Biology > Presentation > PEDS 602 Cardiac_Drip_Presentation_2020 | PEDS602 Cardiac_Drip_Presentation_PEDS 602 Cardiac_Drip_Pr (All)
PEDS 602 Cardiac_Drip_Presentation_2020 Cardiac Medications Used in the Critical Care Unit ALEXANDRA ANGEL, PHARM.D. PHARMACY RESIDENT WEST KENDALL BAPTIST HOSPITALObjectives Provide an over... view for the management of vasoactive medications Apply knowledge and concepts in the initiation, administration, and monitoring of therapy for patients receiving vasoactive medications Discuss overall rationale and management for vasoactive medicationsOutline Adrenergic receptor physiology Medication therapy in: Hypotension (i.e., shock) Hypertension Emergencies Acute Decompensated Heart Failure Arrhythmias Review of: Vasopressors and Inotropes Vasodilators Anti-arrhythmics Other Cardiac medicationsVasoactive Therapy CO: Cardiac Output SVR: Systemic Vascular ResistanceVasopressorsVasopressors Norepinephrine (NE) – Levophed® Epinephrine (Epi) – Adrenalin® Dopamine (DA) – Intropin® Phenylephrine – Neosynephrine Dobutamine – Dobutrex® Vasopressin – Vasostrict®Vasopressors Induce vasoconstriction → ↑ mean arterial pressure (MAP) Some agents may have both vasopressor and inotropic effects Inotropes that ↑ cardiac contractility Dopamine DobutamineAdrenergic Receptor Physiology Receptor Location Physiologic Effect Alpha-1 (α1) Vascular walls • Vasoconstriction (significant) • Heart: ↑ duration of contraction without ↑ chronotropic effects Beta-1 (β1) Heart • ↑ inotropic & chronotropic effects with minimal vasoconstriction Beta-2 (β2) Lungs • Vasodilation Dopamine (DA) Renal, mesenteric, coronary, and cerebral vascular beds • Vasodilation • Stimulates DA receptors → vasoconstriction inducing NE releaseIndications for Vasopressors End-Organ dysfunction due to hypo-perfusion AND either one of the following: Decrease of > 30mmHg from baseline SBP MAP < 60mmHg- - - - - [Show More]
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