Inotropic therapy

Question 1

When is inotropic therapy initiated?

Answer 1

• fluid resuscitation is ineffective

Question 2

How effective is inotropic agents in treating sepsis?

Answer 2

treat life threatening hypotension + improve cardiac output

Question 3

why are adrenergic agents titrated slowly ?

Answer 3

due to complications like tachycardia + myocardial ischaemia

Question 4

MOA and use adrenaline (epinephrine)

Answer 4

• 1st line
• non-selective alpha , B adrenergic agonist
• increase CO + peripheral vasoconstriction
• increase lactate level = impair BF to splanchnic system (internal organs )

Question 5

MOA Dobutamine

Answer 5

• B-adrenergic agonist = increase CO + O2 delivery

- ONLY used in septic patients - adequate filling pressure + BP + low CO

Question 6

Dose of dobutamine

Answer 6

2-20mcg/kg/min - adults
5-15 mcg/kg/min - children
= increase CO , but HR increases significantly

Question 7

MOA Dopamine

Answer 7

• alpha, B adrenergic agonist with dopaminergic activity

Question 8

Low dose of dopamine 1-5mcg/kg/min

Answer 8

• maintain renal perfusion

= not used for renal protection as part of sepsis

Question 9

High dose dopamine > 5mcg/kg/min

Answer 9

• exhibit alpha + B-adrenergic act
• support BP
• improve cardiac func
  = increase SV + HR

Question 10

causes of dopamine

Answer 10

• tachycardia
• potential arrhythmia
• not used routinely for management septic shock