Hemodynamics of shock and sepsis Flashcards

1
Q

what type of shock should dopamine NEVER be used for and why?

A

Cardiogenic shock since it has increased risk of tachycardia and arrhythmogenesis

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2
Q

in which cases is dopamine recommended?

A

if the patient has a LOW arrythmia risk or significant bradycardia

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3
Q

what vasopressor is second line to norepi?

A

technically you want to add on vasopressin but epinephrine could also be considered second line

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4
Q

Norepinephrine MOA

A

potent alpha agonist with some B1 activity

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5
Q

Epinephrine MOA

A

nonslective a1 and b1 agonist with moderate b2 activity
**LOW dose mainly b1 activity
**HIGH dose mainly a1 activity

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6
Q

Dopamine MOA

A

low dose-dopaminergic
mod dose-b1 adrenergic
high dose- a1 adrenergic

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7
Q

Dobutamine MOA

A

b1 inotrope **incr contractility

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8
Q

Phenylephrine MOA

A
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9
Q

Angiotension II MOA

A
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9
Q

Vasopressin MOA

A
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10
Q

vasopressors with more alpha activity have what effect and when are they typically used?

A

they have more vasoconstriction

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11
Q

vasopressors with more beta activity have what effect and when are they typically used?

A

they have a gretaer effect on increasing cardiac output

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12
Q

what effects do both alpha receptors have

A
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13
Q

what effects are unique to alpha 1 receptors

A
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14
Q

what effects are unique to alpha 2 receptors

A
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15
Q

what effects are unique to beta 1 receptors

A
16
Q

what effects are unique to beta 2 receptors

A
17
Q

what effects do both beta receptors have

A
18
Q

what is the dose of vasopressin for septic shock?

A

0.03 units/min

19
Q

t/f vasopression and angiotensin 2 can be used as monotherapy

A

FALSE they are adjunctive agents

20
Q

is it better to keep increasing the dose of norepinephrine or add on vasopressin?

A

add on vasopressin!

21
Q

how is angiotensin II administered?

A
22
Q

when can inotropes such as dobutamine be used

A

when there is persistent hypoperfusion despite adequate fluid resuscitation