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ICU & ER > Vasopressors (Part 1) > Flashcards

Vasopressors (Part 1) Flashcards

1
Q

What is the typical concentration of Neosynephrine?

A

40mg in 250 mL

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2
Q

What is the standard effective dose of Neosynephrine?

A

50-200 mcg/min

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3
Q

What is the onset time for Neo-synephrine?

A

1 minute

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4
Q

What is Vasopressin commonly referred to as?

A

Vaso

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5
Q

When did Vasopressin start being used to treat shock?

A

2001

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6
Q

What is Vasopressin often used as?

A

Second-line treatment

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7
Q

What system does Vasopressin impact to increase blood pressure?

A

Arginine-vasopressin system (AVP)

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8
Q

What receptor site does Vasopressin act on?

A

V1 receptor site

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9
Q

What system does vasopressin impact to increase blood pressure?

A

Arginine-vasopressin system (AVS)

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10
Q

What is the primary action of vasopressin?

A

Agonist at v1 receptor sites to cause smooth muscle contraction

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11
Q

What is the effect of AT2 (Angiotensin II) receptor activation?

A

Peripheral vessel constriction

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12
Q

What is an agonist?

A

A substance that fully activates the receptor to which it binds.

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13
Q

What is Levophed commonly known as?

A

Norepinephrine.

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14
Q

When was Levophed first approved for use as a medication?

A

In the 1950s.

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15
Q

What is Levophed commonly referred to as?

A

Levo

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16
Q

What type of agent is Levophed?

A

Direct acting vasopressor

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17
Q

What is the primary receptor that Levophed activates?

A

Alpha-1 receptor

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18
Q

Does Levophed have effects on Beta-1 receptors?

A

Yes

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19
Q

What are the effects of Levophed on blood vessels?

A

Equal veno and arterial constriction

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20
Q

What can extravasation of Levophed cause?

A

Tissue necrosis and limb ischemia

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21
Q

What is the typical concentration of Levophed?

A

4mg in 250 mL

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22
Q

What is the standard effective dose of Levophed?

A

1-12 mcg/min

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23
Q

What is the onset time for Levophed?

A

1 minute

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24
Q

How often should Levophed dose changes be made?

A

Every 3 to 5 minutes

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25
Q

What is Neosynephrine also known as?

A

Phenylephrine

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26
Q

What is the standard effective dose of vasopressin?

A

0.01-0.04 units/min

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27
Q

How long does it take for vasopressin to have an onset?

A

5 to 15 minutes

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28
Q

Is vasopressin titrated during administration?

A

No, it’s either on or off

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29
Q

What is the common name for epinephrine?

A

Epi

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30
Q

What type of agonist is epinephrine?

A

Non-selective agonist of all adrenergic receptors

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31
Q

What is the typical concentration of epinephrine?

A

1 mg in 250 mL

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32
Q

What is the standard effective dose for epinephrine?

A

1-10 mcg/min

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33
Q

What is the onset time for epinephrine?

A

1 to 2 minutes

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34
Q

How often should epinephrine be titrated?

A

Every 5 to 10 minutes

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35
Q

What is the renal dose range for dopamine?

A

0.5 to 2 mcg/kg/min

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36
Q

What dose range of dopamine has an inotropic effect?

A

5 to 10 mcg/kg/min

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37
Q

What dose range of dopamine acts more as an alpha agonist?

A

10 to 20 mcg/kg/min

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38
Q

What is the onset time for dopamine?

A

About 5 minutes

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39
Q

What is the range where dopamine acts more adrenergically?

A

10 to 20

40
Q

What is the onset time for dopamine?

A

About five minutes

41
Q

How often should dopamine be titrated?

A

Every 10 minutes

42
Q

What is Giapreza?

A

Synthetic angiotensin-2 in IV form

43
Q

When was Giapreza approved for use?

A

2017

44
Q

What system does Giapreza activate?

A

Renin-angiotensin-aldosterone system (RAAS)

45
Q

Which receptors does Giapreza activate?

A

AT2 receptors

46
Q

What is the primary action of Giapreza?

A

Causes arterial vasoconstriction

47
Q

What can reduce the effects of Giapreza?

A

Angiotensin receptor blockers (ARBs)

48
Q

What are the two typical concentrations of Giapreza?

A

2.5 mg in 250 mL (high) and 2.5 mg in 500 mL (standard)

49
Q

What is the standard effective dose for Giapreza?

