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13 Cards in this Set
- Front
- Back
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Mechanism of action of thiopental
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barbiturate: acts on GABA A in spinal cord and brain
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What are the four areas of concern in anesthesia and idea of balanced anesthesia
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1) amnesia
2) analgesia 3) Akinesis 4) stability of autonomics |
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Thiopental effect on SVR, contractility, CO, HR
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decreased SVR
decreased contractility decreased CO Increased HR (baroreceptor reflex) |
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What happens with halothane and epinephrine
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halothane potentiates epinephrine related dysrythmias
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rank rate of emergence from the following drugs:
Desflorane, enflorane, Halothane, isoflorane, N2O, sevoflorane |
desflorane, N2O- very rapid
Sevoflorane-rapide enflorane, isoflorane-intermediate halothane-slow |
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Which drug leads to adrenocortical suppression in longterm use?
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Etomidate
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What does etomidate do to SVR, SV, cardiac index, MAP
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almost no change on most cardiovascular parameters. Sympathetcis and baroreceptors are relatively preserved.
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Patient with heart rate of 170, BP 90/40, what would be a possible treatment
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phenylephrine 50-200mcg/min IV for pressor. alpha 1 agonist only so will not increase HR
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Positive ionotropic drugs
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dobutamine
dopamine milrinone inamrinone amrinone epinephrine digitalis |
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Which positive ionotropic drug causes largest increase in heart rate
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dobutamine. Increased heart rate is main cause of increased cardiac output. this increased oxygen demand on heart may counteract any benefit of giving dobutamine in low cardiac output syndrome s/p CABG
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factors related to positive ionotropic drug use for low cardiac output syndrome after CV surgery
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older age, decreased left ventricular function, emergancy/redo surgery, combined surgery, longer duration of cardiopulmonary bypass
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use of dobutamine
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acute potentially reversable heart failure (CV surgery or shock)
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primary MOA for dobutamine
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B1 adgrenergic agonist causing + ionotropic effect (tachycardia and increased cardiac output)
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