Cv Drugs

Front 1

Low dose dopamine causes _____
moderate dose dopamine causes _____
high dose dopamine causes _____

Back 1

renal vasodilation
beta 1 effects in the heart
vasoconstriction in peripheral vessels

Front 2

alpha 1 receptors

Back 2

postsynaptic located in smooth muscle throughout blood vessels, GI tract, GU system, eye, lungs, uterus
-vasoconstriction
(contraction of vascular smooth muscle, inc force of heart contraction, dilates pupils, bronchoconstriction, contracts prostate, uterine smooth muscle, sphincters of GI/GU tract, secretion from salivary and sweat glands, and inhibits insulin secretion & lipolysis

Front 3

selective beta 1 agonist

Back 3

dobutamine

Front 4

alpha 2 receptors

Back 4

pre- and post-synaptic
pre- inhibits NE release
post- hyperpolarizes CNS, dec MAC, dec sympathetic ouflow causing vasodilation & dec BP, contraction of some vascular smooth muscle, platelet aggregation

Front 5

hyperglycemia is unlikely with this sympathomimetic; what does it agonize?

Back 5

NE; alpha 1= alpha 2; beta 1>>> beta 2

(beta 2 agonist responsible for hyperglycemia)

Front 6

beta 1 receptors

Back 6

postsynaptic located in the heart
-chronotrophic (contractility)
-dromotrophic (conduction/irritability)
-inotropic (force)

Front 7

most significant metabolic effect of all catecholamines

Back 7

epinephrine (hyperglycemia)

Front 8

beta 2 receptors

Back 8

postsynaptic
-located in smooth muscle & glands
relaxation of resp, uterine & vascular smooth muscle causing bronchodilation, vasodilation, relaxation of uterus, GI/GU, vasodilation of skeletal muscle, glycogenolysis, lipolysis, gluconeogensis, insulin release

Front 9

most potent beta agonist

Back 9

isoproterenol
beta1=beta2>>>alpha

Front 10

dopamine 1 receptors

Back 10

postsynaptic
-vasodilation of renal, mesenteric, coronary, and cerebral blood vessels

Front 11

preferred over ephedrine b/c no incidence of fetal acidosis

Back 11

phenyelphrine

Front 12

dopamine 2 receptors

Back 12

presynaptic
-inhibit release of NE, N/V

Front 13

1/250th as potent as epinephrine

Back 13

ephedrine

Front 14

adrenal medulla releases 80% _____, which acts _______

Back 14

epinephrine, hormonally

Front 15

causes inc HR and contractility (not good for CAD pts)

Back 15

ephedrine

Front 16

endogenous catecholamines

Back 16

epi, NE, dopamine

Front 17

causes reflex bradycardia and inc flow to coronary arteries ( good for CAD pts, but don't use if pt's heart rate <50

Back 17

phenylephrine

Front 18

noncatecholamines, last longer b/c metabolizes by MAO only

Back 18

phenylephrine & ephedrine

Front 19

alpha1>>alpha2>>>beta

Back 19

phenylephrine

Front 20

direct acting noncatecholamine

Back 20

phenylephrine

Front 21

irreversible covalent binding to alpha receptors; used to reverse shock in trauma pts after volume replacement

Back 21

phenoxybenzamine

Front 22

indirect noncatecholamine

Back 22

ephedrine

Front 23

cardioselective beta antagonists

Back 23

metoprolol, atenolol, esmolol

Front 24

pt is on reserpine, what does indirect acting catecholamine do?

