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Vasopressor Foundations - #MEDSHED

Updated: Sep 15, 2023

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💥 Vasopressor Basics 📋

💊 Vasopressors are a temporary bandaid for critically ill patients until we fix the problem. They increase CO and vascular tone from catecholamines.

🌐 Vasopressors are a complex medication class, so heres the PHARMD down version. Let's start receptor basics, alpha receptors and vasopressin 1 are responsible for peripheral vasoconstriction. Beta 1, Beta 2. 1 heart 2 lungs. Don't forget theres beta 2 receptors in your periphery cause vasodilation.

📢 Now let me orient you to this graph. The vertical line represents vasoconstriction and the horizontal line indicates inotropy. Vasopressin and phenylephrine, at the top of the graph, are pure vasoconstrictors.

👾 Norepinephrine sits nicely in the middle with potent vasoconstriction from alpha agonist with a side of beta inotropy.

💉 Epinephrine hits alpha and beta everywhere; beta 2 agonism reduces the alpha vasoconstriction effects while beta 1 keeps your heart pumping stronger.

Dopamine is far off the graph because thats where it belongs; high rates of arrhythmias exclude its use and theres better options.

Norepinephrine makes sense in most cases initially because we're not as likely to develop tachycardia as we would with epinephrine. For more PHARMFAX in the drug bank, comment below, what are you reaching for after norepinephrine?

📢 Let me know your thoughts in the comments!

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