My grand padlet by https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt en-us 2023-09-18 13:07:55 UTC 2023-09-18 16:09:27 UTC hello@padlet.com Epinephrine shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708818661 2023-09-18 13:25:22 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708818661 Phenylephrine (Neo-Synephrine) shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708823735 2023-09-18 13:27:57 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708823735 Dopamine shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708833162 2023-09-18 13:32:31 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708833162 Norepinephrine shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708836984 2023-09-18 13:34:31 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708836984 Dobutamine shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708841661 2023-09-18 13:36:55 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708841661 Adrenergic and Dopamine Receptors shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708853379 2023-09-18 13:43:06 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708853379 Vasopressor Administration Policy shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708869986 2023-09-18 13:51:05 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708869986 Overview shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708876834 2023-09-18 13:54:34 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708876834 Vasopressin Use in Shock States shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708894590 2023-09-18 14:03:01 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708894590 1. Hypoperfusion shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708954467 Excessive vasoconstriction from vasopressors can cause inadequate perfusion of the extremities, mesenteric organs, or kidneys.

Commonly occurs in the setting of inadequate cardiac output or inadequate volume resuscitation

Clinical Signs: dusky fingers/toes, gastritis, shock liver, translocation of gut flora with resultant bacteremia

Prevention: adequate fluid resuscitation and maintenance of MAP goals
]]> 2023-09-18 14:33:47 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708954467 2. Dysrhythmias shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708956192 Many vasopressors exert chronotropic effects via stimulation of beta-1 adrenergic receptors. 

Clinical Signs: sinus tachycardia (most common), atrial fibrillation w/ rapid ventricular response, re-entrant atrioventricular node tachycardia, or ventricular tachyarrhythmias.

Prevention: adequate volume loading may minimize the frequency or severity, limit vasopressor dose, switch to another agent with less beta-1 effects. 

]]> 2023-09-18 14:34:42 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708956192 3. Myocardial Ischemia shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708957829 Positive chronotropic and inotropic effects of vasopressors can increase myocardial oxygen consumption. Despite coronary vasodilation with vasopressors, perfusion may be inadequate to accommodate increased oxygen demand.

Clinical Signs: ST depression and T-wave changes

Prevention: routine EKGs to monitor for signs of myocardial ischemia and avoid vasopressor induced tachydysrhythmias. 

]]> 2023-09-18 14:35:32 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708957829 4. Local Effects shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708958838 Peripheral extravasation of vasopressors into the surrounding tissues can lead to local vasoconstriction with subsequent skin necrosis.

Prevention: administer pressors via central line whenever possible, use PIVs in place for less than 24 hours, use 20G PIVs or larger, avoid IVs in areas of flexion. 

]]> 2023-09-18 14:36:08 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708958838 5. Hyperglycemia shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708960064 May occur due to the inhibition of insulin secretion. Hyperglycemia is generally minor however is more pronounced with norepinephrine and epinephrine. 

Prevention: Routine monitoring of blood glucose while on vasopressors. 

]]> 2023-09-18 14:36:46 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708960064 Dopamine in Cardiogenic Shock shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708967380 Norepinephrine is preferred over dopamine as the first-line vasopressor in cardiogenic shock. A randomized trial found that patients with cardiogenic shock who received dopamine had a higher mortality than those who received norepinephrine.]]> 2023-09-18 14:40:28 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708967380 Pheochromocytomas shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708968219 Patients with pheochromocytoma are at risk of excessive autonomic stimulation from adrenergic vasopressors.]]> 2023-09-18 14:40:55 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708968219 Idiopathic Hypertrophic Subaortic Stenosis shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708969260 Dobutamine is contraindicated in idiopathic hypertrophic subaortic stenosis.]]> 2023-09-18 14:41:28 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708969260 Concurrent use with MAOI's shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708970738 Patients receiving monoamine oxidase inhibitors are extremely sensitive to vasopressors and, therefore, require much lower doses.]]> 2023-09-18 14:42:13 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2708970738 Post-Test (Optional) shannon_cartwright https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2709048024 Test your vasopressor knowledge using the link above or go to Kahoot.com and enter this pin:
03943990]]> 2023-09-18 15:23:04 UTC https://padlet.com/shannon_cartwright/4n7fzmpd87svkxvt/wish/2709048024