Vasopressors (Part 1) Flashcards
What is the typical concentration of Neosynephrine?
40mg in 250 mL
What is the standard effective dose of Neosynephrine?
50-200 mcg/min
What is the onset time for Neo-synephrine?
1 minute
What is Vasopressin commonly referred to as?
Vaso
When did Vasopressin start being used to treat shock?
2001
What is Vasopressin often used as?
Second-line treatment
What system does Vasopressin impact to increase blood pressure?
Arginine-vasopressin system (AVP)
What receptor site does Vasopressin act on?
V1 receptor site
What system does vasopressin impact to increase blood pressure?
Arginine-vasopressin system (AVS)
What is the primary action of vasopressin?
Agonist at v1 receptor sites to cause smooth muscle contraction
What is the effect of AT2 (Angiotensin II) receptor activation?
Peripheral vessel constriction
What is an agonist?
A substance that fully activates the receptor to which it binds.
What is Levophed commonly known as?
Norepinephrine.
When was Levophed first approved for use as a medication?
In the 1950s.
What is Levophed commonly referred to as?
Levo
What type of agent is Levophed?
Direct acting vasopressor
What is the primary receptor that Levophed activates?
Alpha-1 receptor
Does Levophed have effects on Beta-1 receptors?
Yes
What are the effects of Levophed on blood vessels?
Equal veno and arterial constriction
What can extravasation of Levophed cause?
Tissue necrosis and limb ischemia
What is the typical concentration of Levophed?
4mg in 250 mL
What is the standard effective dose of Levophed?
1-12 mcg/min
What is the onset time for Levophed?
1 minute
How often should Levophed dose changes be made?
Every 3 to 5 minutes
What is Neosynephrine also known as?
Phenylephrine
What is the standard effective dose of vasopressin?
0.01-0.04 units/min
How long does it take for vasopressin to have an onset?
5 to 15 minutes
Is vasopressin titrated during administration?
No, it’s either on or off
What is the common name for epinephrine?
Epi
What type of agonist is epinephrine?
Non-selective agonist of all adrenergic receptors
What is the typical concentration of epinephrine?
1 mg in 250 mL
What is the standard effective dose for epinephrine?
1-10 mcg/min
What is the onset time for epinephrine?
1 to 2 minutes
How often should epinephrine be titrated?
Every 5 to 10 minutes
What is the renal dose range for dopamine?
0.5 to 2 mcg/kg/min
What dose range of dopamine has an inotropic effect?
5 to 10 mcg/kg/min
What dose range of dopamine acts more as an alpha agonist?
10 to 20 mcg/kg/min
What is the onset time for dopamine?
About 5 minutes
What is the range where dopamine acts more adrenergically?
10 to 20
What is the onset time for dopamine?
About five minutes
How often should dopamine be titrated?
Every 10 minutes
What is Giapreza?
Synthetic angiotensin-2 in IV form
When was Giapreza approved for use?
2017
What system does Giapreza activate?
Renin-angiotensin-aldosterone system (RAAS)
Which receptors does Giapreza activate?
AT2 receptors
What is the primary action of Giapreza?
Causes arterial vasoconstriction
What can reduce the effects of Giapreza?
Angiotensin receptor blockers (ARBs)
What are the two typical concentrations of Giapreza?
2.5 mg in 250 mL (high) and 2.5 mg in 500 mL (standard)
What is the standard effective dose for Giapreza?
20-80 nanograms/kg/min (0.02-0.08 mcgs)
What is the onset time for Giapreza?
About five minutes
How often should Giapreza be titrated?
Every five minutes
What is Levophed also known as?
Norepinephrine
What type of agonist is Levophed?
Strong alpha agonist with beta-1 effects
What effect does Levophed have on SVR?
Strongly increases SVR
What is Neosynephrine?
A pure alpha agonist
How does Neosynephrine affect contractility?
No impact on contractility
What receptor does vasopressin agonize?
V1 receptor
What is the effect of vasopressin on heart rate?
No impact on heart rate
What type of agonist is epinephrine?
Non-selective adrenergic agonist
What receptors does epinephrine affect?
Alpha, beta-1, and beta-2 receptors
How does dopamine act based on dosage?
Dose-dependent effects
What type of agonist is dopamine?
Strong alpha and beta-1 agonist
What type of agonist is typically a strong alpha agonist?
Strong beta-1 agonist with impact on beta-2 receptors.
What effect does Giapreza have on receptors?
It is an AT2 agonist with no effects on alpha or beta receptors.
What is the impact of Giapreza on patients’ SVR?
It has a decent effect on patients’ SVR but no impact on heart rate and contractility.
What is the main function of vasopressors?
To constrict blood vessels, increase blood pressure, and enhance tissue perfusion.
Why is it important to know the dosages of vasopressors?
Different mechanisms of action and receptor impacts require knowledge of concentrations and dosages for patient management.
What will the next lesson focus on?
It will discuss additional important information regarding vasopressors.
What previous series of lessons did the speaker cover?
The endocrine system and various disorders related to patients.
What type of receptor agonist is Neosynephrine?
Pure alpha receptor agonist
What side effect can Neosynephrine cause?
Baroreceptor mediated reflex bradycardia
What are vasopressors commonly referred to as?
Pressors
What do vasopressors primarily activate?
Adrenergic receptors
What do vasopressors increase in patients?
Systemic vascular resistance (SVR)
What is the normal range for SVR?
600-1200 dynes/s/cm-5
What does SVR measure?
Afterload
What is the formula for cardiac output?
Cardiac Output = Heart Rate (HR) x Stroke Volume (SV)
What are the three components of stroke volume?
Preload, contractility, afterload
How do pressors affect heart rate?
They can increase heart rate
How can pressors temporarily affect preload?
By increasing venous constriction
What is the primary focus when determining a patient’s cardiac output?
The impact on the patient’s afterload or systemic vascular resistance (SVR).
What is the goal of increasing afterload or SVR in patients?
To increase tissue perfusion, especially in end organs.
What type of patients are vasopressors primarily used on?
Hypotensive patients and those in shock.
What are the two main groups of adrenergic receptors?
Alpha receptors and beta receptors.
Which alpha receptor is primarily focused on in vasopressors?
Alpha-1 receptors.
What is the function of alpha-1 receptors?
Responsible for smooth muscle contraction.
What are the three types of beta receptors?
Beta-1, beta-2, and beta-3 receptors.
Where are beta-1 receptors located?
In the heart.
Where are beta-2 receptors located?
In the lungs.
What happens when beta-1 receptors are activated?
Increase in heart rate (positive chronotropic effect) and contractility (positive inotropic effect).
What is the effect of beta-2 receptor activation?
Smooth muscle cell relaxation within the lungs.
What activates V1 receptors?
Vasopressin.
What is the effect of V1 receptor activation?
Smooth muscle contraction.
What activates AT2 receptors?
Angiotensin-2.
What is an antagonist?
A substance that does not activate the receptor and can block the effects of an agonist.
