CVICU With 100% COMPREHESIVE QUESTIONS AND ANSWERS
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,8/21/24, 11:32 AM
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phosphodiesterase (PDE3) inhibitor
positive inotrope - enhances CO by directly inhibiting phosphodiesterase from metabolizing cAMP
which increases Ca into cells -> forceful contraction.
Milrinone vasodilator properties (lowers afterload & preload- decrease SVR & PVR, PAOP lv preload) by
decreasing intracellular Ca in vascular smooth muscle
ideal for pts with RV failure. decreases coronary vascular resistance (good for myocardial o2
consumption.
1. CPR
2. shock VF/pVT (Epi only and no shock for 3. Asystole & PEA)
4. CPR 2 min, IV/IO access
5. shock
ACLS
6. epi 1mg q 3-5 min
7. CPR 2 min
8. Amio 300mg then 150mg, or Lido 1mg/kg then 0.5mg/kg
9. Treat reversible causes (H/T)
V2 receptors on renal collecting ducts(Distal convoluted tubule of the loop of henle)
Increases water permeability (cAMP-dependent mechanism), which leads to decreased urine
formation. This increases blood volume, cardiac output and arterial pressure.
Vasopressin
Contracts vascular smooth muscle -> causes vasoconstriction of capillaries & small arterioles ->
increase MAP
May improve LV function, which increases CO and coronary blood flow
Increases secretion of corticotropin in the anterior pituitary gland that stimulates the adrenal cortex.
The adrenal cortex produces cortisol which regulates BP.
For profound hypotension when volume repletion is inadequate. Can be administered with fluid
resus if the pt's BP and CO are significantly impaired.
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