Patient specific
What is the ideal vasopressor for patients with HOCM pathophysiology in septic shock
What is phenylephrine
Vasodilator that acts on coronary arteries
What is Nitroglycerin?
Give this if your CVP is low.
What is give fluids?
What is the first line vasopressor for Septic Shock
What is levophed
When your levophed dosing is about 15mcg/kg/min
A patient with severe MR, with HR in the 60s, BP at 130/80s - what is the medical management before surgical intervention
What is dobutamine?
What anesthetic decreases SVR the most? What is the most cardiac stable anesthetic
Propofol>>Etomidate>Fentanyl> Versed
Name three (non imaging) ways to determine fluid status
What is often the second line of vasopressors in septic shock if normal heart function, and no tachcyardia noted and why is this medication the recommended second choice in the absence of other cardiac issues.
What is vasopressin, during a stress response, endogenous vasopressin starts to drop off with the very first few hours
When do you add on Hydrocortisone in Septic shock
When you are on two pressors, or when you are on a single pressor for at least 4 hours without improvement and generally at doses around >20-25mcg/kg/min
What is the medical management for pt in afib with rvr with blood pressures in 60/40s
What is SHOCK then pressors (phenylephrine)
This inodilator must be used judiciously in renal patients
What is milrinone
What is the RAP/CVP based on US findings of the following
<2cm - <50% Resp Variation
<2cm - >50% Resp Variation
>2Cm - <50% Resp Variation
>2cm - >50% Resp Variation
0,5,5,10
When is Phenylephrine gtt an appropriate choice for vasopressor for shock
In aortic stenosis, in pts with afib with rvr, or generally fast heart, if appropriately resuscitated.
What vasopressor puts you at the highest risk for mesenteric ischemia, and generally what dosing
Vasopressin, any dosing above 0.04, but 0.06 is when the risk really escalates
What is a the vasopressor of choice in patients with cirrhosis of the liver
What medications can cause hypoxemia often seen in NSGY patients (name two common medications and the mechanism of action)
Clevidipine/ Nicardipine - inhibits pulmonary hypoxemic vasoconstric
This ionotropic med decreases preload.
What is dobutamine?
What vasopressors can be administered through an IO
What is all of them
<0.05 and >.1
You can bolus digoxin (but remember digoxin may be less effective, or inadequate, for controlling the ventricular rate during exercise or when sympathetic tone is increased. )
Which two vasodilators can cause methemoglobinemia
What is Nitroglycerin and Nitroprusside
Name me 3 conditions in which you are preload dependent
Cardiac Tamponade, Pericardial Effusion, RV failure
What vasopressor can be administered through the ETT tube?
Remember mneomnic: NAVEL
naloxone, atropine, vasopressin, epinephrine, and lidocaine
At what dosing does levophed have more Beta activity and increases risk for arrhythmogenicity
>15mcg/kg/min