Vasopressors

Question 1

Atropine (IV)

Answer 1

Receptor targets: none

Cardiac output ++
Systemic Vasc resistance +

Uses: bradycardia, hypotension/shock

ADR: hypoperfusion, dysrhymia, M ischemia, extravasation -> vasoconstriction/necrosis

Question 2

Phenylephrine (IV)

Answer 2

Receptor targets:
Alpha 1 agonist vessels (++),
systemic vasc resistance (++)

Uses: bradycardia, hypotension/shock

ADR: hypoperfusion, dysrhymia, M ischemia, extravasation -> vasoconstriction/necrosis

Question 3

Dobutamine (IV)

Answer 3

Receptor Targets: 
Beta-1 heart (++), 
beta 2 (+), 
CO (++) 
systemic vasc resistance - neutral 

Uses: bradycardia, hypotension/shock

ADR: hypoperfusion, dysrhymia, M ischemia, extravasation -> vasoconstriction/necrosis

Question 4

Isoproterenol (IV)

Answer 4

Receptor targets:
Beta 1 heart (++)
Beta 2 (++)
CO (++)
Systemic vasc resistance - neutral 

Uses: bradycardia, hypotension/shock

ADR: hypoperfusion, dysrhymia, M ischemia, extravasation -> vasoconstriction/necrosis

Question 5

Norepinephrine (IV)

Answer 5

Receptor targets: 
Alpha 1 agonist vessels  (++)
Beta 1 heart (+)
CO: +/-
Systemic vasc resistance (++)

Effect: no alpha or beta 2 effect

ADR: hypoperfusion, dysrhymia, M ischemia, extravasation -> vasoconstriction/necrosis

Question 6

Epinephrine (IV)

Answer 6

Non-selective adernergic agonist

Receptor targets: 
Alpha 1 vessels (++)
Beta 1 heart (++)
Beta 2 (++)
CO (++)
Systemic vasc resistance:
 -/+ low dose beta effects
 \+/+ high dose  alpha 1 effects

ADR: hypoperfusion, dysrhymia, M ischemia, extravasation -> vasoconstriction/necrosis

Question 7

Dopamine (IV)

Answer 7

Precursor to NE

Receptor Targets: dopaminergic receptor 1 (D1) -
low dose = renal benefit
Moderate dose - beta 1 activation
High dose - add alpha 1 receptor activation, less D1 activation

Effect:
coronary vessels - vasodilation
Renal vessels increase GFR and dieresis

Uses: edema in CHF patients with fluid overload -> increases urine output
Hemodynamics support of cardiogenic and septic shock

ADR: hypoperfusion, dysrhymia, M ischemia, extravasation -> vasoconstriction/necrosis

Question 8

Dopamine Low dose

Answer 8

Renal benefit

Receptor Targets:
D1 (++)
CO (+)

Question 9

Dopamine moderate dose

Answer 9

Beta 1 activation

Receptor targets:
Beta 1 heart (++)
D1 (++)
CO(++)

Question 10

Dopamine high dose

Answer 10

Add alpha 1 receptor activation, less D1 activation

Receptor targets: 
Alpha 1 vessels (++)
Beta 1 heart (++)
D1(+)
CO(++)
Systemic vasc resistance (++)