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CPB Drugs
Harry Hoerr; CPB Drug Administration
| Question | Answer |
|---|---|
| What kind of drugs are: Halothane, Enflurane, Isoflurane, NO, and Ether? | Inhalation Agents |
| What kind of drugs are Heparin, coumadin, antithrombin III, Hirudin, and CPD? | Anticoagulants |
| What kind of drugs are protamine, sulfate, and Neutralase? | Anticoagulant antagonists |
| What kind of drugs are streptokinase, urokinase, t-PA, ReoPro? | Fibrinolytics and thrombolytics |
| What kind of drugs are DDAVP, Aminocaproic acid, and aprotinin? | Fibrinolytic Inhibitors |
| What kind of drugs are Quinidine, Procanamide, Lidocaine, Bretylium, Propranolol, Isoproterenol, Verapamil, Diltiazem, Esmolol, Nifedipine, Atropine, Epinephrine, Magnesium sulfate? | antiarrhythmics |
| What lind of drugs are Amrinone and Milrinone? | Cardiac Inotropic Agents |
| What do you give during total circulatory arrest? | Steriods, Pentobarbital, mannitol |
| What drugs do you give prior to the removal of the aortic cross clamp? | Lidocaine, MgSO4, mannitol (free-radical scavenger), steroids, and turn off isoflurane. |
| What would you give after the cross clamp is removed? | Calcium chloride |
| What is the mechanism of action for Isoflurane? | MOA unclear, INCREASES THRESHOLD FOR FIRING OF CNS NEURONS, may block ion channels be interacting with membrane lipids? |
| Does Isoflurane has low or high solubility? | Low solubility in blood leading to rapid induction. It has low organ toxicity, causes less cardiac arrythmias, and does not sensitize the heart to the action of epi |
| What is heparin composed of? | Composed of mucopolysaccharides of varying molecular weight and AT-III binding activity. |
| Does HMW or LMW heparin have greater efficacy? | LMW heparin has greater efficacy. |
| What is heparin mechanism of action? | Potentiates activity of antithrombin III over 1,000 fold, induces a conformational change that exposes the AT-III's active site, which inactivates THROMBIN & factors IXa, Xa, XIa, and XIIa. (inhibiting fibrinogen -> fibrin) |
| What is heparins half-life? | 2 hrs |
| What can you do if a conventional dose of heparin produces a negligible ACT (<480)? | -Give more heparin or if low AT-II levels you can give 2 units of FFP or commercial AT-III |
| What is Aprotinins MOA? | Inhibits FIBRINOLYSIS by inhibiting the conversion of plasminogen to plasmin. Protects platelet adhesive glycoproteins making them more resistant to damage during CPB. |
| When is the highest incidence of hypersensitivity reactions when taking Aprotinin? | When a patient has reexposure within six months. |
| What is the formula for determining NaHCO3 dose? | (base deficit x body weight (kg) / 3) x 0.5 |
| What is THAMs MOA? | It is an alkalizing agent that combines with H+ in the plasma to form HCO3 |
| What is hyperkalemia treated with? | hyperkalemia is treated with insulin and glucose, since insulin stimulates K+ and lucose uptake. Increased urine production (lasix) and hemoconcentration can also reduce K+ |
Created by:
allievisner2
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