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Unformatted text preview: spinal anesthesia) or norepinephrine (for
myocardial shock following myocardial infarction) – Replace blood volume
• whole blood, blood constituents (like cells, plasma, or
proteins), & plasma substitutes (like dextran) Does it surprise you that these 3 mechanisms would be
used to increase BP? Antihypotensive Agents
• Therapeutic Uses
– Chronic hypotension - not defined as a specific B.P.
• treated only if symptomatic, i.e. fainting, incr. H.R.
• might use phenylephrine - alpha agonist – Acute hypotension - usually in hospital - often an emergency
• spinal anesthesia - ephedrine (alpha & beta), metaraminol
(alpha), phenylephrine (alpha)
• during surgery - pick alpha agonist (beta may cause cardiac
• myocardial shock - probably N.E. (stimulate heart as well as
• cardiac surgery - dopamine (mild beta & alpha agonist with
added vasodilator effects that help increase sodium ion
• hypovolemic shock
• (1) replace blood volume then
• (2) drugs that mildly dilate and increase C.O. (dopamine, isoproterenol)
• No Contraindication (emergency) Caution: NOT FOR CHRONIC THERAPY Shock: Note signs of
sympathetic stimulation Early
in Shock Antianemic or Hemopoietic Drugs
• Mechanism of Action - replace missing factors
– iron - microcytic - component of hemoglobin
– vitamin B12 - macrocytic anemia
• coenzyme for synthesis of DNA and other cell component – folic acid (also a "B" vitamin) - macrocytic anemia
• needed for amino acid and DNA synthesis – red blood cells, whole blood
– erythropoietin now available as a drug called
Epoetin Alfa (Epogen®) • Therapeutic Uses - treat anemias
• Side or Toxic Effects - chiefly with iron
– headache and G.I. symptoms
– some overdoses in children have caused death • Cautions:
– Iron, human blood components, folic acid Some New Hemopoietic Agents
• For chemotherapy patients
– new stimulating factors for WBC’s and thrombocytes.
– Caution: possibility of stimu...
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This document was uploaded on 02/07/2014.
- Spring '14