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Flashcards in Vasopressors Deck (67):
1

Phenylephrine agonizes what SNS receptor

Pure alpha 1

2

Is phenylephrine a catecholamine

No, it is a synthetic noncatecholamine

3

Phenylephrine produces profound

arterial vasoconstriction

4

What effect does phenylephrine have on SVR

Increased

5

What effect does phyenylephrine have on BP

Increased

6

What effect does phyenylephrine have on contractility

No direct effect

7

What effect does phyenylephrine have on HR

Reflexive decrease from elevation of SVR

8

What effect does phyenylephrine have on CO

Decreased

-from baroreceptor reflexive decrease of HR
-increased afterload

9

What effect does phyenylephrine have on PAP

Increased

-alpha 1 receptors dominant in pulmonary vasculature

10

What effect does phyenylephrine have on CNS

Minimal effects

11

Phenylephrine is metabolized rapidly by

MAO


-DOA= 5 minutes

12

Pheylephrine is indicated for

Hypotension
Hypovolemia (until fluid restored)
SVT
Acute cyanosis

13

Epinephrine is considered a direct

mixed agonist

14

Epi directly agonizes

a1, a2, b1, b2 receptors

15

Does epinephrine cause the release of endogenous NorEpi

No

16

Is tachyphylaxis not with Epi administration

No

17

What catecholamine is the most potent alpha-adrenergic receptor activator

Epi

18

B1 receptors stimulated by epi cause an increase in

Systolic BP
HR
Inotropy
CO

19

Epi cause a -------- in diastolic pressure

decrease

* due to stimulation of B2 receptors of skeletal muscle vessels

20

Epi cause a -----in pulse pressure

increase

*systolic increase>diastolic with minimal change in MAP

21

Epi ------- the rate of ventricular relaxation

increases

22

How is epi metabolized

MAO

COMT

23

What two respiratory effects does epi have

bronchodilation (B2)

Inhibits antigen-induced release of inflammatory mediators from mast cells (B2)

24

Epi related positive inotropy, tachycardia, and increased myocardial oxygen demand will have what effect on myocardial cells

May induce or worsen myocardial ischemia

25

If Epi can cause what effect on tissues

necrosis d/t extravasation

26

Epi stimulation on the pancreas exerts what effect, how?`

Glucagon release from alpha cells via stimulation of alpha 2 receptor>>>>increased plasma glucose

Subsequently, increased glucagon leads to inhibition of glucose

27

Is Epi lipid soluble

No

*No CNS effects

28

Epi can be used to treat hyperkalemia by what mechanism

activaton of sodium-potassium pump in skeletal muscles

29

What are the indications for epi

Cardiac arrest
anaphylaxis/ bronchospasm
cardiogenic shock
Reduced CO after coronary bypass

30

How is coronary perfusion pressure increased by Epi

increases rate of ventricular relaxation and enhances LV filling which improves diastolic function

31

Don't give > how many mcgs of epi

10 mcg

32

What are the routes that epi can be administered

ETT
SQ
IV

*Don't give PO bc rapidly metabolized by GI mucosa and liver

33

Norepi directly agonizes what receptors

a1
a2
b1

34

What effect does Norepi have on SVR

Profound increase

*decreases venous return to the heart

35

Norepi causes a decrease venous return to the heart b/c of SVR increases which does what to the HR

Decreases

36

Norepi does what to the PAP

increases

37

How is Norepi metabolized

MAO
COMT

38

Norepi can what effect on end-organ perfusion and cardiac cells

reduced perfusion and myocardial ischemia

39

What effect can Norepi have on skin in unsafe doses

skin necrosis

40

What is the treatment for Norepi induced extravasation

Phentolamine

*alpha antagonist

41

Norepi is indicated for

Peripheral vascular collapse
Refractory SVR decreases

42

Ephedrine's primary effect is

indirect release of Norepinephrine from mobile pool 1


*adequate stores required to be effective
otherwise tachyphlaxis will develop

43

Epedrine's hemodynamic profile resembles what other catecholamine

Epinephrine

*Increased CO, contractility, HR, SVR (slightly), BP ( systolic and diastolic)

*however, with epi, the diastolic bp decreases d/t b2 vasodilation

44

Can ephedrine stimulate the CNS

Yes, cross the BBB

45

Ephedrine should be avoided in

patient's taking MAO inhibitors

46

Vasopressin can produce direct peripheral vasoconstriction via

activation of smooth muscle V1 receptors

47

Does vasopressin act on adrenergic receptors

No

48

What are the indications for Vasopressin

DI
hemorrhage from esophageal varices, sepsis, and catecholamine-resistant shock

refractory cardiac arrest

49

What is the distinction between vasopressin and epinephrine with regards to cardiac arrests

Vasopressin may increase coronary perfusion pressure without tachycardia as seen with epi

50

Adverse effects of vasopressing include

bronchoconstriction

uterine contractions

visceral hypoperfusion

thrombocytopenia

51

Dobutamine is a synthetic beta agonist catecholamine distributed as

a racemic mixture

* - isomer = potent alpha 1 agonist
* + isomer = potent 1 antagonist
Therefore, dobutamine is considered a Beta agonist

52

Dobutamine primarily agonizes

beta 1 receptors

53

Dobutamine agonizes ---- to a limited extent

B2

54

Dobutamine antagonizes -----at high doses

A1

55

Dobutamine causes what effects on SVR

decreased

56

Dobutamine causes what effects on BP

slight increase

57

Dobutamine causes what effects on HR

Dobutamine causes what effects

58

Dobutamine causes what effects on contractility

increased

59

Dobutamine causes what effects on CO

increased

60

Dobutamine causes what effects on LVEDP

decreased

61

Dobutamine causes what effects PAP

decreased via B2

62

How is dobutamine metabolized

COMT

63

What is the plasma half-life of dobutamine

2 minutes

64

Isoproterenol is a

direct acting b1, b2 catecholamine, agonist

65

Isoproterenol has what effect on SVR

Marked decrease via B2 stimulation of skeletal muscle, renal, and splanchnic vasculature

66

Isoproterenol has what effect on CO

Increased

67

Isoproterenol has what effecto on BP

variable

*Systolic increase only