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Samenvatting Hemodynamische medicatie

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Hoofdstuk hemodynamic medication samenvatting van het boek: Marino's the ICU book

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Hemodynamische medicatie:

Catecholamines:
promoten bloedflow en bloeddruk adrenerge receptoren activeren.




Dobutamine:
synthetisch cathecholamine: inodilator inotropicum+ vasodilatatie

primair een B1-receptor agonist.  verhoogde hartfrequentie en slagvolume+ perifere vasodilatatie.
 verhoogde myocardiale O2 consumptie
Gebruik bij myocardiale depressie bij septische shock+ noradrenaline om tensie te verhogen.

infusie van 3-5mugram/kg/min zonder oplaad.. Therapie gedreven op hemodynamische eindpunten.
Bijwerkingen: regelmatig tachycardie, contra-indicatie bij hypertrofische cardiomyopathie.




Dopamine: endogeen catecholamine; precursor van noradrenaline
Werking: verhoogd bloedflow in darm en nieren. Geeft natriuresis.
Bij hogere dosering > 10 mugram/kg/min  systemische en pulmonaire vasoconstrictie  verhoging
afterload.

Klinisch gebruik:
cardiogene shock en septische shock

Bijwerkingen:
sinus tachycardie en AF, verhoging oogdruk.

 extravasatie van vasopressie:
geeft weefsel necrose( vooral dopamine)  grote centrale venen gebruiken
bij vrij komen in perifeer vat; phentolamine gebruiken( alfa-receptor antagonist)


Adrenaline:
meest potentiele B-agonist
stimuleert zowel alfa als beta receptoren. Verhoogde HF, stroke volume en tensie. Meer potent dan

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