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Critically Ill Exam 1 > Pressors And Inotropes > Flashcards

Pressors And Inotropes Flashcards

1
Q

Shock syndrome: Loss of intravascular fluids/volume

A

Hypovolemic

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2
Q

What are 4 examples of hypovolemic shock?

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

Shock syndrome: Loss of vascular tone

A

Distributive

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4
Q

What are 3 examples of distributive shock?

A
  1. Sepsis
  2. Spinal cord injury
  3. Anaphylaxis
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5
Q

Shock syndrome: Loss of pump function

A

Cardiogenic

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6
Q

Shock syndrome: Extra cardiac obstruction to blood flow

A

Obstructive

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7
Q

What are 4 examples of cardiogenic shock?

A
  1. Arrhythmias
  2. HF
  3. Acute MI
  4. Valve abnormality
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8
Q

What are 3 examples of obstructive shock?

A
  1. Tension pneumothorax
  2. Cardiac tamponade
  3. Pulmonary embolism
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9
Q

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

A

Beta-1

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10
Q

What type of receptor is located on the lungs?

A

Beta-2

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11
Q

What receptor is located on the arterioles?

A

Angiotensin-1

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12
Q

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

A
  1. Alpha-1
  2. V1
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13
Q

What receptor is located in the vasculature and causes vasodilation?

A

Beta-2

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14
Q

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

A

50%

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15
Q

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

A

60%

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16
Q

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

A
  1. NaCl
  2. LR
  3. Plasmalyte
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17
Q

What type of colloid will stay in the vascular space?

A

500 ml of 5% albumin

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18
Q

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

A

100 ml of 25% albumin

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19
Q

What is the low dose for Dopamine?

A

< 2 mcg/kg/min

20
Q

What receptors does low dose dopamine act on?

A
  1. Beta-1
  2. DA
21
Q

What is the moderate dose for dopamine?

A

10 mcg/kg/min

22
Q

What receptors does the moderate dose of dopamine act on?

A

1.Beta-1
2. Alpha-1

23
Q

What is the high dose for dopamine?

A

> 10 mcg/kg/min

24
Q

What receptors does high dose dopamine act on?

A
  1. Beta-1
  2. Alpha-1
25
Q

What is the indication for moderate dose dopamine?

A

Cardiogenic shock

26
Q

What is the indication for high dose dopamine?

A

Sepsis when norepinephrine isn’t available

27
Q

What is the drug of choice for sepsis?

A

Norepinephrine

28
Q

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

A

Increased Beta-1 activation

29
Q

What receptor does norepinephrine mostly act on?

A

Alpha-1

30
Q

What receptor does phenylephrine act on?

A

Alpha-1

31
Q

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

A

Phenylephrine

32
Q

What are the 3 vasopressors utilized?

A
  1. Dopamine
  2. Norepinephrine
  3. Phenylephrine
33
Q

What is the t 1/2 for the vasopressors?

A

1-2 minutes

34
Q

True or false: the vasopressors are metabolized by the liver

A

False

35
Q

True or false: vasopressors are not metabolized by the kidneys

A

True

36
Q

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

A
  1. Phentolamine
  2. Nitropaste
  3. Terbutaline
37
Q

What are the 2 inotropes that are utilized?

A
  1. Dobutamine
  2. Milrinone
38
Q

What are the 2 receptors that Dobutamine act on?

A
  1. Beta-1
  2. Beta-2
39
Q

What receptor does milrinone act on?

A

PDE III

40
Q

What is Dobutamine indicated for?

A

Decompensated HF

41
Q

Which inotrope has more SEs of arrhythmias?

A

Dobutamine

42
Q

What inotrope has more pronounced after load reduction?

A

Milrinone

43
Q

When does tolerance develop with Dobutamine?

A

After 48 hours of use

44
Q

What is the t 1/2 for Dobutamine?

A

1-2 mins

45
Q

What is the t 1/2 of Milrinone?

A

3-5 hours

46
Q

True or false: Milrinone is metabolized by the liver

A

True

47
Q

True or false Milrinone is metabolized by the kidneys

A

True

Critically Ill Exam 1 (7 decks)

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