154594
Description
Mind Map by abbey.g.herman, updated more than 1 year ago
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Created by abbey.g.herman
over 10 years ago
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Cardiac Drugs
- Vasodilators
- Nitroprusside
- Indications: HTN and
CHF without ischemia
- Side Effects: hTN, reflex
tacky, cyanide toxicity
- MOA: direct smooth m.
relaxation; decreases both
preload and after load
- Toxicity if >1mg/kg is given in 2.5 hour period.
Hallmark of cyanide toxicity: unexplained metabolic
acidosis. Treatment: sodium nitrate, thiosulfate
- Indications: HTN and
CHF without ischemia
- Nitroglycerin
- Indications: myocardial
ischemia, pHTN, systemic HTN
- Side Effects: hTN,
arrhthmias,
myocardial ischemia
- MOA: direct smooh muscle
relaxation; primarily reduces
preload
- Indications: myocardial
ischemia, pHTN, systemic HTN
- Nitroprusside
- Alpha and beta agnoists
- Epinephrine
- Indications: hTN, LV failure, bronchospasm
- Side effects: HTN, arrhythmias,
myocardial ischemia
- Small doses (0.01-0.05mcg/kg/min: Beta2 - bronchodilation prominent
4ug/min: Beta 1 --> improved LV fxn 10-20ug/min - alpha + beta
- Other effects: decreases RBF,
Increases CO and HR
- Indications: hTN, LV failure, bronchospasm
- Dopamine
- Indications: hTN, olifuria
- Side effects: HTN, tachycardia,
arrhythmias, myocardial ischemia
- UNIQUE in its ability to
increase contractility,
renal BF and GFR
- Other: less arrhythmogenic than eli; only
modest increase in HR; mix in D5Wto avoid
inactivation of catechol with alkaline
solution
- Dose effects: 1-2mcg/kg/min:
dopaminergic, 2-10 beta, >10
alpha
- Indications: hTN, olifuria
- Dobutamine
- Indications: heart failure
- Side Effects: HTN,
tachy, arrhythmias,
myocardial ischemia
- Selective beta 1 agonist - improves CO (esp if HR
and SVR are high); dose dependent increases in CO
without marked increases in HR or BP
- Indications: heart failure
- Epinephrine
- Phosphodiesterase inhibitors: lead to
increased c-AMP --> improved uptake,
storage and release of Ca from SR
- Amrinone
- Indications: short term CHF tx
- Side effects:
thrombocytopenia,
tachyphylaxis, hypoK, GI
effects
- Increases cardiac index while decreasing SVR and
cardiac filling pressures. HR unchanged/increases
very slightly. DOES NOT increase myocardial
oxygen consumption. Also enhances A-V
conduction; patients with atrial arrhythmias should
be pretreated with digitalis
- Indications: short term CHF tx
- Milrinone - enhanced vasodilatory properties
compared to amrinone; causes greater decreases
in LV pressure and BP than amrinone
- Amrinone
- Chronotropes - heart rate
- Atropine - 0.5mg q2min, total 2mg
- Isoproterenol: B1 + B2 - useful in 3rd degree
block and EMD. PROBLEM: may decrease SVR
and MAP while also increasing HR, contractility
and myocardial O2 consumption
- Atropine - 0.5mg q2min, total 2mg
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