Exam One Med Cards

Pharm: Adrenergic, agonist/sympathomimetic
Therapeutic: Anti-asthmatic, bronchodilator, vasopressor, cardiac stimulant

Stimulates alpha-adrenergic receptors, beta 1 adrenergic receptor, beta 2 adrenergic receptor.
Relaxes smooth muscle of bronchiole tree, produces cardiac stimulation, dilates skeletal muscle vasculature.
Indications: Management of cardiac arrest by increa

Norepinephrine (Levophed)
Pharm: Sympathomimetic/Alpha and Beta Agonist
Therapeutic: Cardiac Stimulant/ Blood Pressure Stabilizer

Indication: Blood Pressure Stabilizer
Stimulates beta1 adrenergic receptors, alpha adrenergic receptors. Increasing contractility, hr, and producing vasoconstriction. Increase in BP and coronary blood flow.
Adverse Effects: Extravasation -> tissue necrosi

Pharm: Adrenergic agonist/sympathomimetic
Therapeutic: Inotropic agent/ vasopressor

Indications: Adjunct to improve bp, cardiac output, and increase urine output in treatment of shock.
Stimulates dopaminergic and beta1 receptors producing vasodilation and larger doses ->alpha adrenergic receptors causing vasoconstriction.
Adverse Effect:

Pharm: anticholinergic
Therapeutic: anti-arrhythmic

Indication: Given preop to decrease oral and respiratory secretions (IM). Treatment of sinus brady and heart blocks (IM,IV), Treatment of exercise induced bronchospasms.
Inhibits action at postganglionic sites in smooth muscle, secretory glands, and CNS.

Beta Blockers (-olol)
Pharm: Beta Adrenergic Receptor Blocker
Therapeutic: Antiarrythmic, antianginal, antihypertensive

Indication: Prevention of MI, decreased mortality post MI, management of stable, symptomatic CHF, AFIB.
Blocks stimulation of beta1
Adverse Effects: Fatigue, weakness, anxiety, depression, dizziness, insomnia, mental status change, nervousness, blurred vi

Cardiac Glycoside - Digoxin

Action: Cause more forceful beats (positive inotropic effect) and slowly.
^ force of contraction= ^ cardiac output
Used to treat HF, AFIB, or tachycardia.
Contraindicated: Heart block, Vfib
Adverse Effects: dysrhythmias, anorexia, n/v/d, headache, weaknes

Renin Inhibitor
Therapeutic: Antihypertensive

Indication: Tx HTN
Action: Inhibits renin resulting in decreased formation of angiotensin II.
Adverse effect: cough, abdominal pain, diarrhea, dyspepsia, reflux, angioedema.

Angiotensin II Receptor Blockers (ARBs)
(-tan -> losartan, valsartan)
Therapeutic: antihypertensive agent

Indication: Management of HTN, Tx of CHF in patients that can not tolerate ACE inhibitors, reduction of stroke risk for CHF.
Blocks receptor for angiotensin II, disables RAAS.
Adverse Effect: Dizziness, HA, fatigue, hypotension, diarrhea, drug induced hep

ACE inhibitor (-pril)
Therapeutic: antihypertensive agent

Indication: Management of HTN, reduction of death to CHF and after MI, slowed progression of left ventricular dysfunction.
Blocks conversion of angiotensin to angiotensin II, a patent vasoconstrictor.
Adverse Effects: Dizziness, fatigue, HA, insomnia, wea

(Isosorbide mononitrate, dinitrate, nitroglycerine)
Pharm: Nitrate
Therapeutic: Antianginal

Indication: Acute (translingual & SL) and long term prophylactic (buccal, transdermal) management of angina pectoris, adjunct tx for CHF.
Increase coronary arterial blood flow by dilating coronary arteries improving collateral flow to ischemic, regions, p


Prolongs duration of myocardial cell action potential and refractory period by acting directly on cardiac tissue. Decreases AV and Sinus Node function.
Supresses Arrhythmias.
Indication: for a wide variety of ventricular and atrial arrhythmias. Decrease m


Anesthetic- Inhibits conduction of nerve impulses. Temporary loss of sensation
Anti arrhythmic- Inhibits ventricular arrhythmia.
(V tach & Vfib)


Prolongs duration of myocardial cell action potential and refractory period by acting directly on cardiac tissue.
Decreases AV and sinus function.
Suppress arrhythmia (V-tach, SVT, A fib w/ RVR)

Two types of calcium channel blockers

-pines: more selective to vascular smooth muscle
Ex: Amlodipine, Nifedipine
HTN & Angina
-Non-dihydropyridines: more selective to myocardium
Ex: Verapamil and Diltiazem
-Antiarrythmic for afib w/ RVR and SVT due to effect on myocytes and nodal tissue.

Calcium Channel Blocker
Adverse Effects, Contraindication, Teaching

Monitor bradycardia, hypotension + orthostatic, tachycardia, signs and symptoms of HF (weight gain, dyspnea, edema)
Could cause first degree block.
Contraindicated: 2nd and 3rd degree blocks
Do not take with grapefruit juice.
Increase fiber because it dec


A form of an anesthetic used for anesthesia, amnesia, analgesic
w/out complete loss of consciousness (conscious sedation)
Can cause: Hallucinations, sympathetic (Stress) stimulation, ?B/P, ? HR, may ? ICP
Quick onset 1-2 min and duration 5-10 min
Can be g

Dexmedetomidine (Precedex)

Short acting alpha 2 receptor agonist w/ sedative properties (May require breakthrough sedative)
Some analgesic properties
Minimal amnesic properties-> patient easy to arouse
Causes: Brady cardia, Hypotension
Doesn't cause resp depression while extubating

Propofol (Diprovan)

Adverse Effects: Injection site pain, allergic reaction (soybeans and eggs), pancreatitis due to increase in triglycerides, Propofol infusion syndrome (Brady arrhythmias. Asystole, metabolic acidosis, Rhabdomyolysis, hyperlipidemia).
FDA approved anesthet


Can be used as sedative, antianxiolytic, anticonvulsant, muscle relaxer and to induce amnesia
What can occur by using this class of meds?
�Resp depression (especially in elderly, hepatic, and renal insufficiency)
�Association has been found bet

Midazolam (Versed)

Short acting
Bolus or cont IV
Long term use = ?metabolites (elderly, renal & hepatic insuf)

Lorazepam (Ativan)

Intermediate acting
IM, Bolus, Cont IV infusion
Med is lipophilic = builds up in fat cells causing prolonged effect

Valium (Diazepam)

Not used much in critical care for sedative effect
Usually used for severe ETOH withdrawal
PO or IV push but NOT cont infusion

Benzo Antidote

Flumazenil (Romazicon)

Five reasons to use sedation

Ventilator tolerance
Safety & agitation
Sleep deprivation


Resistant to Acetylcholinesterase (an enzyme that rapidly breaks down Ach as to not overstimulate nerves, muscles, and exocrine glands).
Leads to prolonged depolarization Leads to transient fasciculations= intermittent flickering of muscles which eventual

Depolarizing Agent NMBA
(Sucs is the only one)

Ach receptor agonist = Mimic acetylcholine
Ach is the chief neurotransmitter of PNS of ANS (Contracts smooth muscle, dilates blood vessels, increase body secretions, slows HR)

Non-Depolarizing NMBA

They bind to Ach recpetors not allowing the ion channels to open, thus not allowing ions through to bind to Ach receptors, thus inhibiting depolarization or contraction.
Used to facilitate:
�Mechanical ventilation
�Tracheal Intubat