"Beta"-cha can't guess this!
These receptors are primarily found in the heart
What are beta-1 receptors
This vasorpressor is first line for septic shock
What is norepinephrine
This is the primary effect of stimulation of Alpha-1 receptors
What is vasoconstriction
This is the definition of shock.
Imbalance between oxygen consumption and delivery.
A 3-year-old male Comes in febrile to 39.5C, lethargic, Pulse 180s with cap refill of 12 seconds BP is 65/25. 7.2/24/125/6/99% BD -25. Lactate is 12. Hemoglobin is 10 g/dL
Interpret the gas.
Metabolic acidosis with incomplete compensation.
This vasoactive can be used for bradycardia, or even for asthma!
What is isoproterenol?
This complication can occur when vasopressors extravasate through peripheral IVs
What is tissue necrosis
Which system are the alpha receptors involved in (sympathetic or parasympathetic)?
Sympathetic (Fight or flight)
What transports oxygen through the body?
Hemoglobin
A 3-year-old comes in febrile to 39.5C, lethargic. Pulse of 180s with cap refill of 12 seconds BP is 65/25. 7.2/24/125/6/99% BD -25. Lactate is 12. Hemoglobin is 10 g/dL.
What is the diagnosis for the child? What are 4 things you want to do?
Septic Shock. Tasks: Antibiotics. Fluid. Norepinephrine. Intubation.
Stimulation of this receptor causes vasodilation and bronchodilation.
Beta 2!
What is the typical dosing range for inhaled nitric oxide?
1 to 20 parts per million.
This drug is a pure alpha-1 agonist
What is phenylephrine
This is the formula for cardiac output.
Heart Rate X Stroke Volume
A 19 year old male with a history of end stage renal disease s/p renal transplant, moderate to severe asthma, and type 2 diabetes, presents with BP 220/140.
What is the diagnosis? How do you treat?
Hypertensive emergency. Nicardipine infusion.
This drug, can be used as an infusion for tachycardia or cardiac arrhythmias, but can cause bronchospasm or hypoglycemia.
When a patient is on epinephrine and norepinephrine for shock, what vasoactive can we use for persistent hypotension?
What is vasopressin?
This vasoactive medication has more alpha 1 effect at higher doses.
What is epinephrine
What kinds of shock does septic shock encompass?
Hypovolemic, cardiogenic, distributive!
6 month old with RSV bronchiolitis is intubated due to respiratory failure, and then is paralyzed, proned, on an epinephrine infusion. She is on high ventilator settings, but still saturating 78%. You have suctioned, sedated, done airway clearance.
What can you do next?
Inhaled nitric oxide.
What end organs do the beta receptors affect? (Points for at least 5)
Eyes, Lungs, Heart, Blood vessels, GI tract, Bladder, Uterus
How does milrinone work in shock?
Leads to increased relaxation of myocardium, peripheral and pulmonary vasodilation
What is the typical dosing range for norepinephrine?
0.05mcg/kg/min- 1mcg/kg/min
These are the types of shock (hint: there are 4)
Hypovolemic, Cardiogenic, Obstructive, Distributive
A 2 year old intubated patient. A line is flat and there is no end tidal CO2.
The rhythm appears to be normal on the monitor.
What do you do?
CPR