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Drugs #1

pharmacology final

QuestionAnswer
What class is epinephrine (1:10,000) Sympathomimetic, vasopressor, bronchodilator
What are the mechanisms of action for epinephrine (1:10,000) 1.) Beta stimulation leads to increased inortropic, chronotropic, and dromotropic effects. Increased CO. Increased myocardail oxygen requirements.
What are the MAO for epinephrine (1:10,000) 2.) Beta 2 stimulation leads to peripheral vasodilation and bronchodilation
What are the MAO for epinephrine (1:10,000) 3.) Alpha 1 stimulation leads to peripheral vasoconstriction, increased SVR, Makes heart more susceptible to countershock, increased afterload
What are the MAO for epinephrine (1:10,000) 4.) Inhibits histamine release (stops degranulation) during anaphylactic reactions
What are the indications for epinephrine (1:10,000) 1.) Asystole 2.) Vfib, pulseless Vtach 3.) PEA 4.) Severe anaphylaxis
What are the contraindications for epinephrine (1:10,000) 1.) Hypersensitivity 2.) Patients with underlying cardiovascular disease 3.) Tachyarrhythmias 4.)Hypovolemic shock 5.) Not with alkaline drugs
What are the CNS side effects for epinephrine (1:10,000) Anxiety, dizziness, headache, restlessness, SUBARACHNOID HEMORRHAGE, tremors, weakness
What are the cardiovascular side effects for epinephrine (1:10,000) Anginal pain, DYSRHYTHMIAS, hypertension, PALPITATIONS, ischemia
What are the GI/GU side effects for epinephrine (1:10,000) nausea (c), vomiting (c), urinary retention
What are the respiratory side effects for epinephrine (1:10,000) dyspnea
What are the skin side effects for epinephrine (1:10,000) pallor, coldness, necrosis, urticaria
What are the eye side effects for epinephrine (1:10,000) pupil dilation
What are the precautions for epinephrine (1:10,000) 1.) increased myocardial workload may lead to ischemia, infarction
What are the precautions for epinephrine (1:10,000) 2.) Hypersensitivity (may have increased airway resistance due to sulfites in the preparation)
What are the precautions for epinephrine (1:10,000) 3.) Use cautiously in patients with: -heart disease -diabetes -hypertension -given along with other sympathomimetics or with phosphodiesterase inhibitors (caffeine, amiophylline, dipyridamole, erectile dysfuntion meds)
What are the precautions for epinephrine (1:10,000) 4.) Deactivated with sodium bicarbonate/lasix (alkaline solutions)
What are the precautions for epinephrine (1:10,000) 5.) Patients on MOA inhibitors (marplan, nardil, parnate) potentiates the effects
How is epinephrine (1:10,000) supplied 1mg/10mL = 1:10,000 prefilled syringe
How is epinephrine (1:10,000) administered IVP, IO, ET
How is epinephrine (1:10,000) given (dose) - cardiac arrest 1mg (1:10,000) IVP or IO Followed by a 20mL flush Raise the patients arm for 10-20 seconds Repeat every 3-5 minutes
How is epinephrine (1:10,000) given (dose) - anaphylaxis 0.1mg (1mL) SIVP (1:10,000) over 5 minutes repeat in 5-15 minutes PRN
What is dopamine class Sympathomimetic, vasopressor
What are the MAO for dopamine catecholamine that stimulates dopaminergic, beta, and alpha adrenergic receptors (dose dependent) Naturally occuring precursor of norepinephrine
What is the MAO for dopamine (low dose) Low doses (dopaminergic stimulation) leads to : (0.5 to 2mcg/kg/min) - NOT used in the field -Renal, mesenteric, cerebral, coronary vasodilation -Increased urinary output
What is the MAO for dopamine (intermediate dose) Intermediate doses (beta 1 stimulation) leads to: (2 to 10mcg/kg/min) -positive inotropic, chronotropic, dromotropic effects -increased cardiac output -increased myocardial oxygen requirements
What is the MAO for dopamine (high dose) High doses (alpha 1 stimulation) leads to peripheral vasoconstriction: (10 to 20mcg/kg/min) -Arterial and venous vasoconstriction (vasopressor) -Increased SVR -Vasoconstriction to renal, mesenteric, and coronary vessels -Increased afterload
