CRNA Interview questions with correct answers

Norepinephrine Mechanism of Action (MOA) CORRECT ANSWER A1, A2, B1 agonist. Primary agent used in distributive shock because it's ability to recruit venous volume and augment preload, while increasing arterial tone, and increasing cardiac output. Alpha one causing peripheral smooth muscle contraction. (low dose venous, high dose venous and arterial). Alpha 2 adrenoreceptor agonism actually antagonizes the release of norepinephrine in the CNS, but these receptors are less present in peripheral vasculature and thus, their anti-hypertensive effects are overtaken by A1 agonism. These alpha effects can increase SVR and thereby increase cardiac workload, decrease cardiac output, and increase coronary perfusion pressure. The slight B1 agonism increases inotropy and chonotropy sufficiently to overcome these A1 effects and result in a fairly "pure" vasopressor. Increasing contraction of the heart and increasing AV nodal conduction. **First line agent in septic shock Epinephrine MOA CORRECT ANSWER A1 A2