Vasoactive Drugs - Vasopressin Flashcards
Which of the following are correct dose ranges for Vasopressin administration? (Select all that apply)
A) 0.5-1 unit IV bolus
B) 5-10 units IV bolus
C) 0.01-0.04 units/min IV for maintenance
D) 1-5 units/min IV for maintenance
A) 0.5-1 unit IV bolus
C) 0.01-0.04 units/min IV for maintenance
-Bolus dose: 0.5-1 unit IV bolus (works fast and large increase in BP)
What is the correct concentration of Vasopressin when prepared as 20 units in 20 mL? (Select all that apply)
A) 1 unit/mL
B) 0.5 units/mL
C) 2 units/mL
D) 1 mg/mL
A) 1 unit/mL
Concentration: 20 units in 20mL = 1u/mL
Which of the following are true about the mechanism of action of Vasopressin? (Select all that apply)
A) Vasopressin activates adenylyl cyclase, which converts ATP to cAMP, leading to the activation of protein kinase A (PKA).
B) Vasopressin directly inhibits adenylyl cyclase to prevent ATP-cAMP conversion.
C) PKA activation causes phosphorylation of storage vesicles for Aquaporin-2 (AQP2).
D) Vasopressin causes vasodilation through V1 receptor activation.
A) Vasopressin activates adenylyl cyclase, which converts ATP to cAMP, leading to the activation of protein kinase A (PKA).
C) PKA activation causes phosphorylation of storage vesicles for Aquaporin-2 (AQP2).
What effect does Vasopressin have on Aquaporin-2 (AQP2)? (Select 2)
A) It increases the synthesis of AQP2 in renal tubular cells.
B) It causes premade AQP2 to move to the tubular lumen of the distal and collecting ducts.
C) It facilitates the reabsorption of water into the vasculature through AQP2 channels and vasoconstriction (V1)
D) It blocks AQP2 movement to the tubular lumen, decreasing water reabsorption.
Answers:
B) It causes premade AQP2 to move to the tubular lumen of the distal and collecting ducts.
C) It facilitates the reabsorption of water into the vasculature through AQP2 channels.
A) It increases the synthesis of AQP2 in renal tubular cells.
C) It facilitates the reabsorption of water into the vasculature through AQP2 channels and vasoconstriction (V1)
o MOA:
-Activation of adenylyl cyclase causes ATP-cAMP = PKA activation
-Phosphorylation of storage vesicles for AQP2
-Premade AQP2 move to tubular lumen of distal and collecting ducts to reabsorb water into vasculature(V2) and vasoconstriction(V1)
What is the onset time for Vasopressin’s pressor activity?
A) 30 minutes
B) 5 minutes
C) 15 minutes
D) Rapid onset, with peak pressor activity in 15 minutes
D) Rapid onset, with peak pressor activity in 15 minutes
What is the half-life of Vasopressin?
A) 15 minutes
B) 30 minutes
C) 60 minutes
D) 90 minutes
B) 30 minutes
Which of the following statements about the elimination of Vasopressin are correct? (Select all that apply)
A) Vasopressin undergoes extensive hepatic metabolism.
B) Approximately 35% of Vasopressin is metabolized via tissue peptidase.
C) Vasopressin is primarily eliminated via renal excretion.
D) Vasopressin is fully metabolized in the liver before elimination.
B) Approximately 35% of Vasopressin is metabolized via tissue peptidase.
C) Vasopressin is primarily eliminated via renal excretion.
Which of the following conditions can be managed with exogenous ADH?
(Select all that apply)
A. Cranial diabetes insipidus
B. Bleeding abnormalities
C. Esophageal variceal hemorrhage
D. Cardiac Arreset
E. Trauma
F. Shock patients
All of the Above
Which of the following statements accurately describe vasopressin as first-line therapy for ACEI or ARB-induced vasoplegia that is refractory to catecholamines?
(Select all that apply)
A. It works effectively in an acidotic environment.
B. It can potentiate the effects of vasoactive agents.
C. It is considered second-line therapy after methylene blue for this condition.
D. It is not effective in treating vasoplegia caused by ACEI or ARB.
E. It is used primarily for the management of hypertension.
A. It works effectively in an acidotic environment.
B. It can potentiate the effects of vasoactive agents.
Which of the following conditions is the vasopressin effective in treating?
A. ACEI or ARB-induced vasoplegia that’s refractory to catecholamines
B. Acidotic shock
C. Cardiac arrest
D. Sepsis-induced hypotension
E. Chronic hypertension
A. ACEI or ARB-induced vasoplegia that’s refractory to catecholamines
In the context of treating ACEI or ARB-induced vasoplegia, which drug is considered next in line after the primary therapy?
A. Methylene blue
B. Norepinephrine
C. Epinephrine
D. Vasopressin
E. Phenylephrine
A. Methylene blue
First line therapy for ACEI or ARB induced vasoplegia that’s refractory to catecholamines (methylene blue is the next best drug).
Which of the following is a contraindication for the use of vasopressin in resuscitation efforts?
A. Use as a sole resuscitation agent
B. Severe dehydration
C. Chronic kidney disease
D. Sepsis-induced hypotension
E. Trauma with significant blood loss
A. Use as a sole resuscitation agent
For which of the following conditions should the drug be used with caution?
(Select all that apply)
A. Heart failure (HF) with an inability to handle increased fluid and vasoconstriction
B. Acute myocardial infarction
C. Severe sepsis
D. Chronic hypertension
E. Trauma with significant fluid loss
A. Heart failure (HF) with an inability to handle increased fluid and vasoconstriction
Which of the following are potential side effects of vasopressin used for managing ACEI or ARB-induced vasoplegia?
(Select all that apply)
A. Increased blood pressure
B. Vasoconstriction
C. Increased intravascular fluid volume
D. Hypernatremia
E. Hyponatremia
A. Increased blood pressure
B. Vasoconstriction
C. Increased intravascular fluid volume
E. Hyponatremia
S/E: Increased BP by way of vasoconstriction and increased intravascular fluid volume (but hyponatremia).
BP Information to know
-know how positioning affects blood flow to brain and how to calculate appropriate BP if head goes above or below the heart
