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Pharm Units 17-19

Pharm - Units 17-19 Anti-hypertensive, Vasopressors, Anti-arrythmic Meds SPC

QuestionAnswer
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
Created by: mac6672