Sympathomimetic- Norepinephrine

Question 1

NE receptors

Answer 1

a1 a2 b1

minimal b2 per flood

Question 2

what medication is the immediate precursor to EPI

Answer 2

NE

Question 3

NE activates beta 1 which increases what 3 things in the heart

Answer 3

HR, conduction, and contractility

Question 4

NE is a potent alpha 1 agonist - what are the effects

Answer 4

intense arterial and venous vasoconstriction in all vascular beds

Question 5

does NE vasoconstrict the coronary arteries

Answer 5

no

Question 6

NE causes greater increase in what 4 things related to BP compared to EPI

Answer 6

SVR, SBP, DBP & MAP

Question 7

NE heart rate change is minimal due to what

Answer 7

baroreceptor reflexes triggered by arterial vasoconstriction are counter acted by beta 1 mediated increases in HR

Question 8

EPI or NE has a greater chronotropic effect

Answer 8

EPI

Question 9

higher doses of NE- what effect predominates

Answer 9

vasoconstriction

Question 10

NE and EPI increases total peripheral vascular resistance more than which drug

Answer 10

dobutamine

Question 11

what are the NE metabolic effects

Answer 11

minimal

Question 12

what are the effects in the blood sugar with NE

Answer 12

hyperglycemia is unlikely

Question 13

IV NE has intense vasoconstriction of what body systems

Answer 13

skeletal muscle
liver
kidneys
skin vascular beds

Question 14

NE has peripheral vasoconstriction such that what condition is seen

Answer 14

metabolic acidosis

Question 15

continuous infusion of NE dose

Answer 15

2-16mcg/min

Question 16

why do we place NE in a 5% glucose solution

Answer 16

prevents oxidation of the drug

Question 17

chronic infusion or increase in circulation of NE may be associated with what three things

Answer 17

pheochromocytoma

precapillary vasoconstriction

loss of protein free fluid into the extracellular spcae

Question 18

what additional monitoring is needed with NE

Answer 18

hemodynamic monitoring

Question 19

what additional vascular access do we need with NE

Answer 19

CVL- due to risk of extravasation

Question 20

metabolism of NE

Answer 20

eliminated by REUPTAKE into the ADRENERGIC NERVE ENDINGS where it is stored for future release

• only small amounts are metabolized

Question 21

NE is a first line agent to treat

Answer 21

refractory hypotension during severe sepsis

Question 22

after a CABG- why give NE

Answer 22

treat low systemic vascular resistance

Question 23

what is the primary use for NE

Answer 23

potent vasoconstrictor to increase PVR and MAP

Question 24

NE effects in splanchnic blood flow and UOP in severely hypotensive septic patients

Answer 24

increase in blood flow and urine output

Question 25

Why is NE used cautiously in patients with RV failure

Answer 25

alpha effects of... increases PAWP increases right partial pressure

Question 26

NE and increased peripheral resistance and increased after load will result in what

Answer 26

decreased CO and increase work of LV

Question 27

NE & hr

Answer 27

may cause tachycardia- more seen with EPI

Question 28

side effect of NE

Answer 28

organ ischemia

Question 29

NE and renal effects

Answer 29

renal arterial vasoconstriction may lead to oliguria and renal failure

Question 30

large doses of NE and adequate fluids volume resuscitation can do what to renal blood flow

Answer 30

increase perfusion pressure of renal blood flow

Question 31

how does NE augment stroke volume and CO

Answer 31

vasoconstriction and increase venous return due to decrease venous capacitance (The measure of a BLOOD VESSEL's ability to increase the volume of BLOOD it holds without a large increase in BLOOD PRESSURE. The vascular capacitance is equal to the change in volume divided by the change in pressure).