Vasopressor Drugs

Question 1

Dobutamine trade name?

Answer 1

Dobutrex

Question 2

Dobutamine classifications?

Answer 2

Inotropics, Adrenergics

Question 3

Dobutamine actions?

Answer 3

Stimulates beta-1 receptors with minor effect to heart rate or peripheral blood vessels. Stimulates beta-2 receptors causing vasodilation. Increased cardiac output without increased heart rate significantly.

Question 4

Dobutamine onset/duration?

Answer 4

1-2 min / brief <1

Question 5

Dobutamine indications?

Answer 5

Cardiogenic shock, hypotension, low cardiac output, reduced perfusion

Question 6

Dobutamine contraindications?

Answer 6

Hypersensitivity;

use with caution in patients with a-fib, MI, history of HTN

Question 7

Dobutamine side effects?

Answer 7

Headache, dysrhythmias, tachycardia, hypertension, nausea, and vomiting

Question 8

Dobutamine route of administration?

Answer 8

IV

Question 9

Dobutamine adult dose?

Answer 9

2.5-15 mcg/kg/min;
titrate to response
(max dose 40 mcg/kg/min)

Question 10

Dobutamine peds dose?

Answer 10

same as adult dose

Question 11

Dobutamine supply?

Answer 11

250mg/20mL

Question 12

Dopamine trade name?

Answer 12

Dopastat, Intropin

Question 13

Dopamine classifications?

Answer 13

Endogenous catecholamine, sympathomimetic

Question 14

Dopamine actions?

Answer 14

With a low dose (1-2 mcg/kg/min), dopaminergic receptors are stimulated which causes vasodilation of the renal and mesenteric arteries that increase the force of contraction of the heart to increase BP. With a dose above 10mcg/kg/min, there is a stimulation of the alpha receptors in the systemic arteries that cause vasoconstriction and increased PVR.

Question 15

Dopamine onset/duration?

Answer 15

2-4 min/ 10-15 min

Question 16

Dopamine indications?

Answer 16

Hemodynamically significant hypotension in the absence of hypovolemia. Symptomatic bradycardia as a second line medication.

Question 17

Dopamine contraindications?

Answer 17

Tachydysrhythmias, ventricular fibrillation, hypovolemia

Question 18

Dopamine side effects?

Answer 18

Hypertension, V-fib, increased myocardial oxygen demand, headache, anxiety, nausea, vomiting

Question 19

Dopamine route of administration?

Answer 19

IV infusion

Question 20

Dopamine adult dose?

Answer 20

2-20 mcg/kg/min

usually started around 5-10 mcg/kg/min and titrated to a systolic BP of 90 or 100

Question 21

Dopamine peds dose?

Answer 21

Same as adult dose

Question 22

Dopamine drip mixture?

Answer 22

400mg in 500 mL NS or 200mg in 250 mL to give 800 mcg/mL;

400mg in 250 mL to give 1600 mcg/mL

Question 23

Dopamine supply?

Answer 23

200mg/5mL (40mg/mL) or 400mg/5mL (80mg/mL) prefilled syringes and ampules

Question 24

Dopamine special considerations?

Answer 24

Do not mix Dopamine with Sodium Bicarbonate

Question 25

Epi 1mg/1mL trade name?

Answer 25

Adrenaline

Question 26

Epi 1mg/1mL classifications?

Answer 26

Endogenous catecholamine, sympathomimetic

Question 27

Epi 1mg/1mL actions?

Answer 27

Contains both alpha, beta-1, and beta-2 properties. It is both a positive chronotropic and inotropic drug as well as a potent bronchodilator.

Question 28

Epi 1mg/1mL onset/duration?

Answer 28

5-10 min

Question 29

Epi 1mg/1mL indications?

Answer 29

acute allergic reaction, anaphylaxis, acute bronchial asthma

Question 30

Epi 1mg/1mL contraindications?

Answer 30

Hypersensitivity, hypovolemic shock (correct hypovolemia first), dilated cardiomyopathy

Question 31

Epi 1mg/1mL side effects?

Answer 31

Tachycardia, headache, nausea, vomiting, restlessness, weakness, dysrhythmias, hypertension, precipitation of angina pectoris

Question 32

Epi 1mg/1mL route of administration?

Answer 32

IM, ETT, IV/IO infusion

Question 33

Epi 1mg/1mL adult dose?

Answer 33

0.01 mg/kg divided into 3 doses (usually 0.3-0.5 mg IM)
Every 20 min for asthma
Every 5-15 min for anaphylaxis

Question 34

Epi 1mg/1mL peds dose?

Answer 34

0.01 mL/kg (0.01 mg/kg up to 0.3 mL total dose)

Every 15 min

Question 35

Epi 1mg/1mL peds drip mixture for children 2-20 kg?

Answer 35

Add 3 mg into 250mL NS (12 mcg/mL concentration). Using 60 gtts/mL IV drop set and set the drip rate off of the patients weight in kg to administer the infusion at 0.2mcg/kg/min.

Question 36

Epi 1mg/1mL peds drip mixture fro children 21-40 kg?

Answer 36

Add 6 mg into 250mL NS (24mcg/mL concentration). Using a 60 gtts/mL IV drop set starting the drip rate off at half the patients weight in kg to administer the infection at 0.2mcg/kg/min.

Question 37

Epi 1mg/1mL supply?

Answer 37

1 mg/mL ampules

1 mg/mL 30 mL vials

Question 38

Norepinephrine trade name?

Answer 38

Levophed, Levarterenol

Question 39

Norepinephrine classifications?

Answer 39

Sympathomimetic, adrenergic agonist agent

Question 40

Norepinephrine actions?

Answer 40

Vasoconstrictor that increases myocardial contractility. Given for hypotensive and shock states not caused for hypovolemia.

Question 41

Norepinephrine onset/duration?

Answer 41

1-3 min/ 5-10 min

Question 42

Norepinephrine indications?

Answer 42

Cardiogenic shock, neurogenic shock, hemodynamically significant hypotension (systolic below 70)

Question 43

Norepinephrine contraindications?

Answer 43

Hypersensitivity and hypotensive patients with hypovolemia

Question 44

Norepinephrine side effects?

Answer 44

Headache, dysrhythmias, tachycardia, hypertension

Question 45

Norepinephrine route of administration?

Answer 45

IV

Question 46

Norepinephrine adult dose?

Answer 46

Dilute 4mg in 250mL of D5;
begin infusion at 0.05-0.5 mcg/kg/min (usually up to 30mcg/min); titrate to effect
(usually begin at 2-4mcg/min)

Question 47

Norepinephrine peds dose?

Answer 47

Dilute 4mg in 250 mL of D5; begin infusion at 0.05-0.1 mcg/kg/min (max dose 2mcg/kg/min); titrate to desired effect

Question 48

Norepinephrine supply?

Answer 48

1mg/mL in 4 mL ampule

Question 49

Norepinephrine special considerations?

Answer 49

Do not administer in the same IV line as alkaline solution