MOA
Which drug only acts on Beta 1 receptors
Dobutamine
Dobutamine is a Selective beta-1 adrenergic agonist that works directly on the heart to increase contractibility and increase cardiac Output
This drug has a 10 minute duration of action
Dopamine
Dopamine has a brief 10- minute action time.
Parental use can cause sx of CNS stimulation, Reflex Bradycardia, and reduced blood flow to tissues.
Phenylephrine
Because it causes reflex bradycardia, patients with preexisting bradycardia should not receive phenylephrine.
Used to correct shock, hypotension, & shock r/t heart failure
Dobutamine
Especially beneficial when shock is related to heart failure vs. hypovolemia or sepsis.
What Drug should not be given to children under 2 years of age.
Phenylephrine
Phenylephrine or pseudoephedrine should not be given to children under age 2 years because overdose may cause serious illness or death.
Contraindicated in closed-angle glaucoma, severe shock, dysrhythmias, and hypersensitive to other adrenergic agonists
Epinephrine
Contraindicated in closed-angle glaucoma, severe shock (other than anaphylaxis), dysrhythmias.
Remember not contraindicated in life-threatening conditions
Which drug is a powerful nonselective vasoconstrictor, but does not act on Beta 2 Receptors?
Norepi
Norepi is similar to epinephrine, except that is does not activate Beta 2 receptors
A drug that shouldn't be given with an MAOI.
Phenylephrine
If a patient takes Phenylephrine with an MAOI- it may cause a hypertensive crisis
Reflex bradycardia, hypotension, dysrhythmias
Dobutamine
Dobutamine leads to decreased systemic vascular resistance and may cause life-threatening hypotension, can cause reflex bradycardia, & dysrhythmias
What med would you use for cardiac arrest after CPR has failed, or reversal of anaphylaxis?
Epinephrine
Preferred for cardiac arrest after CPR has failed
What drug is released from the ends of nerve fibers? It is a hormone and a neurotransmitter.
Norepi
Norepinephrine (Noradrenaline) Norepinephrine, also known as noradrenaline, is both a neurotransmitter and a hormone. It plays an important role in your body's “fight-or-flight” response.
Volume deficit needs to be corrected before using this neurotransmitter
Dopamine
Because Dopamine is used primarily for hypovolemic and cardiogenic shock, correct hypovolemia before starting the infusion.
This drug activates Alpha-1, Beta-1, Alpha 2, and Beta-2 receptors
Epinephrine
Epinephrine is a non-selective adrenergic agonist that works on all adrenergic receptors
Resuscitation dosage is 0.5mg-1mg
Epinephrine
Epinephrine given for CPR is usually dosed at 0.5 mg - 1 mg. It comes in a pre-filled syringe of 1mg/10mL of saline
Reflex bradycardia, CNS stimulation, and blurred vision.
Norepi
Blurred vision and photophobia are signs of overdose, can cause reflex bradycardia, and CNS stimulation
For nasal congestion and for hypotension caused by spinal anesthesia or vascular shock.
Phenylephrine
This drug needs a volume expander first
Dopamine
Treat hypovolemic shock treat with volume expanders first, then dopamine if needed
What drug's contraindications are hypertension and PVT?
Norepi
Due to the hypertensive effects, Norepi is contraindicated in patients with high blood pressure. Pulseless Vtach is also contraindicated- we would try Epi in this case.
A selective alpha 1 adrenergic agonist that produces systemic vasoconstriction.
Phenylephrine
Phenylephrine is a selective alpha-adrenergic agonist that works on Alpha 1 receptors
What is used for the extravasation of Norepi?
Phentolamine
Phentolamine is the antidote to Norepi, Epinephrine, Dopamine, and Phenephlephrine as a non-selective alpha-adrenoceptor antagonist.
Nervousness, tremors, palpitations, tachycardia, dizziness, HA. Severe adverse effects HTN, dysrhythmias, pulmonary edema, and cardiac arrest.
Epinephrine
Serious adverse effects include HTN, dysrhythmias, pulmonary edema, cardiac arrest
What med is used for hypotension and shock
Norepi
Frequently given for Hypotension, shock
This alpha 1 adrenergic agonist is a common OTC medication sold for colds
Phenylephrine
Phenylephrine has replaced pseudoephedrine over the counter d/t bootleg meth making
This drug is a contraindication for longer than 72 hours and increases CO to promote blood flow to essential organs
Dobutamine
Therapeutic effects are increased Myocardial Contractility and Cardiac output which in turn increase blood flow to organs.
This drug can cause vasodilation or vasoconstriction depending on the dose
Dopamine
At low doses the drug works on dopaminergic receptors, especially in the kidneys, =vasodilation increasing renal blood flow and enhancing urine output.
Higher doses, Dopamine stimulates -adrenergic receptors, causing the heart to beat more forcefully, increasing cardiac output.
What drug can only be used for 72 hours max?
Dobutamine
Dobutamine should be used only short-term for acute heart failure shock and is not used over 72 hours
This drug causes v-tack with a high dose and severe necrosis
Dopamine
V-tach with high doses and necrosis with vasoconstriction.
This neurotransmitter is also used for hypovolemic and cardiogenic shock
Dopamine
Primarily for hypovolemic and cardiogenic shock
What drug is best for shock r/t heart failure
Dobutamine
Dobutamine is especially beneficial when shock is related to heart failure
HTN, hx of bradycardia, narrow glaucoma, and may worsen angina. Can't be given within 21 days of MAOI use.
Phenylephrine
Contraindications include -HTN, hx of bradycardia, narrow glaucoma, and may worsen angina. Can't be given within 21 days of MAOI use.