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E stimulate heart as well as increase bp cardiac

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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 Antihypotensive • 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 arrhythmias) • myocardial shock - probably N.E. (stimulate heart as well as increase B.P.) • cardiac surgery - dopamine (mild beta & alpha agonist with added vasodilator effects that help increase sodium ion elimination) • 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 Shock: sympathetic stimulation Early Early Intervention in Shock Antianemic or Hemopoietic Drugs Antianemic • 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 Some • For chemotherapy patients – new stimulating factors for WBC’s and thrombocytes. – Caution: possibility of stimu...
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