Vasopressure Drugs

Question 1

Dobutamine trade name

Answer 1

Dobutrex

Question 2

Dobutamine generic name

Answer 2

Dobutamine

Question 3

Dobutamine classification

Answer 3

Inotropics, Adrenergics

Question 4

Dobutamine actions

Answer 4

Stimulates beta 1 adrenergic receptors with minor effect on heart rate or peripheral blood vessels. Stimulates beta 2 adrenergic receptors causing vasodialation. Increased cardiac output without increased heart rate significantly.

Question 5

Dobutamine onset and duration

Answer 5

1-2 minutes. Brief <1 minute

Question 6

Dobutamine indications

Answer 6

Cardiogenic shock, hypotension, low cardiac output, reduced perfusion.

Question 7

Dobutamine contraindications

Answer 7

Hypersensitivity, use with caution in pts with Afib, MI, history of HTN

Question 8

Dobutamine side effects

Answer 8

Headache, dysrythmias, tachy, HTN, n&v

Question 9

Dobutamine route

Answer 9

IV

Question 10

Dobutamine dose adult

Answer 10

2.5-15mcg/kg/min. Titrate to response. Max dose 40mcg/kg/min.

Question 11

Dobutamine peds dose

Answer 11

Same as adult

Question 12

Dobutamine supplied

Answer 12

250mg/20ml

Question 13

Dobutamine special considerations

Answer 13

Pret Cat: not established.

Toxicity overdose, only treatment is reduce kr DC use.

Question 14

Dopamine trade name

Answer 14

Dopastat, Intropin

Question 15

Dopamine generic name

Answer 15

Dopamine

Question 16

Dopamine actions

Answer 16

Dopamine is vasopressive agent that exhibits various resoonse. Depending on the dose administrated. Low dose (1-2mcg/kg/min) stimulates, dopaminergic receptors that cause vasodilatation of the renal mesentric arteries that increase the force of contraction of the heart to increase blood pressure. Above 10mcg/kg/min there is stimulation of alpha receptors in the systemic arteries that cause vasocontriction and increased peripheral vascular resistance.

Question 17

Dopamine onset and duration

Answer 17

2-4 minutes/ 10-15 minutes

Question 18

Dopamine indications

Answer 18

Hemodynamically significant hypotension in the absence of hypovolemia. Symptomatic bradycardia as a second line medication.

Question 19

Dopamine contraindications

Answer 19

Tachydysrhthmias, ventricular fibrillation, hypovolemia

Question 20

Dopamine side effects

Answer 20

HTN, Vfib, increased myocardial oxygen demand, headache, anxiety, N&V

Question 21

Dopamine route

Answer 21

Iv infusion

Question 22

Dopamine dose adult

Answer 22

2-20mcg/kg/min usually started at 5-10mcg/kg/min and titration to systolic blood pressure of 90 ir 100

Question 23

Dopamine dose peds

Answer 23

2-20mcg/kg/min titration to pt response

Question 24

Dopamine drip mix

Answer 24

400 MG in 500ml NS or 2pp MG in 250 ml NS to give 800 mcg/mL; 400mg in 250mL to give 1600mcg/mL

Question 25

Dopamine supplied

Answer 25

200mg/5mL (40mg/mL) or 400 mg/5mL (80mg/mL) prefilled syringes and ampules.

Question 26

Dopamine special considerations

Answer 26

Preg Cat: C. Infuse thru large stable vein to avoid possible extravasation injury. Very potent presser. Do not mix with sodium bicarbonate.

Question 27

Epinephrine 1mg/1ml trade name

Answer 27

Adrenaline

Question 28

Epinephrine 1mg/1ml generic name

Answer 28

Epinephrine 1mg/1ml

Question 29

Epinephrine 1mg/1ml classification

Answer 29

Endogenous catecholamine , sympathomimetic

Question 30

Epinephrine 1mg/1ml action

Answer 30

Epinephrine contains both alpha 1 and beta 2 properties l. It is both a chronotropic and inotropic drug as well as potential bronchodilator.

