In this 14-minute presentation from Rebellion in EM 2021, Dr. Haney Mallemat, using his chalk talk CritBits style, discusses the various vasopressors and their pros/cons.
Haney Mallemat, MD
Emergency Medicine/Critical Care
Associate Professor
Cooper University Health Care
Twitter:Â @CriticalCareNow
Objectives
- Outline the various vasopressors available
- Discuss the clinical situations when to use specific vasopressors
Vasopressors:
- Dopamine – Pressor looking for an indication
- Phenylephrine – Alpha agonist; Vasoconstriction; Can decrease CO
- Epinephrine – Alpha/Beta agonist; Lower doses Beta > Alpha; Higher doses Alpha > Beta; Can cause arrhythmias and type B lactic acidosis; Consider 1st line in status asthmaticus and anaphylactic shock
- Norepinephrine – Alpha/Beta agonist; Increases arterial/venous tone and can increase pulmonary vascular resistance; Consider 1st line in septic shock
- Vasopressin – V1 receptor agonist; Less likely to increase pulmonary vascular resistance compared to other vasopressors
- Angiotensin II – Very expensive; Not readily available; Studied in sepsis and distributive shock
Post Peer Reviewed By:Â Salim R. Rezaie, MD (Twitter:Â @srrezaie)
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