PGY3 - Vasotropic/Inotropic Drugs

Question 1

Norepinephrine

Answer 1

2-20 mcg/min IV

0.02-2 mcg/kg/min IV

1st line for sepsis/vasodilartory shock

Question 2

Epinephrine (Drip)

Answer 2

2-20 mcg/min

0.05-0.5 mcg/kg/min

A1, B1/2

Cardiogenic, Vasodilatory, ACLS

Question 3

Push Dose Epi

Answer 3

1 mL of 1:10K + 9 mL NS

–> 10 mcg/mL

Push 0.5-2 mL q2-5 minutes (5-20 mcg)

Question 4

Vasopressin

Answer 4

0.01-0.04 units/min

V1, V2

Sepsis adjunct

Question 5

Dopamine (Use not dose)

Answer 5

Vasodilatory Shock, Cardiogenic Shock

Question 6

Dobutamine (Use not dose)

Answer 6

ADHF, Cargiogenic SHock, Vasodilatory Shock

Question 7

Hypertension Tx - Dissection

Answer 7

• First Line - Esmolol
• Second Line (BB Contraindication)
  
  • Dilt First –> Decrease HR
  • Nitroprusside Second –> Decrease BP

Goals

HR 60

SBP 100-140

Question 8

Hypertension Tx - Pulmonary Edema

Answer 8

Nitroglycerin

Goal reduce by 20%

Question 9

Hypertension Tx - ACS

Answer 9

Treat if SBP > 160, goal reduce by 20%

Nitroglycerin or Metoprolol

Question 10

Hypertension Tx - Renal Failure/Enceph

Answer 10

Treat > 180/110, Reduce by 20%

Labetalol or Cardene

Question 11

Hypertension Tx - Pre E

Answer 11

Treat if > 160/110

Labetalol or Hydralazine

Question 12

Hypertension Tx - ICH

Answer 12

• Cardene or Esmolol or Labetalol
• Goals:
  
  • No Inc ICP - SBP < 160, MAP < 130
  • Inc ICP - MAP < 110

Question 13

Hypertension Tx - CVA

Answer 13

• Cardene or Nitro or Labetalol
• Goals:
  
  • tPA - < 180/110
  • If no tPA - < 220/120

Question 14

Nitroglycerin

Answer 14

• SL = 0.4 mg x 3 doses
• Topical - 1-2 inches paste
• 20-80 mcg/min IV