Back 24

ephedrine will not have an effect bc NE stores are depleted

Front 25

nonselective beta antagonists

Back 25

propanolol, timolol

Front 26

with ephedrine, you could get _____ intraop r/t _____ of receptors

Back 26

tachyphylaxis, down-regulation (desensitization)

Front 27

selective beta blockers allow for ____ to be unblocked, which is good for _________ (metoprolol, atenolol, esmolol)

Back 27

bronchodilation (asthmatics)
metabolic stability (DM)

Front 28

most potent alpha stimulant

Back 28

epinephrine
alpha1=alpha2
beta1=beta2

Front 29

give _____ with OD of selective beta blocker, give ____ with OD of nonselective beta blocker, give ____ with OD of pure antagonist (propanolol)

Back 29

atropine (7mcg/kg IV)
isoproterenol (2-25mcg/min)
dobutamine

Front 30

low dose of epi causes _____
moderate dose of epi causes ____
large dose of epi causes _______

Back 30

dec DBP
inc susceptibility to arrhythmias
vasoconstriction, dec RBF

Front 31

selective alpha 1 blocker, non-selective beta 1& 2 blocker (weak beta 2 agonist)

Back 31

labetelol

Front 32

beta blocker + epi = _____

Back 32

unopposed alpha 1, bronchoconstriction

Front 33

most common side effect of labetelol; good for ____ r/t prevention of reflex tachycardia & change in CO

Back 33

orthostatic hypotension
deliberate hypotension

Front 34

D1=D2>>beta>>alpha

Back 34

dopamine

Front 35

beta blockers are recommended for _____

Back 35

intermediate risk surgery w/CAD
high risk surgery (vascular) with CAD or high cardiac risk

Front 36

inhibits ventilatory response to arterial hypoxemia

Back 36

dopamine

Front 37

Stimulates formation of cAMP and causes a secondary release of catecholamines to improve CO

Back 37

glucagon

Front 38

Used for infiltration of sympathomimetic

Back 38

regitine (phentolamine)

Front 39

stimulates K+ channels to hyperpolarize atrial cells and slow AV node

Back 39

adenosine

Front 40

May mask the signs of acute blood loss

Back 40

labetelol

Front 41

Robin hood effect

Back 41

nitroglycerine

Front 42

CCB used primarily for its effects on the AV node. What is the dose?

Back 42

cardizem
0.25mg/kg IV over 2 min

Front 43

Inhibit Na/ K ATPase ion transport system causing ↑ contractility

Back 43

digoxin

Front 44

Used to treat refractory hypotension

Back 44

vasopressin

Front 45

Antihypertensive that must be discontinued 24hrs prior to anesthesia to avoid severe hypotension

Back 45

enalapril

Front 46

Suggested to start infusion of this drug with acute withdrawal of beta blockers

Back 46

propanolol at 3mg/hr

Front 47

Should be used cautiously with the elderly AND renal failure patients

Back 47

digoxin

Front 48

Binds irreversibly with receptors; Impairs compensatory vasoconstriction in trauma patients

Back 48

phenoxybenzamine

Front 49

Inactivated by MAO only (2)

Back 49

phenylephrine & ephedrine

Front 50

Given to convert cyanide to thiocyanate

Back 50

thianosulfate

Front 51

When used there is an increase likelihood of hypotension and hypothermia

Back 51

clonodine & precedex

Front 52

two classes that should be given preoperatively to a patient with a pheochromocytoma

Back 52

alpha blockers & beta blockers

Front 53

Allergic type symptoms due to excess circulating bradykinins

Back 53

ACE inhibitors

Front 54

Given to reduces dose and prevent rebound HTN of SNP

Back 54

propanolol (can also give captopril, enalapril)

Front 55

Significantly reduces plasma renin activity (used for CDH)

Back 55

esmolol

Front 56

Used for stroke reduction and often combined with thiazide diurectic

Back 56

losartan

Front 57

Orthostatic hypotension and possible bronchospasm in brittle asthmatics

Back 57

labetelol

Front 58

Used to diagnose pheochromocytoma

Back 58

clonodine

Front 59

Better HR protection than liodcaine and fentanyl

Back 59

esmolol

Front 60

↓CO in a normal heart but ↑ CO with heart failure

Back 60

nitroglycerin, digoxin

Front 61

↑ cGMP causing smooth muscle relaxation (↓intracellular Ca+, produced more in arteries than veins)

