Hypotension and Sepsis Drugs

  1. What is the action of vasopressor?
  2. What is the affect of vascular resistance with vasopressor use?
    Increase systemic vascular resistance
  3. What happens to blood pressure with vasopressor use?
    Increases blood pressure
  4. What is vasopressor used for?
    Treat hypotension by increasing blood pressure
  5. What is crystalloid?
    IV fluids containing NaCl
  6. What are the rationales for treating hypotension?
    • Increase cardiac output
    • Increase systemic vascular resistance
  7. How is cardiac output increased?
    • Increasing blood volume via IV fluids
    • Stimulate heart contractility via inotropic drugs
  8. How to increase systemic vascular resistance?
    Using vasoconstrictor drugs
  9. Whah normal serum osmolarity?
    300 mOsm/L
  10. What could excess chloride cause?
    Hyper Chloe is metabolic acidosis
  11. What is the recommended therapy to treat sepsis and septic shock?
    Administration of IV antimicrobials
  12. What is the recommended antimicrobial therapy for sepsis treatment?
    Empiric broad-spectrum therapy to cover all likely pathogens (fungal and viral included)
  13. What are the most likely microorganisms for intra-abdominal infections?
    Enteric gram-negative rods and anaerobes
  14. What is the regimen to treat intra-abdominal infections?
    Cephalosporins with Metronidazole
  15. True/False: metronidazole is a prodrug activated in susceptible organisms
  16. Is metronidazole bactericidal or bacteristatic?
  17. Metronidazole is the drug of choice for which bacterial infection?
    Anaerobic gram negative (ie. B. frag)
  18. True/false: Metronidazole HAS aerobic gram positive coverage
  19. True/false: Metronidazole does not have aerobic gram negative coverage
  20. What is an aerobic intra-abdominal/ pelvic infection bug?
    E. coli
  21. Can metronidazole be used to treat E. coli?
    No, metronidazole does not have aerobic gram negative coverage
  22. What is the recommended first-choice vasopressor?
  23. What is an alternative vasopressor to norepinephrine?
    Dopamine, in Higley selected patients who are low risk of developing tachyarrhytmias
  24. What is the recommended dosage for soap in for renal protection?
  25. When is dobutamine a recommend vasoactive agent?
    Persistent hypoperfusion despite adequate fluid loading and other vasopressors
  26. What is the physiological respond to Beta one receptor stimulation?
    Increases cardiac output
  27. What is the physiological respond to alpha 1 receptor stimulation?
    Vasoconstriction —> thereby increasing blood pressure
  28. Name 3 catecholamines:
    • Dopamine
    • Norepinephrine
    • Epinephrine
  29. True/false: epinephrine at low dose has vasoconstriction ability by stimulating alpha 1 receptor
    False, only at high dose epi does it have vasoconstriction
  30. What occurs with low dose epinephrine?
    • Contractility
    • Vasodilation
  31. What occurs with high dose epinephrine?
    Contractility and vasoconstriction
  32. True/false: at high dose epinephrine, there is no vasodilation but instead there is vasoconstriction
  33. Does norepinephrine cause vasoconstriction or vasodilation?
  34. Name 4 vasoactive drugs that are catecholamines:
    • Epinephrine
    • Norepinpnephrine
    • Dopamine
    • Dobutamine
  35. Which vasopressor is the main “code” vasopressor?
  36. True/false: epinephrine is the main agent used in CPR
  37. What is vasopressin?
    • A non-peptide hormone formed in the hypothalamus to regulate fluid volume
    • A potent vasoconstrictor
  38. True/False: vasopressin is ADH (antidiuretic hormone)
  39. True/False: vasopressin is typically an add-on therapy to norepinephrine for added vasoconstriction to increase blood pressure
  40. Is dobutamine an inotropic agent?
  41. Is dopamine an inotropic agent?
  42. True/False: Dobutamine is a vasoactive agent but not a vasopressor
  43. Which receptors do dobutamine have an effect on?
    Beta 1 and Beta 2
  44. At which dosage of dopamine would there be vasoconstriction?
    High dose
  45. What receptors do high dose dopamine act on?
    Beta 1 and Alpha
  46. What happens physiologically with low dose dopamine?
    Stimulate contractility and vasodilation
  47. What happens physiologically with high dose dopamine?
    Contractility and vasoconstriction, override previously seen vasodilation
  48. What is a major side effect of beta agonists?
    Cardiac arrhythmia
  49. What is a side effect of beta agonists?
    Cause angina by increasing myocardial O2 demand
  50. What is an adverse effect of alpha 1 receptor mediate vasoconstriction?
    Tissue injury from drug extravasation
Card Set
Hypotension and Sepsis Drugs
Cardiovascular Final