What are the indications for dopamine cardiogenic shock, neurogenic shock, septic shock, hypotension that occurs after ROSC, symptomatic bradycardia (refractory, not responding to oxygen, atropine, or pacing), symptomatic heart blocks (2nd type 2 and 3rd), severe CHF
What are the contraindications for dopamine not used first line for hypovolemic shock, tachyarrhythmias or vfib, patients with pheochromocytoma (catecholamine producing tumor on adrenal gland), known hypersensitivity, not with alkaline solutions
What are the CNS side effects for dopamine headache (c), anxiety
What are the cardiovascular side effects for dopamine Anginal pain (c), tachycardia (c), ectopic beats (c), palpitations (c), vasoconstriction (c), aberrant conduction, hypertension (rise in diastolic pressure)
What are the eyes side effects for dopamine Dilated pupils (in high doses)
What are the respiratory side effects for dopamine dyspnea (c)
What are the GI effects for dopamine nausea (c), vomiting (c)
What are the skin side effects for dopamine gangrene (high doses for a long time), necrosis, tissue sloughing with extravasation
What are the precautions for dopamine 1.) May cause increased workload on the heart
What are the precautions for dopamine 2.) Hypoxia, hypercarbia, acidosis reduce drug effectiveness
What are the precautions for dopamine 3.) Tissue necrosis if it infiltrates
What are the precautions for dopamine 4.) High doses may cause pradoxical hypotension because the increased SVR = decrease in stroke volume and cardiac output
What are the precautions for dopamine 5.) Discontinue use gradually
What are the precautions for dopamine 6.) Deactivated with sodium bicarbonate/lasix (alkaline solutions)
What are the precautions for dopamine 7.) Patients on MAO inihibitors (Marplan, Nardil, Parnate) potentiates the effects
What are the precautions for dopamine 8.) Beta blockers may blunt the inotropic effects
What are the precautions for dopamine 9.) When given with phenytoin (dilatnin) - hypotension, bradycardia, and seizures may develop
What are the precautions for dopamine 10.) Given along with other sympathomimetics or with phosphyodiesterase inhibitors (caffeine, amiophylline, dipyridamole, erectile dysfunction meds) may exacerbate dysrhythmia respons
How is dopamine supplied -200mg/5mL -400mg/5mL -800mg/5mL READ LABEL CAREFULLY
How is dopamine given Administered: titrate intravenous infusion (IV infusion, piggyback)
How is dopamine prepared 200, 400, 800mg in 250-500mL Beta dose range: 2-10mcg/kg/mi (start at 2-5) Alpha dose range: 10-20mcg/kg/min (start at 10-15mcg/kg/min
What other name does dopamine go by intropin
What class is norepinephrine sympathomimetic, agonist, vasopressor
What is the MAO of norepinephrine Alpha 1 stimulation leads to peripheral vasoconstriction: -arterial/venous vasoconstriction -increased SVR -Increased afterload could result in increased back pressure on the heat leading to increased workload and O2 requirements
What is the MAO of norepinephrine Beta 1 stimulation leads to positive inotropic, chronotropic, and dromotropic effects, increased myocardial O2 requirements, increased cardiac output PREDOMINATELY ALPHA 1 STIMULATION DRUG
What are the indications for norepinephrine Use if other vasopressors aren't workikng - severe hypotension <70mmHg, drug of last resort -cardiogenic shock -neurogenic shock -septic shock -poison/drug induced hypotension -blood pressure support after resuscitation from cardiac arrect
What are the contraindications for norepinephrine 1.) hypotension due to hypovolomia (need appropriate fluid replacement first) 2.) profound hypoxia 3.) profound hypercarbia 4.) hypertension 5.) hypersensitivity
What are the CNS side effects for norepinephrine headache (c), restlessness, tremor, dizziness, anxiety
What are the cardiovascular side effects for norepinephrine reflex bradycardia, DYSRHYTHMIAS, CHEST PAIN, hypertension, palpitations, tachycardia, decreased cardiac output
