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Pharm Units 17-19
Pharm - Units 17-19 Anti-hypertensive, Vasopressors, Anti-arrythmic Meds SPC
| Question | Answer |
|---|---|
| Preload | Amount of blood returning to Right Heart. Lower preload = lower work load for Right Heart. Higher = higher work load |
| Afterload | Resistance to blood movement from Left Ventricle at systole. If Systemic Vascular Resistance(SVR) is low = low work for Left Heart. Higher SVR = higher work for Left Heart |
| Hypertension adversely alters what? Can result in? | Alters organ function. Can result in stroke. |
| Inderal (propranolo) | Sympathetic(Epi, NE, and Dopa) Blocker = Lowers BP. Anti-hypertensive |
| ACE inhibitors | given PO, act by interfering with angiotension II(strong vasoconstrictor)resulting in Lower BP. Anti-hypertensive |
| Vasotec | ACE inhibitor for Lowering BP. Swelling of the tongue = possible airway problem. Anti-hypertensive |
| Thiazides | Diuretic. Lowers BP by promoting sodium (NA+) loss = loss of sympathetic tone = blood vessels dilate Lowering BP. Anti-hypertensive |
| Nipride (sodium nitroprusside) | light sensitive, fast acting , rescue med for acute rise in BP. Given IV drip and require close monitor. Anti-hypertensive |
| ACE inhibitors do what to afterload? | Reduces = lower BP |
| Morphine sulfate | Drops preload AND afterload in tx of Left sided heart failure(MI). Relaxes smooth muscle surrounding blood vessels = Lower BP and hypotension. Anti-hypertensive |
| What are the Anti-hypertentive (BP Lowering)Meds? | Morphine sulfate, ACE inhibitors, Inderal, Nipride, Thiazides, Vasotec or M.A.I.N.T.V. |
| Vasopressors | Used to treat systemic hypotension or raise BP |
| Low blood pressure results in? | Lack of prefusion = death as absence of O2 and build up of acids take toll on cellular function |
| Dopamine (Intropine) | sympathomimetic to tx hypotension. In low dose promotes renal vasodilation and diuresis. In high doses stimulates Alpha1 receptors = vasoconstriction. Vasopressor |
| Levophed (norepinephrine) | very strong vasoconstrictor used ONLY when Dopamine fails to increase BP. Vasoconstriction so significant can result in ischemia and tissue necrosis. Vasopressor |
| Dopamine can be used to treat? | Heart failure (MI), by acting as a cardiac stimulant in moderate doses. Beta1 agonist promoting + inotropic and chronotropic. |
| Cardiac Glycosides | promote availibility of free Ca+ within myocardium = improved stroke volume. Vasopressor |
| Digitalis, Lanoxin, and Digitoxin | All cardiac glycosides used to tx heart failure. Efficacy and toxicity are associated with levels of potassium (K+). Higher K+ levels = lower efficacy, Lower K+ = Toxic |
| Digitalis Toxicity | caused by high levels of digitalis or decrease tolerance. Pts with decrease tol. may have normal levels. Cause from single exposure or chronic overmed. Risks = taking w/quinidine, verapamil, amiodarone. MI commonly given diuretics w/digoxin. Diuretics cau |
| Dobutrex (dobutamine) | sympathomimietic w/good Beta1 agonist effects to tx heart failure by improving stroke volume and vasodilation = lower workload on heart |
| What are the Vasopressor Meds? (BP rising)...thinks D w/LLC (D -press) | Dopamine, Levophed, Dobutrex, Cardiac glycosides, digitalis, digitoxin, Lanoxin), Dobutrex |
| What are the Anti-arrythmic Meds? C.C.A.A.A.L.I.E. | Cardizem, Calan, Amiodarone, Atropine sulfate, Adenocard, Lidocaine, Inderal, Epinephrine |
| Adeoncard (adenosine) | drug of choice to tx Paroxysmal Supraventricular Tachycardia (PSVT. Anti-arrythmic |
| Atropine sulfate | Tx of sinus bradycardia(slow heart rate) and other arrythmias. Anti-arrythmic |
| Cardizem (diltazem) | Ca+ channel blocker used to tx atrial fibrillation but can cause side effects of heart block. Anti-arrythmic |
| Calan (verapamil) | Ca+ channel blocker used to tx atrial arrythmias. Anti-arrythmic |
| Lidocaine | Tx of Premature Ventricular Contractions(PVCs) and othe ventticular arrythmias. Action by reducing sodium influx. Increases resting potential slowing nerve impulse conduction. Higher dose = production of Methemoglobin and seizure. Met reduces availability |
| Inderal ( propranolo) | Beta blocker tx of tachy arrythmias. Reduces hear rate but can cause bronchospasm. Anti-arrythmia |
| Epinephrine | Rescue sympathomimetic. Fast acting agonist to both Alpha and Beta receptors = stimulation of sympathomimetic recptors. Given during cardiac arrest to treat asystole. Anti-arrythmia |
| Nitrates and vasodilators to treat CHF. How? | Reduce preload, afterload, and corornary artery vasodilation from limiting free Ca+. |
| What do long term use of steroids do to pH? | Promotes retention of HCO3 and development of METABOLIC ALKALOSIS. Noted in COPD |
| What receptors does Racemic Epinephrine stimulate? | Alpha1 , Beta1 and Beta2 |
| Benefits of Methyxanthines? | 1. Enhance bronchodilation 2. Reduces PVR 3. Enhances the contraction and endurance of the Diaphragm 4. Improve Resp. drive 5. Positive ino and chrono 6. Improve stroke volume 7. Downgrade of inflammatory cells 8. Slows histamine, luekotrienes, and cytoki |
| What us DuoNeb? | SVN solution - .5mg ipratropium(atrovent) and 3mg albuterol sulfate |
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