Heart Failure/Shock

Question 1

Milrinone

Answer 1

Function: Inotrope & vasodilator, PDE3 inhibitor

Usage: Cardiogenic shock

Toxicity: Hypotension, arrhythmogenic

Question 2

Dobutamine

Answer 2

Action: Selective beta-1-adrenergic agonist (also has some alpha-1-adrenergic agonist activity).

Uses: Increase cardiac output.

Toxicity: Tachycardia; hypertension.

Other: Low doses preferentially increase force over rate of contraction of heart; higher doses increase both and used for stress tests.

Question 3

Dopamine

Answer 3

Uses: Agonist at dopamine, beta-adrenergic , and alpha-1-adrenergic recceptors.

Uses: Shock (especially w/ renal shutdown); heart failure; bradycardia.

Toxicity: Tachycardia; vasoconconstriction; local necrosis.

Question 4

Isoproterenol

Answer 4

Action: Non-selective beta-adrenergic receptor agonist.

Uses: Bradycardia; heart block; bronchospasm; hypoperfusion states.

Toxicity: Blurred vision; tachycardia; hypotension.

Question 5

Phenylephrine

Answer 5

Action: Alpha-adrenergic receptor agonist.

Uses: Nasal congestion.

Toxicity: Hypertension; bradycardia; CNS stimulation; headache; urinary retention.