What are the GI side effects for norepinephrine nausea (c), vomiting (c), organ ischemia
What are the GU side effects for norepinephrine oliguria, renal failure, organ ischemia
What are the respiratory side effects for norepinephrine distress, dyspnea, apnea
What are the eyes side effects for norepinephrine photophobia
What are the skin side effects for norepinephrine diaphoresis, gangrene, necrosis (with infiltration)
What are the precautions for norepinephrine 1.) Increases myocardial workload and O2 consumption 2.) If it infiltrates it can cause tissue necrosis 3.) May contribute to hypoxia due to pulmonary vasoconstriction
What are the precautions for norepinephrine 4.) Use cautiously with: -cardiogenic shock -acute MI -CHF -in the presence of hypoxia,hypercarbia, acidosis -MAO inhibitor therapy within 14 days (Marplan, Nardil, Parnate) -beta adrenergic antagnosists blunt the beta 1 effects
How is norepinephrine supplied 4mg/4mL
How is norepinephrine administered administered IV infusion (piggyback)
How is norepinephrine given (dose) Mix: 4mg/250mL or 8mg/500mL in D5W Dosage range: 0.1 to 0.5mcg/kg/min Titrate to systolic BP 90-110mmHg Higher doses may be needed for poison/drug induced hypotension CONSTANTLY ASSESS HEMODYNAMIC STATUS
What other name is norepinephrine have Levophed (leave em dead)
What class is propranolol non-selective beta-adrenergic blocker (beta 1 and beta 2), sympatholytic, antihypertensive, antianginal
What are the MOA of propranolol Blocks beta 1 receptors leading to: -depressed automaticity at the SA node -decreased AV node and intraventricular conduction -decreased heart rate and force of contraction -decreased myocardial O2 consumption -decreased BP
What are the MOA of propranolol Block beta 2 receptors leading to: -possible bronchoconstriction
What are the MOA of propranolol Decreases renin release from the kidneys (blocks beta 1 receptors in kidneys) -vasodilation
What are the indications of propranolol Stable supraventricular tachyarrythmias (refractory to other therapies - vagal maneuver and adenosine) -HR 150 and above
What are the indications of propranolol To prevent recurrent Vtach - HR 150 and above
What are the indications of propranolol Stable Afib/Aflutter with RVR - HR 150 and above
What are the indications of propranolol Stable MAT - HR 150 and above to prevent angina to treat hypertension
What are the contraindications of propranolol asthma/COPD bradycardia/heart blocks (second and third degree) CHF patients cardiogenic shock any patient with depressed cardiac function cocaine intoxication
What are the CNS side effects of propranolol depression, dizziness (c), drowsiness, fatigue (c), hallucinations, insomnia, lethargy (c)
What are the cardiovascular side effects of propranolol bradycardia, CHF, cold extremities, postural hypotension, profound hypotension, 2ND OR 3RD HEART BLOCKS, vasodilation
What are the GI side effects of propranolol diarrhea, dry mouth, nausea (c), vomiting
What are the eyes/ears side effecs of propranolol dry/burning eyes, visual disturbances
What are the metabolic side effects of propranolol hypoglycemia
What are the respiratory side effects of propranolol BRONCHOSPASMS, dyspnea, wheezing
What are the precautions of propranolol -DM -renal/hepatic disease -peripheral vascular disease -history of systemic sting reaction (anaphylactic reactions) -may mask the symptoms of hypoglycemia -myasthenia gravis
How is propranolol administered 1mg/1mL
What is the dose for propranolol? Initial dose: 1-3mg SIVP (1mg/min) - May dilute in 10-30mL Subsequent dose: May repeat dose in 2 minutes Total dose: 5mg
What is the other name for propranolol inderol
What do you give in toxic cases of propranolol IV calcium may restore BP in toxic cases IV glucagon - exerts positive inotropic action on the heart and decreased renal vascular resistance Effects may also be reversed with NE, dopamine, or epi Atropine should be available
Created by: m.cruzer