ANS Medications

Question 1

Phenylephrine

Answer 1

PURE ALPHA!

Increase: SBP/DBP/SVR

Decrease: HR d/t reflex bradycardia

Question 2

Norepinephrine actions

Answer 2

alpha, some beta

Increase: HR/BP/SVR… mostly vasoconstriction

Question 3

Epinephrine actions

Answer 3

Beta, some alpha

Increase: SBP/HR

Decrease: DBP/SVR d/t slight vasodilation from b receptors

Question 4

Dobutamine actions

Answer 4

PURE BETA!

Increase: SBP/HR

Decrease: DBP/SVR

Works on heart, vasodilation from b receptors, widened pulse pressure

Question 5

Dopamine actions

Answer 5

Dopamine, beta, alpha

Increase: SBP/HR

Decrease: DBP/SVR…decrease SVR in high doses

Question 6

Dopamine Dosing Effects

Answer 6

Low dose (2-5 mcg): stimulate dopamine receptors mainly in brain and kidney

Medium dose (5-10): B (heart) effects, vasodilates—> shock dose

High dose (10-15): B and A effects

Dopamine—>beta—>alpha

Question 7

Milrinone MOA

Answer 7

PDE III inhibitor: prevent breakdown of second messenger cAMP allowing catecholamine release

Increase: HR/Contractility, vasodilation

Question 8

Vasopressin Dosing

Answer 8

0.04-0.1 units/min

Question 9

Phenylephrine dosing

Answer 9

20-200 mcg/min

Question 10

Norepinephrine Dosing

Answer 10

1-20 mcg/min

Question 11

Epinephrine Dosing

Answer 11

1-20 mcg/min

Question 12

Dobutamine Dosing

Answer 12

1-20 mcg/kg/min

Question 13

Milrinone Dosing

Answer 13

37.5-75 mcg/kg bolus following by 0.375-0.75 mcg/min

Question 14

Adverse Effects of Dobutamine

Answer 14

Tachycardia, dysrhtymias, hypotension

Question 15

Adverse Effects of Dopamine

Answer 15

Tachycardia dysrhythmias, decrease PaO2, mesenteric hypoperfusion, GI motility inhibition, T-cell inhibition

Question 16

Adverse Effects of Epinephrine

Answer 16

Tachycardia, dysrhythmias, decreased PaO2, mesenteric hypoperfusion, increased lactase, hyperglycemia, immunomodulation

Question 17

Adverse Effects of NE

Answer 17

Mixed effects on myocardial performance and mesenteric perfusion, peripheral ischemia

Question 18

Adverse Effects of Phenylephrine

Answer 18

Mixed effects on myocardial performance, peripheral ischemia

Question 19

Adverse Effects of Vasopressin

Answer 19

Mixed effects on myocardial performance, mesenteric hypoperfusion, peripheral ischemia, hyponatremia, thrombocytopenia

Question 20

Ephedrine Action

Answer 20

Alpha and beta agonist

Direct (on receptor itself) and indirect (causes release of catecholamines)

Central (pass BBB) and peripheral

***will increase HR

Question 21

Ephedrine dosing

Answer 21

5 mg at a time up to …..