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Neonatal Pharmacology - Fall 2021 > Vasopressors > Flashcards

Vasopressors Flashcards

1
Q

Dopamine: Receptors

A

Alpha 1, Beta 1, Dopaminergic

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2
Q

Dopamine: Releases which Catecholamine

A

Norepi

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3
Q

Dopamine: Effect on CO

A

Increase BP via peripheral vasoconstriction, little effect on stroke volume

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4
Q

Dopamine: Effect on MAP

A

More effective than dobutamine, colloid, or hydrocortisone in increasing MAP

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5
Q

Dopamine: Dosing Effects

A

Low dose: dopaminergic effect
Medium: primarily beta receptor effects
High: Primarily alpha receptor effects

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6
Q

Dobutamine: Receptors

A

Alpha 1, beta 1, beta 2

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7
Q

Dobutamine: Releases Catecholamine?

A

Does not release norepi

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8
Q

Dobutamine: Effect on CO

A

Augments myocardial contractility, decreases afterload

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9
Q

Epinephrine: Receptors

A

Alpha 1, Alpha 2, beta 1, beta 2

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10
Q

Epi: Effect on MAP

A

Increases MAP and UOP

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11
Q

Epi: Effect on CO

A

INcrease SV and HR

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12
Q

Epi: Cautions

A

Peripheral ischemia
Tachycardia
Higher incidence of hyperglycemia and lactic acidosis

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13
Q

Epi: Low Dose stimulate

A

Beta Receptors –> increase contractility and peripheral vasodilation

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14
Q

Norepir: Receptors

A

Alpha 1, alpha 2, beta 1

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15
Q

Norepi: Use

A

Greater than 35 weeks and refractory to dopamine or dobutamine

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16
Q

Norepi: Effect on CO

A

Increases SVR more than PVR

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17
Q

Vasopressin: Other Hormone Name

A

ADH

18
Q

Vasopressin: MoA

A

Regulating water balance:
Activates collecting duct of kidney to increase water absorption

Regulating Vascular tone:
vascular smooth muscle cells increase SVR

19
Q

Vasopressin: Vasodilatory effects

A

Pulmonary, coronary, and cerebral smooth muslce

20
Q

Vasopressin: Caution

A

Hyponatremia (retaining fluid leads to dilutional hyponatremia) and transmanitis

21
Q

Milrinone: MoA

A

Inhibits PDE-3 –> Increases cAMP

Improves contractility and myocardial relaxation

22
Q

Increase cAMP with Milrinone?

A

Enhances myocardial contractility while promoting vasodilation

23
Q

Milrinone: Beneficial for which conditions/diseases

A

PPHN, CDH, and post-ligation PDA

24
Q

Hydrocortisone: Electrolyte Effects

A

Decreased Na
Increased K
Decreased Cl
Increased Glucose

25
Q

Hydrocortisone: Use

A

Refractory initial vasopressor administration. Effective in increasing systemic BP and reducing catecholamine requirements through upregulation adrenergic receptors

USE IN WARM SHOCK

26
Q

Hydrocortisone: Benefits

A

Improves endothelial integrity, reduces capillary leak, increases available calcium by myocardial and smooth muscle contraction

27
Q

Hydrocortisone: Negative Side Effects

A

Short term: hyperglycemia and gastric irritation

Long term: Growth impairment, immunosuppression, osteopenia

28
Q

Dopamine: Dosage

A

5-20 microg/kg/min

29
Q

Dobutamine: Dosage

A

5-20 microg/kg/min

30
Q

Epinephrine: Dosage

A

0.01-0.03 microg/kg/min

31
Q

Norepinephrine: Dosage

A

0.02-0.1 microg/kg/min

32
Q

Vasopressin: Dosage

A

0.01-0.36 units/kg/hour

33
Q

Hydrocortisone: Dosage

A

Loading: 2mg/kg
Maintenance: 0.5-1 mg/kg/dose, q6-8hr

34
Q

Milrinone: Dosage

A

Loading: 75 microg/kg
Maintenance: 0.3-0.9 microg/kg/min

35
Q

Dopamine:

Effect on Stroke Volume, SVR, and PVR

A

SV: Increase
SVR: Increase (x2)
PVR: Increase (x3)

36
Q

Norepinephrine:

Effect on Stroke Volume, SVR, and PVR

A

SV: Increase/no effect
SVR: Increase (x3)
PVR: Decrease/no effect

37
Q

Vasopressin:

Effect on Stroke Volume, SVR, and PVR

A

SV: Decrease
SVR: Increase (x3)
PVR: Decrease

38
Q

Dobutamine:

Effect on Stroke Volume, SVR, and PVR

A

SV: Increase (x2)
SVR: No effect
PVR: No effect

39
Q

Milrinone:

Effect on Stroke Volume, SVR, and PVR

A

SV: Increase (x2)
SVR: Decrease (x2)
PVR: Decrease (x2)

40
Q

Epinephrine:

Effect on Stroke Volume, SVR, and PVR

A

SV: Increase (x3)
SVR: Increase (x3)
PVR: Increase (x2)

Neonatal Pharmacology - Fall 2021 (6 decks)

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