Pharm - Vasopressor and Inotropes for shock

Question 1

inotropes

Answer 1

i. Dobutamine (Dobutrex)—β-1 adrenergic

ii. Milrinone (Primacor)—non-adrenergic PDE3 inhibitor

Question 2

vasopressors

Answer 2

i. Norepinephrine (Levophed)
ii. Epinephrine (Adrenalin)
iii. Phenylephrine (Neo-Synephrine)
iv. Dopamine (Intropin)
v. Vasopressin (Pitressin, Antidiuretic Hormone)

Question 3

dobutamine receptor sensitivity

Answer 3

B1 > B2 > a

Question 4

dobutamine pharmacologic effect

Answer 4

INT > VD > CHT

no VC

Question 5

dopamine receptor sensitivity by dose

Answer 5

0.5: none
2-5: B1
5-10: B1 > a
15-20: a > B1

Question 6

dopamine pharmacologic effects by dose

Answer 6

0.5: VS, INT, CHT minimally and equally
2-5: same as 0.5
5-10: VS, INT, CHT equally and slightly more than above
15-20: VC > INT and CHT

Question 7

epi receptor sensitivity by dose

Answer 7

.01-.1: B1 > B2 > a

0.1: a > B1 and B2

Question 8

epi pharmacologic effects by dose

Answer 8

.01-.1: INT > CHT

0.1: VC > INT and CHT

Question 9

norepinephrine receptor sensitivity

Answer 9

a***** > B1

no B2

Question 10

norepinephrine pharmacologic effects

Answer 10

VC&raquo_space; INT and CHT

Question 11

drug of choice for cardiogenic shock

Answer 11

i. Norepinephrine: initial vasopressor of choice
ii. Dobutamine: initial inotropic agent of choice in cardiogenic shock with lock cardiac output and maintained blood pressure

Question 12

drug of choice for septic shock

Answer 12

i. Norepinephrine: initial vasopressor of choice

ii. Epinephrine and dobutamine are add-ons to norepinephrine

Question 13

drug of choice for anaphylaxis

Answer 13

i. Epinephrine: initial vasopressor of choice

Question 14

drug of choice for hypovolemic shock

Answer 14

i. Norepinephrine: initial vasopressor of choice