













































Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
Community
Ask the community for help and clear up your study doubts
Discover the best universities in your country according to Docsity users
Free resources
Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors
Review the mechanism of action for vasopressors and inotropes. ▷ Recognize common side effects of different ... Contractility and chronotropic effects.
Typology: Summaries
1 / 53
This page cannot be seen from the preview
Don't miss anything!
MATT RUBERTUS, PHARMD CLINICAL PHARMACY SPECIALIST – CARDIOTHORACIC SURGERY/CRITICAL CARE EMORY UNIVERSITY HOSPITAL ATLANTA, GA
I have nothing to disclose pertaining to this presentation http://oz.wikia.com
Shock Cardiogenic Vasodilatory Sepsis Cardiac Surgery Valve Disease Decompensated Heart Failure http://thefilmspectrum.com
Hypotension Baroreceptor Activation Decreased Renal Perfusion Increased Sympathetic Activity RASS Activation Cardiac Stimulation Vasoconstriction Volume Expansion Increased HR and Contractility Increased Preload Increased Cardiac Output Increased Systemic Vascular Resistance Increased Cardiac Output Increased Blood Pressure
Heart Rate Rate Rhythm Stroke Volume Preload CVP Contractility Afterload MAP
Vasopressors http://thefilmspectrum.com
Beta 1 Located in cardiac tissue Contractility and chronotropic effects Beta 2 Smooth muscle relaxation in bronchi and GI tract Beta 3 Lipolysis – may be a target for weight loss
1 receptor causes vasoconstriction in vascular smooth muscle V 2 receptor has an antidiuretic effect V 3 receptor is responsible for endocrine functions
Has effect on both alpha and beta receptors Primarily alpha causing vasoconstriction Beta activity less than other vasopressors First line vasopressor in most clinical scenarios SOAP-II trial Recommended as first-line agent in surviving sepsis guidelines
Has both vasopressor and inotrope activity Could be considered an “ino-pressor”
Nearly equal on both Important to know what the titration goal is!
Acts on vasopressin receptors to induce vasoconstriction Differentiates from other vasopressors Targeting alternate pathway may provide additional benefit Potential for gut ischemia due to vasoconstriction in splanchnic circulation
Spectrum of primary activity is dose dependent Affects dopamine, beta, and alpha receptors No longer considered a first line vasopressor in sepsis guidelines Higher incidence of adverse effects than norepinephrine (SOAP II trial)
N Engl J Med 2010;362:779- 89
All patients with shock were randomized for first-line vasopressor therapy Dopamine: n = 858 Norepinephrine: n = 821 Over 60% of patients with septic shock Primary outcome was 28 day mortality N Engl J Med 2010;362:779- 89