Term
|
Definition
| persisten hypotension and tissue hypoperfusion due to cardiac dysfunction in the presence of adequate intravascular volume |
|
|
Term
|
Definition
hypotension SBP < 90 for at least 30 min
reduced Cardiac index
(<2.2 L/min per m2) in the presence of elevated PAOP |
|
|
Term
| Inotropic support in patients with: |
|
Definition
inadequate tissue perfusion
adequate intravascular volume
options: milrinone
dobutamine |
|
|
Term
| ideal drug attributes for shock status |
|
Definition
quick onset
easy titration
metabolism,elimination
minimal AE
ROA
cost low |
|
|
Term
|
Definition
| drug that causes increased myocardial contractility |
|
|
Term
|
Definition
| drug that causes increased heart rate |
|
|
Term
| inotrope of choice for cardiogenic shock |
|
Definition
DOBUTamine
increases CO, SV
decreases PCWP, SVR
predominant B1 agonist with weak B2
|
|
|
Term
|
Definition
2.5-20 mcg/kg/min
change every 30 min - hour |
|
|
Term
| secondline inotrope and MOA |
|
Definition
milrinone
MOA: inhibits breakdown of cAMP by inhibiting PDE3
increases Calcium influx which increases contraction
some peripheral vasodilation possible |
|
|
Term
|
Definition
0.125 - 0.375 mcg/kg/min
renal adjustment required |
|
|
Term
| dopamine dose dependent effects |
|
Definition
1-3 : activates DA rec. in renal, mesenteric, and cerebral circ. inc blood flow
5-10 :stimulates Beta recep. in heart (inc. CO, HR, contractility)
10-20: stimulates alpha receptors, inc. SVR by vasoconstriction |
|
|
Term
| epinephrine dose dependent actions |
|
Definition
B-receptor agonist at low doses (0.01-0.05)
a-receptor agonist at high doses (>0.05) |
|
|
