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24 Cards in this Set
- Front
- Back
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What are the Effects of Low dose Epi?
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Low dose Epi is B1/B2 action:
B1: +ionotrophy, + C.O. + HR (BP?) B2: relax smooth mm., vasodilation to skeletal mm, liver (glycogenolysis) Since vasodilation (decrease BP), but B1 effects (increase BP), net effect is little change in BP, but there is increase HR, CO, and blood flow to skeletal mm. & liver. |
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How does glucose enter cells?
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Beta 2 mediated mechanism
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What are the effects of High dose Epi?
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Since high dose Epi (B1/B2) will be saturated (since most sensitive) and see effects of (a1/a2) receptor action.
A1: constricts smooth mm. of vasculature |
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Why doesn't High dose Epi cause increased HR since a1 constricts teh vasculature?
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Baroreceptors reflexively decrease HR
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What is the effect of high dose Epi on coronary blood flow?
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increase coronary blood flow because of adenosine
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if patient has hypovolemic shock, would you give high dose or low dose EPI?
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High dose, want to increase BP!
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Pt. presents with DIC but also has hypothyroidism. What drug should you be worried about giving them?
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Epinephrine. Epi mixed drug (alpha/Beta). Hypothyroid pts. have overexpression of B1 and can get hypertensive crisis (mimic SNS effects) stimulates the heart
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What are the CNS side effects of EPI?
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HATT
Head ache Anxiety Tremor Tension |
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What are the side effects of the B1 action of high dose Epi?
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B1 increases CO, BP (increases risk for:
1. Pulmonary edema 2. Cerebral hemorrhage |
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How is NE different from Epi?
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NE is selective for alpha, not beta
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What are the Effects of Low dose Epi?
|
Low dose Epi is B1/B2 action:
B1: +ionotrophy, + C.O. + HR (BP?) B2: relax smooth mm., vasodilation to skeletal mm, liver (glycogenolysis) Since vasodilation (decrease BP), but B1 effects (increase BP), net effect is little change in BP, but there is increase HR, CO, and blood flow to skeletal mm. & liver. |
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How does glucose enter cells?
|
Beta 2 mediated mechanism
|
|
|
What are the effects of High dose Epi?
|
Since high dose Epi (B1/B2) will be saturated (since most sensitive) and see effects of (a1/a2) receptor action.
A1: constricts smooth mm. of vasculature |
|
|
Why doesn't High dose Epi cause increased HR since a1 constricts teh vasculature?
|
Baroreceptors reflexively decrease HR
|
|
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What is the effect of high dose Epi on coronary blood flow?
|
increase coronary blood flow because of adenosine
|
|
|
if patient has hypovolemic shock, would you give high dose or low dose EPI?
|
High dose, want to increase BP!
|
|
|
Pt. presents with DIC but also has hypothyroidism. What drug should you be worried about giving them?
|
Epinephrine. Epi mixed drug (alpha/Beta). Hypothyroid pts. have overexpression of B1 and can get hypertensive crisis (mimic SNS effects) stimulates the heart
|
|
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What are the CNS side effects of EPI?
|
HATT
Head ache Anxiety Tremor Tension |
|
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What are the side effects of the B1 action of high dose Epi?
|
B1 increases CO, BP (increases risk for:
1. Pulmonary edema 2. Cerebral hemorrhage |
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How is NE different from Epi?
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NE is mainly selective for alpha, but still some Beta activity
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What is the effect of NE on the coronary artery?
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Also causes vasodilation like EPI, but not due to adenosine. NE causes NO release.
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Why is (medium dose) Dopamine a better Rx than NE or EPI in treating shock?
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Dopamine acts on D2 (pre-) which decreases NE levels, and inhibits vasconstriction at renal tubules, therefore there is no kidney SE while it also acts on B1 to elicit cardiogenic effects.
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What is the downfall of (high dose dopamine)?
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It also activates a1/a2 receptors (vasoconstriction at Renal Tubules) so you have to monitor renal function carefully.
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What are the side effects of Dopamine?
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nausea (since DA acts on the area postrema)
arrythmia ( since b1 effect) NO CNS side effects since it doesn't cross BBB. |