A

20-80 nanograms/kg/min (0.02-0.08 mcgs)

50
Q

What is the onset time for Giapreza?

A

About five minutes

51
Q

How often should Giapreza be titrated?

A

Every five minutes

52
Q

What is Levophed also known as?

A

Norepinephrine

53
Q

What type of agonist is Levophed?

A

Strong alpha agonist with beta-1 effects

54
Q

What effect does Levophed have on SVR?

A

Strongly increases SVR

55
Q

What is Neosynephrine?

A

A pure alpha agonist

56
Q

How does Neosynephrine affect contractility?

A

No impact on contractility

57
Q

What receptor does vasopressin agonize?

A

V1 receptor

58
Q

What is the effect of vasopressin on heart rate?

A

No impact on heart rate

59
Q

What type of agonist is epinephrine?

A

Non-selective adrenergic agonist

60
Q

What receptors does epinephrine affect?

A

Alpha, beta-1, and beta-2 receptors

61
Q

How does dopamine act based on dosage?

A

Dose-dependent effects

62
Q

What type of agonist is dopamine?

A

Strong alpha and beta-1 agonist

63
Q

What type of agonist is typically a strong alpha agonist?

A

Strong beta-1 agonist with impact on beta-2 receptors.

64
Q

What effect does Giapreza have on receptors?

A

It is an AT2 agonist with no effects on alpha or beta receptors.

65
Q

What is the impact of Giapreza on patients’ SVR?

A

It has a decent effect on patients’ SVR but no impact on heart rate and contractility.

66
Q

What is the main function of vasopressors?

A

To constrict blood vessels, increase blood pressure, and enhance tissue perfusion.

67
Q

Why is it important to know the dosages of vasopressors?

A

Different mechanisms of action and receptor impacts require knowledge of concentrations and dosages for patient management.

68
Q

What will the next lesson focus on?

A

It will discuss additional important information regarding vasopressors.

69
Q

What previous series of lessons did the speaker cover?

A

The endocrine system and various disorders related to patients.

70
Q

What type of receptor agonist is Neosynephrine?

A

Pure alpha receptor agonist

71
Q

What side effect can Neosynephrine cause?

A

Baroreceptor mediated reflex bradycardia

72
Q

What are vasopressors commonly referred to as?

A

Pressors

73
Q

What do vasopressors primarily activate?

A

Adrenergic receptors

74
Q

What do vasopressors increase in patients?

A

Systemic vascular resistance (SVR)

75
Q

What is the normal range for SVR?

A

600-1200 dynes/s/cm-5

76
Q

What does SVR measure?

A

Afterload

77
Q

What is the formula for cardiac output?

A

Cardiac Output = Heart Rate (HR) x Stroke Volume (SV)

78
Q

What are the three components of stroke volume?

A

Preload, contractility, afterload

79
Q

How do pressors affect heart rate?

A

They can increase heart rate

80
Q

How can pressors temporarily affect preload?

A

By increasing venous constriction

81
Q

What is the primary focus when determining a patient’s cardiac output?

A

The impact on the patient’s afterload or systemic vascular resistance (SVR).

82
Q

What is the goal of increasing afterload or SVR in patients?

A

To increase tissue perfusion, especially in end organs.

83
Q

What type of patients are vasopressors primarily used on?

A

Hypotensive patients and those in shock.

84
Q

What are the two main groups of adrenergic receptors?

A

Alpha receptors and beta receptors.

85
Q

Which alpha receptor is primarily focused on in vasopressors?

A

Alpha-1 receptors.

86
Q

What is the function of alpha-1 receptors?

A

Responsible for smooth muscle contraction.

87
Q

What are the three types of beta receptors?

A

Beta-1, beta-2, and beta-3 receptors.

88
Q

Where are beta-1 receptors located?

A

In the heart.

89
Q

Where are beta-2 receptors located?

A

In the lungs.

90
Q

What happens when beta-1 receptors are activated?

A

Increase in heart rate (positive chronotropic effect) and contractility (positive inotropic effect).

91
Q

What is the effect of beta-2 receptor activation?

A

Smooth muscle cell relaxation within the lungs.

92
Q

What activates V1 receptors?

A

Vasopressin.

93
Q

What is the effect of V1 receptor activation?

A

Smooth muscle contraction.

94
Q

What activates AT2 receptors?

A

Angiotensin-2.

95
Q

What is an antagonist?

A

A substance that does not activate the receptor and can block the effects of an agonist.

ICU & ER (2 decks)

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