Vasopressors

Question 1

Name the vasopressor medications

Answer 1

• Norepinephrine (levofed)
• Epinephrine
• Vasopressin
• Hydrocortisone

Iinotropes:
- dobutamine

Push dose pressors:
- Epinephrine
- phenylephrine

Question 2

Is hydrocortisone really a pressor?

Answer 2

Nope, its a steroid but you can use when adrenal insufficiency is suspected and they aren’t responding to pressors

Question 3

Levophed (norepinephrine) dose (vasopressor)

Answer 3

0.05-3mcg/kg/min
- start at 5mcg/min
- no true max but if you rach approx 30mcg/min or 0.4mcg/kg/min consider a second pressor
- also consider broadening ddx (adrenal failure, acidosis etc)

Question 4

Epinephrine dose (vasopressor)

Answer 4

0.01-0.5mcg/kg/min
(up to 1mcg/kg/min post arrest)
- usually start at 5mcg/min

Question 5

Vasopressin dose (vasopressor)

Answer 5

0.04 units/min
- on or off; dont titrate

Question 6

Hydrocortisone dose (vasopressors)

Answer 6

100mg IV
- (if adrenal insufficiency suspected and not responding to pressors)

Question 7

Dobutamine is an:

Answer 7

Inotrope
(Inotropes are drugs that tell your heart muscles to beat or contract with more power or less power)

Question 8

Dobutamine dose (vasopressors)

Answer 8

2-20mcg/kg/min

Question 9

Use caution with dobutamine because?

Answer 9

Its a vasodilator

Question 10

What are the “push dose pressors”

Answer 10

Epinephrine
Phenylephrine

Question 11

Push dose epinephrine dose

Answer 11

Mix 1mL of crash/cardiac epi (100mcg/mL) into 9mL NS flush
- Give at 0.5-2mL q 2-5 min
- Once mixed its 10mcg/mL

Question 12

Push dose phenylephrine dose

Answer 12

1mL (10mg/mL) into 100mL NS
- give at 0.5-2mL q 2-5 min
- once mixed dose is 100mcg/mL

Question 13

Difference/similarities between epinephrine and phenylephrine dose for push does pressor?

Answer 13

Epinephrine: 1mL into 9mL flush
Phenylephrine 1mL into 100mL

After mixing dose is the same (though its 10mcg/mL vs 100mcg/mL)
- 0.5-2mL q 2-5 min