Term
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Definition
USES
-Optimize hemodynamic parmeters
-Cardiogenic shock
-Multi-system organ failure
-Hypovolemic Shock
--Unresponsive to fluids |
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Term
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Definition
Physiology
-Stimulation of beta-1
--Increases: CO, HR, Mycardial oxygen demand
--Arrhythmogenic
-Stimulation of beta-2
Decreases: BP PCWP |
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Term
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Definition
Physiology
-Stimulation of Alpha 1
--Vasoconstriction
--Increases BP
--Decreases CO |
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Term
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Definition
Pharmocology
-Precursor to NE an stimulates NE release
-Effects are dose dependent
-titrate to desired response
-400 mg/250ml |
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Term
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Definition
Low (renal) dose: 1-3 mg/kg/min
-Stimulates dopaminergic receptors
-Dilates renal arteries
-Increases urine output
-Some inotropic activity
-some increases in CO |
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Term
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Definition
5-10 mcg/kg/min
--Predominantly beta effects
---Beta 1 > beta-2
-Increases CO, HR
--Slight increases: BP PCWP
--DLight Decreases: SVR |
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Term
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Definition
10-20 mcg/kg/min
-Alpha stimulation in addition to beta effects-->result is vasoconstriction
INCREASES: HR,BP, PCWP, SVR
DECREASES: CO
--Secondary to increased work |
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Term
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Definition
-Extravasation
-Tachyarrhythmias
-Angina
-Hypertension
-Decreased peripheral perfusion |
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Term
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Definition
-Endogenoue catecholemine that stimulates alpha and beta receptors
LOW DOSE: 0.01-0.05 mcg/kg/min
-Beta-1 > beta-2
Increases: CO, HR
DECREASES: SVR, PCWP |
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Term
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Definition
>0.05 mcg/kg/min
--Alpha effects in addition to beta effects
INCREASES: BP, PCWP, CO, SVR, HR
-Decreases: Urine output |
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Term
Epinephrine
Adverse Effects |
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Definition
-Arrhythmias
-Renal Vasoconstriction
-Decreased periphperal perfusion
-Angina
-Pulmonary Edema
-Extravasation |
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Term
Epinephrine
Administration |
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Definition
-1 to 2mg in 250-500ml
-Continuous infusion
-Central Line
-Titrate to desired response |
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Term
| Norepinephrine (Levophed) |
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Definition
Pharmacology
-Alpha effects, some beta-1 activity
-Increases: BP, PCWP, SVR
-Decreases: Urine Output
-slight decrease in HR, CO |
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Term
| Norepinephrine (Levophed) |
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Definition
Dose: 2-20 mcg/min
-Mix 4mg in 250-500ml D5W
-Administer via central line
-Titrate to response |
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Term
Norepinephrine (Levophed)
ADVERSE EFFECTS |
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Definition
-Arrhythmias
-Angina
-Extravasation
-Hypertension
-Decreased peripheral perfusion |
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Term
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Definition
Pure alpha agonist
MIX: 50-100mg in 250ml
DOSE:
Initial: 100-180 mcg/min
Maintenance: 40-60 mcg/min
INCREASES: BP, SVR, PCWP
DECREASES renal perfusion |
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Term
Phenylephrine
Adverse Effects |
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Definition
Reflex bradycardia
-Extravasation
-Hypertension |
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Term
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Definition
Pharmacology
Used for inotropic support
-Improves oxygen delivery to tissues
-Mostly beta-1 efects
-Alpha and Beta-2 Activity at higher Dose |
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Term
|
Definition
Dose: 2-20 mcg/kg/min
Mix: 250-500mg in 250-500ml
-maximum: 4mg/ml
-May be infused peripherally
-Titrate to response |
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Term
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Definition
Drug of choice in cerdiogenic shock
Increases: CO, UO
Decreases: PCWP, SVR
Minimal Effects in BP, HR |
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Term
Dobutamine
ADVERSE EFFECTS |
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Definition
At higher doses: Hypotensiom, Tachycardia, Extravasation
Tolerance
-Infusions longer than 72 hrours |
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