CV stimulants

Created by taratae 

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Small doses of Epi may do what?

decrease BP, because B2 vasodilator is more sensitive than the constrictor A receptors

Why is Epi coformulated with local anesthetics?

local vasoconstrictive effects slows absorption to keep injection where the dentist wants it to be

What does Epi do to heart?

powerful and direct cardiac stimulant, increases HR, shortens systole, increases CO, increases O2 consumption

Do catecholamines predispose to arrthymias?

yes they also predispose to sudden cardiac death

What does Epi do to coronary blood flow?

increases it, increases diastole duration and aortic pressure

What is epi good for in patients with cardiac arrest?

restoration of cardiac rhythm

what can be given if NE leaks out (would cause bad necrosis!)

phentolamine

what does NE do to CO, TPR, and SV?

decreases CO, increases TPR, increases SV

What is low dose dopa good for?

D1 action, vasodilates, good for improving GFR/renal perfusion/urine output

What does moderate dose dopa do?

D1 and B1 action, increases CO, and some D1 vasodilation

What does high dose dopa do?

Alpha agonist action, increases PVR and renal vasoconstriction

what receptor activity for Dobutamine

B agonist, enantiomers (+/-) A1 agonist (should cancel out)

what is T1/2 of dobutamine?

2 min

what does dobutamine do to CO, SV, and HR

increases CO
increases SV
does nothing to HR

What would dobutamine be used for?

short term treatment of cardiac decompensation (after cardiac surgery, CHF, acute MI)

What does isoproterenol do to CO and diastolic BP?

raises CO
lowers diastolic BP

when should isoproterenol be used?

in emergencies to stimulate HR in pts with heart block/bradycardia, esp before insertion of pacemaker, and in pts with torsades de pointes

What receptors does phenylephrine work on?

alpha

what does this do to arteries, BP, HR, CO

arterial vasoconstriction, raises BP, leading to a reflex drop in HR and CO

When might phenylephrine be useful?

control of hypotension associated with epidural (regional or spinal anesthesia)

where does ephedrine work?

direct agonist and alpha and beta receptors
enhances NE release

what does ephedrine do to HR, CO, TPR, BP

raises everything

what can ephedrine cause?

fatal arrhythmias, v fib

What ephedra containing herbs have been banned?

herbal products containing ephedra alkaloids, also ephedra is precursor of amphetamine and methamphetamine

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