3 Vasoactive Meds Flashcards
Dobutamine is a
catecholamine
Dobutamine vasoactive effect
vasodilation
Dobutamine renal effect
INC blood flow and UO
Dobutamine main use
HF
Dobutamine effect on filling pressures
DEC
Dobutamine dose
2-20, 40 max
Dobutamine units
mcg/kg/min
Dobutamine effect on HR / CO / MAP
slight INC, INC
Dobutamine effect on afterload and preload
DEC
Dopamine indication
2nd line in sepsis hypoTN, hypoTN refractory to fluids
Dopamine effect on HR
INC
Dopamine effect on work
INC
Dopamine is a
catecholamine
Dopamine renal dose?
None
Dopamine dose
< 6, > 6
Dopamine units
mcg/kg/min
Dopamine CO / MAP / HR / afterload / preload
All INC
Epinephrine indications
ACLS
Epinephrine effect on contractility
INC
Epinephrine effect on HR
INC
Epinephrine effect on cerebral and coronary blood flow
INC
Epinephrine effect on vasomotor
vasocontriction (alpha)
Epinephrine dose
1-10
Epinephrine units
mcg/min
Epinephrine effect on PAC
INC all
Levophed indication in septic shock
first line
How does Levophed INC BP?
INC contractility and afterload with mild effect on CO
Levophed effect on HR
none
Levophed dose
2-30
Levophed units
mcg/min
Add what to Levophed after 20?
vasopressin
Levophed effect on afterload and preload
INC
Levophed effect on MAP
INC
Levophed effect on CO
Slight
Milrinone effect on vasomotor
vasodilation
Milrinone effect on HR
Little
Titrate Milrinone ?
No
Milrinone effect on CO
INC
Milrinone effect on myocardial O2 demand
no effect
Milrinone dose
.25 - .75
Milrinone units
mcg/kg/min
Milrinone half life
long
Milrinone bolus
.50 mcg/kg
Use _______ before Milrinone
Dobutamine
NTG indication
DEC preload and afterload in LV failure, myocardial ischemia (dilates coronary arts INC perfusion)
NTG effect on vasomotor
dilation
NTG effect on preload and afterload
DEC
NTG: arterial dilation achieved at ___ mcg/kg
1 mcg/kg
NTG does not dilate ________ arteries
calcified
NTG dose to DEC wedge
20-40 mcg/min
NTG dose to dilate arteries
50-250 mcg/min
NTG effect on HR/CO at 40-250 mcg/min
INC HR
Nipride used in ______ crisis
HTN crisis
Nipride dilation of both…
arteries and veins
Nipride effect on CO / HR
INC CO by DEC afterload on LV
Nipride effect on pulmonary HTN
DEC pulmonary HTN
Nipride dose
0.5 to 10
Nipride units
mcg/kg/min
Nipride effect on MAP, wedge, SVR, CVP
DEC
Nipride: causes massive hypoTN
Cyanide tox
Nipride: Cyanide tox: # of hours, dose > ___, brown cover…
> 72 hours, > 4 mcg/kg, brown cover left off
Neosynephrine vasomotor effect
vasoconstrictor
Neosynephrine: alpha _______
agonist
Neosynephrine slows HR by stimulating ….
barorecptors, INC vagal tone, DEC HR /CO
Neosynephrine dose
100 to 180
Neosynephrine units
mcg/min
Neosynephrine max dose
300 mcg/min
Neosynephrine MAP, wedge, SVR, CVP
INC
Vasopressin vasomotor effect
arterial constriction
Vasopressin use in shock
shock/hypoTN refractory to to catecholamine tx, not responding to Levo
Vasopressin GI use
GIB
Vasopressin ACLS dose
40 units IVP x1
Vasopressin CO/MAP, wedge, SVR
INC