Dosing
What vasopressor generally uses fixed dosing instead of titrations?
Vasopressin
Alpha-1 agonism of phenylephrine leads to a(n)_____ in cardiac output.
Decrease
Which vasopressor acts on angiotensin receptors?
A. Norepinephrine
B. Vasopressin
C. Dopamine
D. Angiotensin II
D. Angiotensin II
A patient presents with septic shock, what vasopressor would be preferred?
Norepinephrine
What is the MAP goal for patients with septic shock receiving norepinephrine?
A. 55
B. 65
C. 75
D. 85
B. 65
What is the default initial dose of norepinephrine here at SNGH?
A. 0.5 mcg/min
B. 5 mcg/min
C. 5 mg/min
D. 0.5 mg/min
B. 5 mcg/min
What electrolyte abnormality can be attributed to vasopressin?
A. Hypernatremia
B. Hyponatremia
C. Hypocalcemia
D. Hypercalcemia
B. Hyponatremia
What is the only vasopressor to act on dopamine receptors?
Dopamine
You're rounding on a patient in the GICU who is experiencing refractory shock on a high dose of norepinephrine. What vasopressor would you recommend adding?
A. Angiotensin II
B. Terlipressin
C. Isoproterenol
D. Vasopressin
D. Vasopressin
If high dose vasopressors are run peripherally, this adverse event may occur and cause tissue damage.
Extravasation
A. 8mg/250mL
B. 12mg/250mL
C. 16mg/250mL
D. 20mg/250mL
C. 16mg/250mL
Dusky extremities are a sign of what adverse effect of vasopressors?
(HINT: VIALI)
Vasopressor-Induced Acute Limb Ischemia
This vasopressor exerts its effect exclusively through alpha-adrenergic agonism
A. Vasopressin
B. Norepinephrine
C. Phenylephrine
D. Epinephrine
C. Phenylephrine
A patient requiring vasopressors has developed relative bradycardia. You remember your ACLS bradycardia training and recommend what vasopressor?
Dopamine
What type of line is preferred for vasopressor administration?
Central line
What is the dose of vasopressin that is used in the majority of units at SNGH?
A. 0.02 units/min
B. 0.03 units/min
C. 0.04 units/min
D. 0.05 units/min
B. 0.03 units/min
Which of these vasopressors is not associated with splanchnic hypoperfusion?
A. Low Dose Dopamine
B. Phenylephrine
C. Vasopressin
D. Epinephrine
A. Low Dose Dopamine
Which of these receptors is vasopressin NOT an agonist of?
A. V1a
B. V1b
C. V1c
D. V2
C. V1c
A patient has improved perfusion on their vasopressor but has developed a tachyarrhythmia and their lactate is increasing. What vasopressor are they likely taking?
Epinephrine
Vasopressors are compatible to y-site with each other.
TRUE or FALSE
TRUE
Dopamine exerts its effects on different receptors depending on the dose. What are the receptors and the doses at which they are activated?
DAILY DOUBLE
D1 and D2 - 1-5 mcg/kg/min
B - 5-10 mcg/kg/min
a - >10 mcg/kg/min
Which vasopressor can increase lactate levels even if perfusion is adequate?
A. Epinephrine
B. Phenylephrine
C. Angiotensin II
D. Dopamine
A. Epinephrine
On which receptors does epinephrine act?
A. Angiotensin
B. alpha-1 and beta-1
C. beta-1, beta-2, and alpha-1
D. alpha-1, alpha-2, beta-1, and D1
C. beta-1, beta-2, and alpha-1
A nurse comes running up to your team on rounds and tells you that they ran norepinephrine through a PIV which has now extravasated causing tissue ischemia. The resident panics and stares at you, what medication do you recommend the doctors order?
DAILY DOUBLE
Phentolamine 5-10mg injected along the area of extravasation
What year was norepinephrine first approved?
1950