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13 Cards in this Set

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