Therapies for Alterations in Hemodynamics

Question 1

Increases Preload

Answer 1

Volume expanders (crystalloids, colloids)
Pressors

Question 2

Decreases Preload

Answer 2

Diuretics
Dilators (Nitrates, nitroprusside, nesiritide)
Morphine

Question 3

Increases Afterload

Answer 3

Norepinephrine
Phenylephrine
High-dose dopamine (11-20 mcg/kg/min)
Epinephrine gtt

Question 4

Decreases Afterload

Answer 4

Nitroprusside
ACE inhibitors
Hydralazine
Calcium Channel Blockers
IABP
Nitroglycerin (high doses)

Question 5

Increases Contractility

Answer 5

Positive Inotropes…
Dobutamine
Dopamine 5-10 mcg/kg/min
Primacor
Epinephrine gtt

Question 6

Decreases Contractility

Answer 6

Negative inotropes (BB, CCB)
Metabolic problems (ex: metabolic acidosis, endotoxins of sepsis)