Vasoactive Adrenergic Meds - VASOPRESSORS

Question 1

PHENYLEPHRINE (NEOSYNEPHRINE) - a.k.a. “Neo”
Receptors

Answer 1

Pure Alpha-1

Question 2

PHENYLEPHRINE (NEOSYNEPHRINE) - a.k.a. “Neo”
Effects

Answer 2

vasoconstriction so an increase in SVR and BP; may also cause reflex bradycardia; mixed effects on cardiac output

Question 3

PHENYLEPHRINE (NEOSYNEPHRINE) - a.k.a. “Neo”
Concentration, Onset, Titrate, Dose

Answer 3

Concentration: 20 mg/250 ml or 40 mg/250 ml
Onset: 1 min
Titrate: Q3-5 min
Dose: 50-200 mcg/min (varies by hospital)

Question 4

PHENYLEPHRINE (NEOSYNEPHRINE) - a.k.a. “Neo”
Area(s) of Effect

Answer 4

peripheral blood vessels (veno-arterial); smooth muscles

Question 5

NOREPINEPHRINE (LEVOPHED) - a.k.a. “Levo”
Receptors

Answer 5

(+++) ALPHA - 1 (++) BETA - 1

Question 6

NOREPINEPHRINE (LEVOPHED) - a.k.a. “Levo”
Effects

Answer 6

vasoconstriction so an increase SVR, BP, HR, contractility, AV node conduction

Question 7

NOREPINEPHRINE (LEVOPHED) - a.k.a. “Levo”
Concentration, Onset, Titrate, Dose

Answer 7

Concentration: 4 mg/250 ml (also 2mg, 8mg, 16mg all in 250 ml)
Onset: 1 minute
Titrate: Q3-5 min
Dose: 1-12 mcg/min (varies by hospital)

Question 8

NOREPINEPHRINE (LEVOPHED) - a.k.a. “Levo”
Area(s) of Effects

Answer 8

blood vessels (veno-arterial)

Question 9

ISOPROTERENOL
Receptors

Answer 9

pure (+++) Beta-1; (+++) Beta-2

Question 10

ISOPROTERENOL
Effects

Answer 10

increase HR, less effect on contractility, increase CO, mixed effect on BP

Question 11

ISOPROTERENOL
Concentration, Onset, Titrate, Dose

Answer 11

Concent:
Onset: 1-5 min
Titrate:
Dose: 0.5-30 mcg/min

Question 12

ISOPROTERENOL
Area(s) of Effects

Answer 12

heart, peripheral vessels, smooth muscle

Question 13

EPINEPHRINE (ADRENALIN) - used in codes; last resort treatment for shock
Receptors

Answer 13

nonselective (mostly beta-1, beta-2, alpha-1)
mostly (+++) BETA - 1 (++) BETA - 2
low/high dose (+/++) ALPHA - 1

Question 14

EPINEPHRINE (ADRENALIN) - used in codes; last resort treatment for shock
Effects

Answer 14

Vasoconstriction, increase HR. Increase BP is not as much as levo effects; varied effects on SVR.

Question 15

EPINEPHRINE (ADRENALIN) - used in codes; last resort treatment for shock
Concentration, Onset, Titration, Dose

Answer 15

Concentration: 1 mg/250 ml
Onset: 1-2 min
Titrate: Q5-10 min
Dose: 1-10 mcg/min
(varies at hospitals;
more beta effects at lower doses,
more alpha effects at higher doses

Question 16

DOPAMINERGIC Receptor (Agonist)

Answer 16

~increases BP and cardiac activity
~vasodilation in renal system

Question 17

DOPAMINE
Receptors

Answer 17

(+/++) beta-1; (++) dopamine
*(also some alpha)
Low Dose - stimulates dopamine
Interm Dose - stimulates beta-1
High Dose - stimulates alpha

Question 18

DOPAMINE
Effects

Answer 18

~Vasoconstriction at higher doses so
increases SVR, BP—some increase
in HR and CO.
~Low doses: vasodilate

Question 19

DOPAMINE
Concentration, Onset, Titrate, Dose

Answer 19

Concentration: 400 mg/250 ml
Onset: 5 min
Titrate: Q10 min
Dose: 2-20 mcg/kg/min
(varies at hospitals)
renal effects (0.5-2)
inc. contractility (2-10)
*larger doses metabolized into norepinephrine causing more vasoconstriction than contractility

Question 20

DOPAMINE
Area(s) of Effects

Answer 20

heart; peripheral vessels; renal

Question 21

DOBUTAMINE
Receptors

Answer 21

both Beta-1 and Beta-2
(a little of alpha)

Question 22

DOBUTAMINE
Effect(s)

Answer 22

~inc. HR, CO, contractility (beta-1) but
minimal BP increase
~dec. SVR because of vasodilation

Question 23

DOBUTAMINE
Area(s) of Effect

Answer 23

heart and peripheral vessels

Question 24

DOBUTAMINE
Concentration, Onset, Titrate, Dose

Answer 24

Concent: 250 mg/250 ml
(500 mg/250 ml)
Onset: 1-2 min
Titrate: Q10 min
Dose: 2-20 mcg/kg/min