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22 Cards in this Set
- Front
- Back
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Dopamine
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low dose: 1-5 mcg/kg/min DA ceceptors vasodilate renal and mesneteric blood vessels
Medium dose: 5-10mcg/kg/min- beta1 effect-inc CO/slight BP inc High-10-15mcg/kg/min- Alpha effects vasoconstrictor used for sepsis |
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Dobutamine
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beta1 primarly, inc CO--> dec SVR & renal/mesenteric perfusion. HR may ^ at high doses expecially, (>5mcg/kg/min) causes less o2 demand
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Isoproterinol-isuprel
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beta 1 primarily effects beta 2 - + chrono/iono/dromotropic agent. some bronchodilation. B2 effect --> vasodilation and some venous pooling.. POst heart transplant to maintain higher HR. Sig inc in heart o2 demand
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Epinephrine-
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a & b stimulation peripheral vasoconstrictor(^ SBP/DBp/SVR) ionotrop/chronotopic agent(^HR/CO)
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Norepinephrine-levophed
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similiar to epi less beta 2- potent vasoconstrictor with some increase in CO and little effects on HR- first line alrternative to dopamine for septic shock- may cause mesenteric or limb ischemia
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phenylephrine= neosynephrine
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alpha agonist 1. potent vasocnstrictor. ^ MAP/CVP/SVR. no effect on dec CO/SV. may cause ischemia
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vasopressin
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v1 recfeptor agonist antidiuretic horomen- inc BP/SVR-improves response to catecholamines=expec acidosis
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milrinone-=
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phosphodiesterase inhibitor inc. cAMP. promote + inotropic /vasodilator activity- hemodynamic effects(inc CO/contractility/dec. PVR/SVR) hypotension expecially likely if initial bolus is given
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nitroglycerin
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venous and art. direct vasodilator by increasing nitric oxide in vasculature-promo coronary artery dilation- decreases preload/afterload0more so preload-may decrease PA pressure. mya cause headaches. patients dedvelop tolerance if used > 72 hours
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sodium nitroprusside-snp nipride
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direct vasodilator- very potent and effects arterial and venous beds- has immediate onset and short duratino- hemodynamic effects- afterload reduction--used w/ inotropic support to promo inc CO. TOXic metabolite thiocyanate- with renal failure
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hydralazine-
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direct vasodilator-primary arteriolar dec-afterload0 longer onset and duration than nitroglycerin or nitroprusside- avialable IV or PO
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ACE inhibitors
-Enalapril/vasotec captopril |
block angiotensin 2 -vasoconstrictor
-may cause hyperkalemia |
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Esmolol-
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b1 specific ultra short activng tx sVT AF/flutter/sinus tach. used to treat HTN but effect on Bp is sig less than effec ton HR. turned on off and effects immediately seen. contorl rate during aortic dissection
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Metoprolol
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beta1 specific longer acting IV/po used for rate control and AF/flutter, maintenance antihypertensive therapy for HF post mi, CAD
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Atenolol -
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Beta 1 specific PO only , once daily dosing, may be BID
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Labetalol
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b1 2/alpha 1 -IV and po- more antihypertensive affects than b1 specific, still has some effect in dec. hr
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carvedilol
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b1/2 and alpha1 =po only, used in pt with hf for HR/BP control to decrease morality
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CCB
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dec hr contractility, inhibit ca influx into heart and vbascular smooth muscle- arterial vasodilation, decreased av nodal conduction, reduction in bp, may reduce cornary artery vasospasm
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CCB-dihydropyridine-(amlodipine, norvasc, nifedipine, felodipine
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no effect on av nodal conduction= strong vascular smooth muscle-= dec bp,svr, may cause REFLEX TACHYCARDIA and peri edema, use safe in HF
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CCB-Non -dihydropyridine:verapamil, diltizem,kcardizem
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greater effect on av nodal conduction hr control during a fib,svt , a flutter. first line in A FIB! provided sbp will tolerate > 95mmHG
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Digoxin
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cardiac glycoside- icnrease contractle forse, dec rate of conduction through sa /av nodes- tx af/flutter to slow ventricular response- Dig. tox= first dgeree av block-halo vision. dec dose by 1/2
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amiodarone
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class3 antiarrhythmic= delays ventricular repol. K+ channel blocker with some beta blocking activity. 1st lien for VF/pulseless VT 300mg bolus- used for af/flutter 150mg bolus, SVT - may cause hypotension, central line- qtc prolongation- interactions big time warfarin. increased INR
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