Vasopressors

Question 1

What affects do D-1 and D-2 stimulation have in the body for the sympathetic nervous system?

Answer 1

Renal Vasodilation

Question 2

What is the first-line medication for septic shock?

Answer 2

Norepinephrine (Levophed)

Question 3

What medication is used in anaphylaxis and advanced cardiac life support? (ACLS)

Answer 3

Epinephrine

Question 4

Medication that is used for various shock state and has dose-dependent effects.

Answer 4

Dopamine

Question 5

Medication that is often used as an adjunct in septic shock.

Answer 5

Vasopressin (ADH)

Question 6

Medication that is a pure Alpha-1 agonist and is used in hypotension with a low heart rate.

Answer 6

Phenylephrine

Question 7

What two medications have both a positive inotropic and positive chronotropic effect?

Answer 7

Dopamine
Epinephrine

Question 8

Name two inotropic medications.

Answer 8

Dobutamine
Milrinone

Question 9

Medication that is the preferred vasopressor in septic shock and ACLS post-ROSC

Answer 9

Norepinephrine (Levophed)

Question 10

Medication that is the treatment of choice for anaphylaxis and is used in the ACLS algorithm to treat Asystole, PEA, and pulseless V-Tach and V-Fib.

Answer 10

Epinephrine

Question 11

What receptor is Epinephrine the most potent agonist of?

Answer 11

Beta-1

Question 12

At low doses, what effect does Epinephrine have?

Answer 12

Beta effects

Question 13

At higher doses, what effect does Epinephrine have?

Answer 13

Alpha-1 effects

Question 14

How does Epinephrine affect Cardiac Output and Pulmonary Vascular Resistance at low doses?

Answer 14

↑ Cardiac Output
↓ Pulmonary Vascular Resistance

Question 15

Medication that is indicated for hemodynamic support and inotropic support in advanced heart failure.

Answer 15

Dopamine

Question 16

High dose dopamine causes what effects?

Answer 16

Vasoconstriction
↑ BP + ↑ HR

Question 17

At high doses, what receptor does Dopamine primarily dominate?

Answer 17

Alpha-1

Question 18

What is an adverse reaction of Dopamine?

Answer 18

Severe Hypertension
Tissue Ischemia/Gangrene

Question 19

Medication that is used in patients with diabetes insipidus, esophageal variceal bleeding, and vasodilatory shock.

Answer 19

Vasopressin (ADH)

Question 20

What is the second line treatment for refractory vasodilatory shock?

Answer 20

Vasopressin (ADH)

Question 21

Medication that causes vasoconstriction with minimal cardiac inotropy or chronotropy due to it being an Alpha-1 selective agonist.

Answer 21

Phenylephrine

Question 22

Phenylephrine may ↓ Stroke Volume so it is reserved for what scenario?

Answer 22

When there is a contraindication for Norepinephrine.

Question 23

What medication is used as a first line agent for Septic Shock?

Answer 23

Norepinephrine

Question 24

What medications are used as a first line agent for Cardiogenic Shock?

Answer 24

Norepinephrine + Dopamine

Question 25

Medication used for medically refractory heart failure and cardiogenic shock with a low cardiac output.

Answer 25

Dobutamine

Question 26

What type of agonist is Dobutamine primarily?

Answer 26

Beta-1

Question 27

Is Dobutamine a potent inotrope or chronotrope?

Answer 27

Inotrope
↑ HR + ↑ CO

Question 28

Medication that is a Phosphodiesterase-3 Enzyme Inhibitor.

Answer 28

Milrinone

Question 29

When is Milrinone indicated?

Answer 29

Heart Failure or Heart Transplant
(VERY USEFUL IF ADRENERGIC RECEPTORS ARE DOWNREGULATED or DENSISTIZED)

Question 30

What medication is the recommended Inotrope if a patient is not on a beta blocker and not hypotensive?

Answer 30

Milrinone

Question 31

What is the mechanism of action of Milrinone?

Answer 31

Potent Inotrope and Vasodilator