Question 31

Epinephrine 1mg/1ml onset and duration

Answer 31

SQ: 5-10 minutes; IV/ET; 5-10 minutes. IM 5-10 minutes.

Question 32

Epinephrine 1mg/1ml indications

Answer 32

Acute allergic reaction, anaphylaxis, acute bronchial asthma

Question 33

Epinephrine 1mg/1ml contraindications

Answer 33

Hypersensitivity, hypovolemic shock, dilated cardiomyopathy

Question 34

Epinephrine 1mg/1ml side effects

Answer 34

Tachy, headache, N&V, restlessness, weakness, dysrythmias, hypertension, precipitation of angina pectoris

Question 35

Epinephrine 1mg/1ml route

Answer 35

IM, ETT, IV, IO

Question 36

Epinephrine 1mg/1ml dose adult

Answer 36

Anaphylaxis and asthma: .01mg/kg divided into 3 doses usually 0.3-.05 mg IM. Every 20 minutes for asthma. Every 5-15 minutes for anaphylaxis.

Question 37

Epinephrine 1mg/1ml dose peds

Answer 37

Anaphylaxis and asthma: IM .01 mg/kg (.01 mg/kg up to .3mL total dose q 15 minutes)

Question 38

Epinephrine 1mg/1ml peds dose drip mix

Answer 38

Children 2-20kg: Add 3mg (3mL) into 250 mL NS (12mcg/mL concentration). Using a 60 drip set, start the drip rate off at the pts weight in Kg to administer the infusion at .2mcg/kg/min. And titrate to effect.

Question 39

Epinephrine 1mg/1ml dose mix continued

Answer 39

21/40kg: add 6 mg (6mL) into 250 mL NS (24mcg/mL concentration). Using a 60 drip set, start the drip at a rate of half (1/2) the pts weight in Kg to administer the infusion at .2mcg/kg/min a day titrate to effect.

Question 40

Epinephrine 1mg/1ml supplied

Answer 40

1mg/mL ampules, 1mg/mL 30 mL vials

Question 41

Epinephrine 1mg/1ml special considerations

Answer 41

Epinephrine is light sensitive. Keep out of sun.

Question 42

Norepinephrine trade name

Answer 42

Levophed, levarterenol

Question 43

Norepinephrine generic name

Answer 43

Norepinephrine

Question 44

Norepinephrine classification

Answer 44

Sympathomimrtic, adrenergic agonist agent

Question 45

Norepinephrine actions

Answer 45

Vasoconstrictor that increases myocardial contractility. Given for hypotension, shock not caused by hypovelemia.

Question 46

Norepinephrine onset and duration

Answer 46

1-3 minutes. 5-10 minutes.

Question 47

Norepinephrine indications

Answer 47

Cardiogenic shock, Neurogenic shock, hemodynamically significant hypotension. (SBP <70mmHg)

Question 48

Norepinephrine contraindications

Answer 48

Hypersensitivity and hypotension pts with hypovelemia

Question 49

Norepinephrine side effects

Answer 49

Headache, dysrythmias, tachycardia, hypertension

Question 50

Norepinephrine route

Answer 50

IV

Question 51

Norepinephrine dose adult

Answer 51

Dilute 4mg in 250mL of D5; begin infusion at .05-.5mcg/kg/min (up to 30mcg/min); titrate to desired effect. (Usually begin at 2-4mcg/min).

Question 52

Norepinephrine dose peds

Answer 52

Dilute 4mg in 250mL of D5; begin infusion at .05-.1mcg/kg/min (mqx dose 2mcg/kg/min); titrate to desired effect.

Question 53

Norepinephrine supplied

Answer 53

1mg/mL in 4mL ampule

Question 54

Norepinephrine special considerations

Answer 54

Preg cat C. Infuse through large, stable vein to avoid extravasation and tissue necrosis. Do not administer in the same IV as alkaline solutions.