Questions and CORRECT Answers
alpha receptors I & II - CORRECT ANSWER - Alpha I is GQ- leads to increased ca and
smooth muscle contraction
Alpha II GIO-pre-synaptic negative feedback.
Beta receptors I & II - CORRECT ANSWER - Beta I GS increases, mainly cardiac muscle
cyclic AMP, increased contractility, HR, Av nodal conduction
Beta II-GS, smooth muscle relaxer, peripheral and lungs
Beta III-lypolosis.
Vasopressin - CORRECT ANSWER -
Norepinephrine - CORRECT ANSWER - A neurotransmitter involved in arousal, as well as in
learning and mood regulation
Minimal beta II (related to bronchial constriction)
Positive inotrope, and a lot of peripheral alpha, so peripheral vasoconstrictor.
Epinephrine - CORRECT ANSWER - Neurotransmitter secreted by the adrenal medulla in
response to stress. Also known as adrenaline.
Alpha I &II
Beta I & II
Low dose is Beta I- inotropy w.o a lot of vasoconstriction.
Increased doses alpha and beta
Mcg/kg/min
Beta II has to do with allergic reaction and bronchial relaxation
Dopamine receptor - CORRECT ANSWER - smooth muscle contraction
,V I receptors - CORRECT ANSWER - G protein couple with smooth muscle contraction
Phosphodiasterase receptor III - CORRECT ANSWER - Breaks down cyclic AMP, so if you
inhibit it, you prevent the breakdown and have more available, in cardiac it's the same as Beta I,
peripheral is smooth muscle relaxation
Inodilators - CORRECT ANSWER - contractility and vasodilation
dobutamine
isoproterenol
milrinone
Systemic vasodilation with hypotension. Beta I can cause arrhythmia.
Phenylephrine - CORRECT ANSWER - Selective alpha I receptor, causing peripheral
vasoconstriction. No beta, so effect on heart
Dopamine - CORRECT ANSWER - A neurotransmitter associated with movement, attention
and learning and the brain's pleasure and reward system.
Beta I, II Alpha I, II, and all the dopamine receptors
Hypotension with bradycardia, be careful with arrhythmia b/c of beta I
Ephedrine - CORRECT ANSWER - Indirect release of norepinephrine , so will lose effect
Dobutamine - CORRECT ANSWER - beta 1 agonist and to lesser extent Beta II. Beta I
increased contractility, increased AV nodal, increased HR. Beta II is what causes vasodilator.
Milrinone - CORRECT ANSWER - leads to more cyclic AMP, causes inotropy, av node, hr,
vasodilation. lower svr and pvr
, Isoproterenol - CORRECT ANSWER - Mostly beta I, increased HR with some inotropy and
av nodal conduction. Beta II is less apparent.
Risk with Beta I agonism - CORRECT ANSWER - Risk of arrhythmia and peripheral
ischemia . The higher the dose, the more risk. Intestinal ischemia w/or w/o anastomosis.
Vasopressor priority in septic shock - CORRECT ANSWER - Norepinephrine
Vasopressin
Epinephrine
Peripheral vasodilation, need strong Alpha I for constriction.
Phenylephrine will decrease cardiac output by increase svr with out any Beta I (inotropy)
Vasopressor priority in cardiogenic shock - CORRECT ANSWER - Epinephrine for increased
co and increased SVR
If you need to decrease SVR, use inotrope
Treatment priority in hemorrhagic shock - CORRECT ANSWER - Volume is first, then
pressor to support
Vasopressor priority in aortic stenosis - CORRECT ANSWER - Phenylephrine- raise svr and
possible decrease HR, because your heart is already pushing against stenotic valve. Possible
reflex Bradycardia
Vasopressor priority in cardiac tamponade - CORRECT ANSWER - Epinephrine for
increased HR and inotropy
Increased pulmonary pressure with hypotension - CORRECT ANSWER - Vasopressin is go to
b/c it only acts peripherally.