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29 Cards in this Set
- Front
- Back
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Beta 1 agonists
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dobutamine
dopamine isoproterenol |
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alpha1 agonist
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phenylephrine (also known as neosynephrine)
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effects of phenylephrine on:
preload afterload Heart rate cardiac output |
alpha 1 agonist
increase preload (predominantly vasoconstriction) increase afterload (arterial constriction) reflex bradycardia transient decrease CO |
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HR 160
BP 70/35 hx of cardiomyopathy what drug should be used |
50-200mcg phenylephrine (neosynephrine).
It causes no ionotropic or chronotropic effect. Good for tachycardia or cardiomyopathy |
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what are the direct acting sympathomimetic?
What does this mean? |
phenylephrine
methoxamine These drugs mimic the effects of norepinephrine. |
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MAC of sevoflorane
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1.85
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MAC of Nitrous oxide
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104
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MAC of isoflorane
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1.15
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MAC of Desflorane
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6.0
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At what MAC wil 99% of patients not move
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1.3 MAC
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What does hypernatremia do to MAC
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increase MAC
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What does hypothermia do to MAC
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decrease MAC
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What is the second gas effect effect?
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As one gas flows out of an air-filled space (i.e. nitrous oxide out of alveoli), the concentration of the remaining gas in that space increases (accelerated increase in PA of second gas (i.e. O2 in the alveoli) and this inturn increases rate at which brain reaches equilibrium with inspired concentration of second gas
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What is the concentration effect?
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The increase in the inspired concentration of a gas increases the rate of increase of PA
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What is diffusion hypoxia?
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If room air is inhaled the end of anesthesia, the diffusion of N2O out of the blood can lead to dilution of PaO2 leading to hypoxia.
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What do all volatile anesthetics do to myocardial contractility?
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Decrease contractility by altering intracellular Ca+
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Which volatile anesthetics cause dose related increase in HR? Why?
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Desflorane and isoflorane. Baroreceptor reflex if relatively perserved.
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Test card file
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test card file
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alpha 1 blockers
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prazosin
phentolamine phenoxybenzamine |
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All drugs (that I remembered) that act on the alpha 1 receptor begin with what letter? Name these drugs.
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phenylephrine (neosynephrine) is an alpha 1 agonist
Prazosin, phenoxybenzamine and phentolamine are alpha 1 antagonists |
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What drug would be given for severe hypertension due to norepinephrine
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phentolamine (alpha 1 antagonist)
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At what receptors does dopamine act and what is its relationship to norepinephrine
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alpa, beta, dopamine receptors
It causes increased release of norepinephrine and acts as a direct and indirect sympathomimetic |
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Describe the dose dependent effect of dopamine
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low doses: DA1 receptor activated with dilation of renal and mesentaric vasculature
Medium dose: activate Beta1 receptors and release of NE causing activation of the heart High dose: activation of alpha1 with vasoconstriction |
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What is fenoldopam and what is it used for?
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DA1 agonist used for as IV treatment to increase renal perfusion during severe hypertension
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What would be the treatment for a patient who has hypotension and oliguria after fluid resuscitation
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dopamine
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What drug acts on all adrenergic receptors?
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epinephrine acts on alpha 1 and 2 and beta 1,2,3
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Why is epinephrine good for establishing coronary blood flow during cardiac arrest
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It increases arortic pressure (vasoconstriction due to alpha 1) causing increased coronary blood flow
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What dose of epinephrine is used for pressure support, what dose is used for cardiac collapse
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2-8mcg for pressure support
.02mg/kg or about 1mg for cardiac collapse |
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What are clinical uses for epinephrine?
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pressure support (low dose)
cardiac collapse, asystole, ventricular fibrillation, electrical mechanical dissociation, anaphylactic shock (It maintains myocardial and cerebral infusion at higher doses) |
