Vasoactive drugs - down to the cellular level - Resources anyone?

sandman1 · Sep 23, 2004

vasoactive drugs.......down to the cellular level just means knowing what receptor sites the drugs bind to and how activating or blocking the sites would affect the body. For instance neosynephrine activates strictly alpha which causes vasoconstriction. Alpha1, alpha 2, beta1, beta2, dopaminergic, etc etc. Any high quality drug reference could tell you that. You should also acquire a phys book and self study the autonomic nervous system which would give you a good understanding of the receptors .......and then learn the drugs and exactly what they do "on the cellular level". I'm sure there are numerous websites that are good references to that material. One that I have found is familypracticenotebook.com. You can look up the drugs and get most of the info you need with a lot of the BS filtered out. good luck

Kiwi, BSN, RN · Sep 24, 2004

I know which school it is. :) I'll be applying there next yr. Look in IV med book, or PDR. Consult A&P teacher (mine had a good understanding of cellular-level physiology).

For example, Levophed (NE):

-receptor sites

-alpha stim.

-increased periph. resistance

-inotropic-> affects heart contractility->contractile state of the heart depends on intracellular Ca2+.

apaisRN, RN, CRNA · Sep 24, 2004

I've just sent in my apps (all but one, gotta finish the essay) and my personal strategy is to cram like hell for the CCRN exam with the goal of passing it by the end of the year. Most places aren't interviewing until after that, so I will have refreshed my knowledge for the interview and hopefully have CCRN certification to show for it.

If I had to know vasoactive drugs in particular, I'd make flashcards. What material is used in the critical care course your hospital is putting you through? Can you get hold of it early? I know I got boatloads of stuff in my internship, probably didn't even read half of it.

Brenna's Dad · Sep 24, 2004

Explaining the G-protein linked mechanism I'm sure would be impressive.

charles-thor · Sep 24, 2004

Katzung's Basic and Clinical Pharmacology has a nice section on vasoactive drugs that includes second messenger systems. Also, don't forget about vasopressin. I've heard some schools ask about it, and it throws some people off. Good luck!

rn29306 · Sep 25, 2004

We were required to purchase Basics of Anesthesia by Robert K. Stoelting / Ronald Miller (4th ed) by Churchill Livingstone publishing, ISBN # 0-443-06573-X. We were supposed to read this book prior to starting the program and we also have a small class based on this book, currently in our 2nd semester of srna school. I can honestly say that if you know this book, you will most certainly ace your interview as this book covers all aspects, including the in-depth material of anesthetics, mechanism of action, the cellular processes, and yes GABA and 2nd messenger activities. One of the most difficult concepts to grasp as an ICU RN was the autonomic nervous system and how anesthesia is the altering of this system. If you study up on the ANS and drugs, from this book or a similar book, I would say that you would be ahead of the curve as far as the other applicants. My interview progressed to the alpha and beta components of vasopressors, so I certainly know where you are coming from as being concerned with these concepts. Good luck in your interview. Let us know how you do.

gaspassah · Sep 25, 2004

i think there is an importance of having the basic understanding of how drugs work, where they work an how long they work. especially when you are in school.

however this kind of question always makes me ask...

do schools want informed intelligent ppl who know a whole lot of pharmacology and book info but have no common sense vs the student who is well rounded has a good personality, is teachable and has a basic understanding of physiology, pharmacology and anatomy.

there are programs who will tell you, dont worry about reading this or that, we will teach you what you need and what we want you to know.

so my question is, do you think this line of questioning is more about how you deal under pressure or what you know.

do you think as a student, not yet is school, a person is going to understand camp and gamp, posttetanic stimulation etc without some instruction and faculty help. and if they do expect this, do they skip this part then move on (from a faculty point of view)?

i always felt that grilling prospective students to be a waste. i always felt you miss out on really good candidates because they crank up the pressure. the interview is pressure enough to get a feel for a persons degree of pressure handling ability. wouldnt you want to know more about the person who you will have to deal with for the next 3 years?

d

Gump · Sep 26, 2004

Gaspassah,

I was just thinking along them same lines as you. I agree, I think most schools (maybe not all) they are looking for applicants who are "well rounded have a good personality, are teachable, and has a basic understanding of physiology, pharmacology and anatomy" Well said.

-Gump

CougRN · Sep 26, 2004

well said gas and gump. i believe that teachability is the key. we all come in to this with the desire to learn and hopefully the ability to learn. most nurses don't have a working knowledge of the information we learn in school, that is why we go to grad school. if it was required to know how to take care of our patients in the icu then we would have learned it already. i definately like the schools that want moldable students and not students who think they already know it all.

rn29306 · Sep 26, 2004

Good points are being made about the interview process. Our program director(the same guy that led our interview) was asked exactly what he looked for in an applicant as far as the interview goes. He said he looked for confidence mainly, not cockiness or arrogance. He said the interview would progress until the applicant either made something up (bad idea) or actually said "I don't know". The questions concerning the vasoactive drips I felt was relevant, as it had implications about ICU care. Questions concerning the bradycardic effect of some meds was asked and Swan numbers were asked about. While no one thinks you should know as much as a seasoned SRNA or CRNA, the fact that candidates use these drugs in daily in the units IS something that should be known and is certainly valid topics for a SRNA interview. While I didn't mean to imply that studying pre-interview would make a candidate appear "a know it all", I do think the schools look for a candiate that has some initiative in educating him/herself further than the minimum that is required.

Look at it this way: If you were a program director of an anesthesia school and one candidate was a great person, but had no clue of alpha1 properties of a drug that they use on a daily basis in their current job and the other candidate actually had a understanding of drugs they use now and will use in the future, which one would you actually choose?

Education is not synomous with arrogance or 'being a know it all'. All I know is what worked for me getting in school.

gaspassah · Sep 26, 2004

noone is trying to belittle your accomplishment nor your knowledge gained prior to getting into school.

what i was trying to say is that i think it is a little over the top to grill prospective students on swan numbers, what percentage of dopamine is alpha and beta, etc. not all nurses work with swans even with icu experience.

i dont know many icu nurses that actually contemplate the cellular action of dopamine when they start it. yeah they know what it does, and may know a little about how it works. but how often do you think they get to make the decision on what to use based on patient condition? not often i would think.

what i'm saying is, in the daily routine of the icu it's not imperitive to know these thingsin detail. what is imperitive is to have good assessment skills, communications skills, critical thinking skills, and a working knowledge of anat., physiology and pharm.

yes it show initiative if you have learned them and know it well.

i still believe tho that if there is something that the institution wants you to know, they will teach it to you. it's not imperitive to know it beforehand nor is it imperitive to grill the applicant on it either.

if an applicant is accepted for an interview then the school has a feeling from letters of recomendation, previous school history and a narrative letter from the applicant if they are a quality applicant.

equally important is finding out if the applicant takes on leadership roles, is teachable, and can integrate into the srna program without creating problems of interpersonal conflicts.

these of course are just my humble opinions.

d