Back 61

nitric oxide

Front 62

What class can be given for acute cardiac failure

Back 62

selective PDE inhibitors

Front 63

(2) sympathomimetics that cause reflex bradycardia

Back 63

norepinephrine & neosynephrine (phenylephrine)

Front 64

↑ contractility in the presence of beta blockers

Back 64

glucagon (independent of receptor blockade)

Front 65

The 1st treatment of beta- blocker overdose

Back 65

atropine (0.5mg)

Front 66

Used for eye surgery, may cause apnea in neonates

Back 66

timolol

Front 67

coronary steal syndrome

Back 67

SNP

Front 68

long duration of action, 75% excreted unchanged in kidneys

Back 68

nadol

Front 69

Class that should be used with caution in diabetic patients is _____.
What 2 specific drugs in this class can be used for diabetics due to their selectivity.

Back 69

beta blockers (non-selective)
metoprolol, atenolol

Front 70

Substance that has antithrombotic properties

Back 70

nitric oxide

Front 71

What ACEI would be most appropriate for CAD patients?

Back 71

captopril (HR/CO unchanged)

Front 72

Use to treat SVT but additive myocardial depressant and vasodilation w/ volatile agents (not first choice)

Back 72

verapamil

Front 73

Given pre-op to CABG patients, and used prophylactically for angina

Back 73

sorbital (isosorbide dinitrate)

Front 74

↑ MAP and SVR but ↓ venous return and HR

Back 74

NE

Front 75

Coronary vasodilator but negative chronotrope

Back 75

adenosine

Front 76

Contractility is its principle effect

Back 76

ephedrine

Front 77

Additive PNS effect or dysrhythmias with SCh

Back 77

calcium channel blockers

Front 78

Used for cerebral vasospasm because it crosses the BBB

Back 78

nimotop

Front 79

Can ↓ its own metabolism and the metabolism of amide LA

Back 79

propanolol

Front 80

Can ↑ CO within 5 min but may cause hypotension and thrombocytopenia

Back 80

amrinone

Front 81

Inotrope + coronary vasodilating properties

Back 81

dobutamine

Front 82

Great inotrope, with little effect on HR and myocardial oxygen consumption allowing its use for post – pump

Back 82

milrinone

Front 83

Hypergylcemia, hypokalemia, hypomagnesiumia with acute administration

Back 83

albuterol

Front 84

May actually decrease the size of MI (1 specific drug, and 1 class)

Back 84

nitroglycerine, beta blockers

Front 85

Requires a higher dosage in smokers

Back 85

theophylline

Front 86

Ganglionic blocker that blocks ANS reflexes is ______.
What side effect may offset the benefit use of this drug?

Back 86

trimethaphan; tachycardia

Front 87

tx for coronary artery vasospasm

Back 87

nifedipine

Front 88

Most cardioselective beta antagonist

Back 88

atenolol

Front 89

Major side of GE sphincter relaxation indicating RSI

Back 89

theophylline

Front 90

Inhaled forms used to treat pulmonary HTN and ↓ECMO in neonates

Back 90

nitric oxide

Front 91

Life – threatening hyperkalemia with severe toxicity

Back 91

digoxin

Front 92

↓ MAC > 90%

Back 92

precedex

Front 93

Avoid with aortic stenosis or CAD. Which drug would you use?

Back 93

ephedrine; use phenylephrine

Front 94

Interferes with calcium ion transport, arterial vasodilation > venous and ↓ DBP > SBP

Back 94

hydralazine

Front 95

Class that causes fetal bradycardia, hypotension, hypoglycemia if given to maternal patient

Back 95

beta blockers

Front 96

What is the one major contraindication to administration of an ACEI

Back 96

renal artery stenosis

Front 97

Narrow therapeutic index of 10 – 20 mcg/ml. What is the major toxic effect?

Back 97

theophylline; dysrhythmias

Front 98

Selective blockade of alpha 1 receptors limits the reflex tachycardia unlike others in its class

Back 98

prazosin (minipress)