Hemodynamics of shock and sepsis Flashcards
(23 cards)
what type of shock should dopamine NEVER be used for and why?
Cardiogenic shock since it has increased risk of tachycardia and arrhythmogenesis
in which cases is dopamine recommended?
if the patient has a LOW arrythmia risk or significant bradycardia
what vasopressor is second line to norepi?
technically you want to add on vasopressin but epinephrine could also be considered second line
Norepinephrine MOA
potent alpha agonist with some B1 activity
Epinephrine MOA
nonslective a1 and b1 agonist with moderate b2 activity
**LOW dose mainly b1 activity
**HIGH dose mainly a1 activity
Dopamine MOA
low dose-dopaminergic
mod dose-b1 adrenergic
high dose- a1 adrenergic
Dobutamine MOA
b1 inotrope **incr contractility
Phenylephrine MOA
Angiotension II MOA
Vasopressin MOA
vasopressors with more alpha activity have what effect and when are they typically used?
they have more vasoconstriction
vasopressors with more beta activity have what effect and when are they typically used?
they have a gretaer effect on increasing cardiac output
what effects do both alpha receptors have
what effects are unique to alpha 1 receptors
what effects are unique to alpha 2 receptors
what effects are unique to beta 1 receptors
what effects are unique to beta 2 receptors
what effects do both beta receptors have
what is the dose of vasopressin for septic shock?
0.03 units/min
t/f vasopression and angiotensin 2 can be used as monotherapy
FALSE they are adjunctive agents
is it better to keep increasing the dose of norepinephrine or add on vasopressin?
add on vasopressin!
how is angiotensin II administered?
when can inotropes such as dobutamine be used
when there is persistent hypoperfusion despite adequate fluid resuscitation
