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32 Cards in this Set

  • Front
  • Back
in most pts with high BP, there is no obvious cause; this is called?
essential HTN
pathogenesis of HTN?
1) > sympathetic activity
2) Na retention
3) > circulating volume
4) > vasucular rigidity and reactivity
5) > circulating catecholamines
6) > activation of the renin-angiotensin-aldosterone system
7) abnormal baroreceptor responses
as a general rule, elective surgery should be delayed if the resting DBP is greater than?
110 mm Hg
anti-hypertensive medications
1) diuretics (thiazide/loop)
2) ACE-inhibitors
3) Ca antagonists
4) direct vasodilator (Hydralazine)
5) beta-blockers
6) alpha 1-receptor antagonist (Prazosin)
anti-hypertensive drugs dose should be titrated against the response, because rapid falls in BP can cause?
1) reduced cerebral perfusion
2) infarction
Tx for severe HTN?
1) Lavetalol (Trandate)
2) Hydralazine (Apresoline)
3) Na nitroprusside (SNP, Nitropress)
Labetalol blocks?
both alpha-1 and beta adrenergic receptors
the ratio of alpha: beta activity?
Labetalol is used for?
1) emergent tx of severe HTN
2) pre-eclampsia
3) to provide hypotension for certain Sx procedures
half-life of Labetalol?
3-6 hrs
Labetalol can cause?
hepatic damage
Hydralazine (Apresoline) is?
1) an arteriolar vasodilator
2) so, reduces SVR
Hydralazine cause?
reflex tachycardia
onset of action?
may be up to 20 min.
side effects of Hydralazine?
1) headache
2) N/V
3) flushing
the use of Hydralazine in pts with ischmic heart disease can cause?
Hydralazine is used for?
pre-eclampsia pts to keep the BP below 170/110 mm Hg
Sodium Nitroprusside acts directly on?
vascular smooth muscle
Sodium Nitroprusside causes?
both arteriolar and venous dilation
What's the difference between Hydralazine and SNP?
Hydralazine dilate only artery, but SNP act on both artery and venous
similarity on both Hydralazine and SNP?
both cause reflex tachycardia
SNP: onset and duration?
1) very rapid onset
2) duration, only a few min.
SNP produce toxicity by production of?
all volatile agents depress?
myocardial contractility
all volatile agents except for halothane will decrease?
(cause <BP, and reflex tachycardia)
halothane anesthesia will cause?
1) bradycardia
2) nodal rhythms
(due to vagal stimulation)
3) no change in SVR
4) sensitizes the heart to the arrythmogenic effects of catecholamines
high levels of circulating catecholamines can cause?
1) V-tac/V-fib
(esp. in the presence of hypercarbia, which can occur in a pt spontaneously breathing halothane)
Ether causes?
1) sympathetic stimulation
2) catecholamine release
3) vagus nerve blockade
4) > CO, HR, SVR
(BP is well maintained)
Thiopental cause a reflex tachycardia mediatied by?
the barareceptor reflex
Propofol will cause?
1) marked fall in BP, SVR, and HR
Versed and Valium are associated with?
cardiovascular stability
(only high doses will cause CV depression)
Etomidate (Amidate) provides?
1) the most CV stability
2) has little effect on myocardial O2 balance