5.6.24
Quick Review #133 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry #dental
1. Neo (Phenylephrine):
- Mechanism: Phenylephrine is a pure alpha-1 adrenergic receptor agonist, which means it primarily causes vasoconstriction.
- Effects: It increases blood pressure by constricting blood vessels but does not significantly affect heart rate or cardiac output. This makes it useful in situations where an increase in blood pressure is needed without stimulating the heart, such as in patients with tachyarrhythmias.
2. Ephedrine:
- Mechanism: Ephedrine acts by increasing the release of norepinephrine and also has some direct agonist activity at alpha and beta adrenergic receptors.
- Effects: It increases both blood pressure and cardiac output by causing vasoconstriction and increasing heart rate. It can also lead to a more pronounced increase in heart rate compared to phenylephrine or norepinephrine.
3. Levophed (Norepinephrine):
- Mechanism: Norepinephrine is a potent agonist at both alpha-1 and beta-1 adrenergic receptors, though it predominantly affects alpha receptors.
- Effects: It significantly increases blood pressure through vasoconstriction and also has some effect on increasing cardiac output and heart rate, but these are generally less pronounced compared to ephedrine.
4. Vasopressin:
- Mechanism: Vasopressin is a non-catecholamine vasopressor that primarily acts on V1 receptors, which are located on vascular smooth muscle cells. Activation of these receptors leads to vasoconstriction, which increases blood pressure. Vasopressin also acts on V2 receptors in the kidneys, increasing water reabsorption and contributing to an increase in blood volume.
- Effects:
1. Increased Blood Pressure: Vasopressin increases systemic vascular resistance through vasoconstriction, effectively elevating blood pressure.
2. Adjunct in Septic Shock: It's often used as an adjunct to catecholamine vasopressors in septic shock, especially when catecholamines alone are insufficient or when tachyarrhythmias need to be avoided.
3. Minimal Effects on Heart Rate: Vasopressin generally does not significantly affect heart rate, making it useful in situations where tachycardia is undesirable.
References:
1. Farkas, J. (2020, February 20). Vasopressors. In Internet Book of Critical Care (IBCC). Retrieved from https://lnkd.in/ernhavwk.
2. Vanderbilt University Medical Center. (2023). Clinical Practice Guidelines. Retrieved from https://www.vumc.org
3. UCSC Genome Browser Home. (2024). Retrieved from https://genome.ucsc.edu
4. Massachusetts Institute of Technology. (2024). Retrieved from https://www.mit.edu
5. ChatGPT. 2024. - #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #oralsurgeon #dentist #doctorgallagher #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency
