Pressors And Inotropes

Question 1

Shock syndrome: Loss of intravascular fluids/volume

Answer 1

Hypovolemic

Question 2

What are 4 examples of hypovolemic shock?

Answer 2

1. Surgery
2. Trauma
3. Hemorrhage
4. Severe Dehydration

Question 3

Shock syndrome: Loss of vascular tone

Answer 3

Distributive

Question 4

What are 3 examples of distributive shock?

Answer 4

1. Sepsis
2. Spinal cord injury
3. Anaphylaxis

Question 5

Shock syndrome: Loss of pump function

Answer 5

Cardiogenic

Question 6

Shock syndrome: Extra cardiac obstruction to blood flow

Answer 6

Obstructive

Question 7

What are 4 examples of cardiogenic shock?

Answer 7

1. Arrhythmias
2. HF
3. Acute MI
4. Valve abnormality

Question 8

What are 3 examples of obstructive shock?

Answer 8

1. Tension pneumothorax
2. Cardiac tamponade
3. Pulmonary embolism

Question 9

What type of receptor is located on the heart and liver?

Answer 9

Beta-1

Question 10

What type of receptor is located on the lungs?

Answer 10

Beta-2

Question 11

What receptor is located on the arterioles?

Answer 11

Angiotensin-1

Question 12

What 2 receptors are located in the vasculature and cause vasoconstriction?

Answer 12

1. Alpha-1
2. V1

Question 13

What receptor is located in the vasculature and causes vasodilation?

Answer 13

Beta-2

Question 14

What is a female patients % of total body water of body weight?

Answer 14

50%

Question 15

What is a male patients % of total body water of body weight?

Answer 15

60%

Question 16

What type of crystalloids can’t get into the intracellular space? 3

Answer 16

1. NaCl
2. LR
3. Plasmalyte

Question 17

What type of colloid will stay in the vascular space?

Answer 17

500 ml of 5% albumin

Question 18

What type of colloid pulls fluid from the interstitial space into the vasculature?

Answer 18

100 ml of 25% albumin

Question 19

What is the low dose for Dopamine?

Answer 19

< 2 mcg/kg/min

Question 20

What receptors does low dose dopamine act on?

Answer 20

1. Beta-1
2. DA

Question 21

What is the moderate dose for dopamine?

Answer 21

10 mcg/kg/min

Question 22

What receptors does the moderate dose of dopamine act on?

Answer 22

1.Beta-1
2. Alpha-1

Question 23

What is the high dose for dopamine?

Answer 23

> 10 mcg/kg/min

Question 24

What receptors does high dose dopamine act on?

Answer 24

1. Beta-1
2. Alpha-1

Question 25

What is the indication for moderate dose dopamine?

Answer 25

Cardiogenic shock

Question 26

What is the indication for high dose dopamine?

Answer 26

Sepsis when norepinephrine isn’t available

Question 27

What is the drug of choice for sepsis?

Answer 27

Norepinephrine

Question 28

Why does dopamine have a higher incidence of arrhythmias than norepinephrine?

Answer 28

Increased Beta-1 activation

Question 29

What receptor does norepinephrine mostly act on?

Answer 29

Alpha-1

Question 30

What receptor does phenylephrine act on?

Answer 30

Alpha-1

Question 31

What can be used as a substitute for hypotension during shock in patients who have developed tachycardia while on norepinephrine?

Answer 31

Phenylephrine

Question 32

What are the 3 vasopressors utilized?

Answer 32

1. Dopamine 2. Norepinephrine 3. Phenylephrine

Question 33

What is the t 1/2 for the vasopressors?

Answer 33

1-2 minutes

Question 34

True or false: the vasopressors are metabolized by the liver

Answer 34

False

Question 35

True or false: vasopressors are not metabolized by the kidneys

Answer 35

True

Question 36

What are 3 agents that can be used to treat extravasation of vasopressors?

Answer 36

1. Phentolamine 2. Nitropaste 3. Terbutaline

Question 37

What are the 2 inotropes that are utilized?

Answer 37

1. Dobutamine 2. Milrinone

Question 38

What are the 2 receptors that Dobutamine act on?

Answer 38

1. Beta-1 2. Beta-2

Question 39

What receptor does milrinone act on?

Answer 39

PDE III

Question 40

What is Dobutamine indicated for?

Answer 40

Decompensated HF

Question 41

Which inotrope has more SEs of arrhythmias?

Answer 41

Dobutamine

Question 42

What inotrope has more pronounced after load reduction?

Answer 42

Milrinone

Question 43

When does tolerance develop with Dobutamine?

Answer 43

After 48 hours of use

Question 44

What is the t 1/2 for Dobutamine?

Answer 44

1-2 mins

Question 45

What is the t 1/2 of Milrinone?

Answer 45

3-5 hours

Question 46

True or false: Milrinone is metabolized by the liver

Answer 46

True

Question 47

True or false Milrinone is metabolized by the kidneys

Answer 47

True