Week 2

Question 1

Dopamine

Answer 1

Dopamine Sympathomimetic
Brand: Intropin

MOA: Alpha, Beta, & Dopaminergic Agonist. Increase cardiac contractility and cause peripheral vasoconstriction

IND: Hypotension (not due to hypovolemia), symptomatic bradycardia.

CON: Hypersensitivity, hypovolemic shock, pheochromocytoma. VF/VT

Adverse: Arrhythmias, HTN, palpitations, N/V
Dose/Route: 2-5mcg/kg/min (kidneys) dopaminergic effect
5-10mcg/kg/min (Cardiac) Beta effect
10-20mcg/kg/min (Vasculature) Alpha Effect
Infussion only Pedi dose is the same
Spec Special: Pregnancy Class C, irritant to vasculature. No benefits gained at doses +20mcg/kg/min.
I

Question 2

Epinephrine

Answer 2

Epinephrine Sympathomimetic
Brand: epi pen, addrenaline
MOA: Alpha & Beta agonist, positive inotrope & positive chronotrope, vasoconstricts,bronchodilation
IND: Bronchospasm, Cardiac Arrest, Anaphylaxis, Symptomatic bradycardia.
CON: Sensitivity, HTN, dysrhythmias, cardiovascular disease.
Adverse: N/V, tremors, nervousness, anxiety, dysrhythmia.
DOSE: Cardiac- 1mg 1:10,000 every 3-5 min IV/IO/ET
Pedi- 0.01mg/kg 1:10,000 up to 1mg IV/IO/ET
Anaphylaxis- 0.1mg 1:10,000 SLOW IV push // 0.3mg-0.5mg 1:1,000 IM
Pedi- 0.1-1mcg/kg/min INFUSION// 0.01mg/kg up to 0.3mg IM
Bradycardia 2-10 mcg/min 1:10,000 INFUSION
Pedi- 0.01mg/kg 1:10,000 INFUSION
Status Asthmaticus- 0.3mg 1:1,000 IM
Pedi- 0.01mg/kg 1:1,000 IM

Special: Pregnancy Class C, photophobic, alkaline deactivated.

Question 3

Norepinephrine

Answer 3

Norepinephrine Sympathomimetic

Brand: Levophed
MOA: Alpha (vasoconstrict) & Beta (Inotrope) Agonist.
IND: Hypotension (not due to hypovolemia).
CON: Hypersensitivity, Hypovolemia, HTN
Adverse: HTN, anxiety, palpitations, N/V

Dose/Route: 0.5-30mcg/min INFUSION
Pedi: 0.01mcg/kg/min up to 0.5mcg.
**Titrate to effect
Systolic 90 map of 60

Special: Preg. Class C, deactivated by alkaline solutions, extravasation (necrosis of the tissue), “leave’m dead with Levophed.”

Question 4

Vasopressin

Answer 4

Vasopressin Pressor-Antidiuretic Hormone (ADH)

Brand: Pitressin

MOA: Pure synthetic alpha agonist; vasoconstriction. Sympathomimetic

IND: cardiac arrest, hypotension (not due to hypovolemia)

CON: none in emergency setting, hypovolemia, HTN, Cardiovascular disease

Adverse: HTN, bradycardia, bronchoconstriction, palpitations, N/V.

Dose/Route: 40 units IV, IO, ET
Pedi—0.4-1unit/kg IV/IO

Special: Class C Pregnancy, given instead of epi