Vasopressors

Question 1

Dopamine: Receptors

Answer 1

Alpha 1, Beta 1, Dopaminergic

Question 2

Dopamine: Releases which Catecholamine

Answer 2

Norepi

Question 3

Dopamine: Effect on CO

Answer 3

Increase BP via peripheral vasoconstriction, little effect on stroke volume

Question 4

Dopamine: Effect on MAP

Answer 4

More effective than dobutamine, colloid, or hydrocortisone in increasing MAP

Question 5

Dopamine: Dosing Effects

Answer 5

Low dose: dopaminergic effect
Medium: primarily beta receptor effects
High: Primarily alpha receptor effects

Question 6

Dobutamine: Receptors

Answer 6

Alpha 1, beta 1, beta 2

Question 7

Dobutamine: Releases Catecholamine?

Answer 7

Does not release norepi

Question 8

Dobutamine: Effect on CO

Answer 8

Augments myocardial contractility, decreases afterload

Question 9

Epinephrine: Receptors

Answer 9

Alpha 1, Alpha 2, beta 1, beta 2

Question 10

Epi: Effect on MAP

Answer 10

Increases MAP and UOP

Question 11

Epi: Effect on CO

Answer 11

INcrease SV and HR

Question 12

Epi: Cautions

Answer 12

Peripheral ischemia
Tachycardia
Higher incidence of hyperglycemia and lactic acidosis

Question 13

Epi: Low Dose stimulate

Answer 13

Beta Receptors –> increase contractility and peripheral vasodilation

Question 14

Norepir: Receptors

Answer 14

Alpha 1, alpha 2, beta 1

Question 15

Norepi: Use

Answer 15

Greater than 35 weeks and refractory to dopamine or dobutamine

Question 16

Norepi: Effect on CO

Answer 16

Increases SVR more than PVR

Question 17

Vasopressin: Other Hormone Name

Answer 17

ADH

Question 18

Vasopressin: MoA

Answer 18

Regulating water balance:
Activates collecting duct of kidney to increase water absorption

Regulating Vascular tone:
vascular smooth muscle cells increase SVR

Question 19

Vasopressin: Vasodilatory effects

Answer 19

Pulmonary, coronary, and cerebral smooth muslce

Question 20

Vasopressin: Caution

Answer 20

Hyponatremia (retaining fluid leads to dilutional hyponatremia) and transmanitis

Question 21

Milrinone: MoA

Answer 21

Inhibits PDE-3 –> Increases cAMP

Improves contractility and myocardial relaxation

Question 22

Increase cAMP with Milrinone?

Answer 22

Enhances myocardial contractility while promoting vasodilation

Question 23

Milrinone: Beneficial for which conditions/diseases

Answer 23

PPHN, CDH, and post-ligation PDA

Question 24

Hydrocortisone: Electrolyte Effects

Answer 24

Decreased Na
Increased K
Decreased Cl
Increased Glucose

Question 25

Hydrocortisone: Use

Answer 25

Refractory initial vasopressor administration. Effective in increasing systemic BP and reducing catecholamine requirements through upregulation adrenergic receptors USE IN WARM SHOCK

Question 26

Hydrocortisone: Benefits

Answer 26

Improves endothelial integrity, reduces capillary leak, increases available calcium by myocardial and smooth muscle contraction

Question 27

Hydrocortisone: Negative Side Effects

Answer 27

Short term: hyperglycemia and gastric irritation Long term: Growth impairment, immunosuppression, osteopenia

Question 28

Dopamine: Dosage

Answer 28

5-20 microg/kg/min

Question 29

Dobutamine: Dosage

Answer 29

5-20 microg/kg/min

Question 30

Epinephrine: Dosage

Answer 30

0.01-0.03 microg/kg/min

Question 31

Norepinephrine: Dosage

Answer 31

0.02-0.1 microg/kg/min

Question 32

Vasopressin: Dosage

Answer 32

0.01-0.36 units/kg/hour

Question 33

Hydrocortisone: Dosage

Answer 33

Loading: 2mg/kg Maintenance: 0.5-1 mg/kg/dose, q6-8hr

Question 34

Milrinone: Dosage

Answer 34

Loading: 75 microg/kg Maintenance: 0.3-0.9 microg/kg/min

Question 35

Dopamine: | Effect on Stroke Volume, SVR, and PVR

Answer 35

SV: Increase SVR: Increase (x2) PVR: Increase (x3)

Question 36

Norepinephrine: | Effect on Stroke Volume, SVR, and PVR

Answer 36

SV: Increase/no effect SVR: Increase (x3) PVR: Decrease/no effect

Question 37

Vasopressin: | Effect on Stroke Volume, SVR, and PVR

Answer 37

SV: Decrease SVR: Increase (x3) PVR: Decrease

Question 38

Dobutamine: | Effect on Stroke Volume, SVR, and PVR

Answer 38

SV: Increase (x2) SVR: No effect PVR: No effect

Question 39

Milrinone: | Effect on Stroke Volume, SVR, and PVR

Answer 39

SV: Increase (x2) SVR: Decrease (x2) PVR: Decrease (x2)

Question 40

Epinephrine: | Effect on Stroke Volume, SVR, and PVR

Answer 40

SV: Increase (x3) SVR: Increase (x3) PVR: Increase (x2)