses of phenylephrine?

- Significant vasoconstriction
- Splenic contraction
- Decrease epistaxis
- Decrease nasal edema

47

What are 2 side effects seen with phenylephrine?

- Decreased blood flow
- Decreased cardiac output (increased afterload, reflex bradycardia)

48

Caution should be used when using phenylephrine in what species?
Why?

- Horses
- Decrease in blood flow to GIT

49

High doses of phenylephrine have potential for what?

Some Beta effects

50

How is phenylephrine administered?

As a CRI

51

What are 2 clinical uses for ephedrine?

- Treatment of hypotension
- Increase cardiac output

52

What are 3 effects of ephedrine?

- Increase HR
- Increase vascular resistance
- Increase contractility

53

Which drugs are used routinely for the treatment mild of hypotension?

- Ephedrine
- Dopamine
- Dobutamine
- Phenylephrine

54

Which drugs are used routinely for the treatment of moderate hypotension?

- Phenylephrine
- Norepinephrine

55

Which drugs are used for the treatment of severe hypotension?

- Vasopressin
- Epinephrine

56

Does ephedrine have a slow or fast onset?

Fast onset

57

What can ephedrine cause?

CNS excitement

58

Which cardiovascular drug is not given CRI?

Ephedrine

59

Which 2 drugs are mainly or only non-selective beta agonists?

- Mainly: dobutamine
- Only: isoproterenol

60

What are 3 clinical uses for vasopressin?

- Treatment during CPA (cardiopulmonary arrest)
- Vasodilatory shock
- Von Willebrand disease (stimulates platelets and bone marrow)

61

Which is better for the treatment of CPA, epinephrine or vasopressin?

Vasopressin

62

What are 4 side effects of vasopressin?

- Decrease tissue perfusion
- Contraction (bladder, gall bladder)
- Local irritation at injection site
- Skin necrosis (extravasation)

63

What are the 3 steps in the treatment of hypotension in order?

1) Check anesthetic depth
2) Check volume status
3) Administer CV drugs

64

What can cause hypotension in regards to anesthetic depth?
What should be done?

- Too deep
- Decrease anesthetic

65

What are 3 things that can be done if patient has a low volume status causing hypotension?

- Administer fluid bolus
- Increase fluid rate
- Change to more appropriate fluid choice

66

What can be given to treat an ephedrine overdose that has caused ventricular tachycardia?

1-2 mg/kg lidocaine

67

What is used to treat ventricular tachyarrhythmias by reducing cellular excitation?

Lidocaine

68

When treating a hypertensive emergency, the MAP should be reduced by no more than what?

25% within minutes to 1 hour

69

Excessive falls in arterial blood pressure can lead to what?

Renal, cerebral and coronary ischemia

70

Nitroprusside CRI causes what?

Arterial & venous dilation

71

Nitroprusside CRI can't be used longer than what time period?
Why?

- 24 hours
- Cyanide can build up

72

Hydralazine can cause what?
This can lead to what?

- Arterial vasodilator
- Profound hypotension

73

What is enalaprilat?

ACE inhibitor

74

What is a class of drugs that will slow down heart rate?

Beta blockers

75

What are 3 drugs that can be used to treat hypertension?

- Nitroprusside CRI
- Hydralazine
- Enalaprilat

76

What are 3 examples of negative dromotropic agents?

- Diltiazem
- Esmolol
- Adenosine

77

What does a dromotropic agent do?

Decreases conduction of electrical impulses to the heart.

78

What are 2 indications for the use of temporary transvenous pacing?

- Support HR & BP while under general anesthesia for permanent pacemaker
- Refractory bradycardia stabilization prior to pacemaker implantation

79

What type of cardiac disorder do we commonly apply transvenous pacing?

Severe 3rd degree AV block