Vasopressors Flashcards
What affects do D-1 and D-2 stimulation have in the body for the sympathetic nervous system?
Renal Vasodilation
What is the first-line medication for septic shock?
Norepinephrine (Levophed)
What medication is used in anaphylaxis and advanced cardiac life support? (ACLS)
Epinephrine
Medication that is used for various shock state and has dose-dependent effects.
Dopamine
Medication that is often used as an adjunct in septic shock.
Vasopressin (ADH)
Medication that is a pure Alpha-1 agonist and is used in hypotension with a low heart rate.
Phenylephrine
What two medications have both a positive inotropic and positive chronotropic effect?
Dopamine
Epinephrine
Name two inotropic medications.
Dobutamine
Milrinone
Medication that is the preferred vasopressor in septic shock and ACLS post-ROSC
Norepinephrine (Levophed)
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.
Epinephrine
What receptor is Epinephrine the most potent agonist of?
Beta-1
At low doses, what effect does Epinephrine have?
Beta effects
At higher doses, what effect does Epinephrine have?
Alpha-1 effects
How does Epinephrine affect Cardiac Output and Pulmonary Vascular Resistance at low doses?
↑ Cardiac Output
↓ Pulmonary Vascular Resistance
Medication that is indicated for hemodynamic support and inotropic support in advanced heart failure.
Dopamine
High dose dopamine causes what effects?
Vasoconstriction
↑ BP + ↑ HR
At high doses, what receptor does Dopamine primarily dominate?
Alpha-1
What is an adverse reaction of Dopamine?
Severe Hypertension
Tissue Ischemia/Gangrene
Medication that is used in patients with diabetes insipidus, esophageal variceal bleeding, and vasodilatory shock.
Vasopressin (ADH)
What is the second line treatment for refractory vasodilatory shock?
Vasopressin (ADH)
Medication that causes vasoconstriction with minimal cardiac inotropy or chronotropy due to it being an Alpha-1 selective agonist.
Phenylephrine
Phenylephrine may ↓ Stroke Volume so it is reserved for what scenario?
When there is a contraindication for Norepinephrine.
What medication is used as a first line agent for Septic Shock?
Norepinephrine
What medications are used as a first line agent for Cardiogenic Shock?
Norepinephrine + Dopamine
Medication used for medically refractory heart failure and cardiogenic shock with a low cardiac output.
Dobutamine
What type of agonist is Dobutamine primarily?
Beta-1
Is Dobutamine a potent inotrope or chronotrope?
Inotrope
↑ HR + ↑ CO
Medication that is a Phosphodiesterase-3 Enzyme Inhibitor.
Milrinone
When is Milrinone indicated?
Heart Failure or Heart Transplant
(VERY USEFUL IF ADRENERGIC RECEPTORS ARE DOWNREGULATED or DENSISTIZED)
What medication is the recommended Inotrope if a patient is not on a beta blocker and not hypotensive?
Milrinone
What is the mechanism of action of Milrinone?
Potent Inotrope and Vasodilator
