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See below: Levophed’s dosing is variable, depends on the condition treated, and may itself change depending the reference or guideline you consult). A common treatment is for low blood pressure/shock, 0.1-0.5 mcg/kg/minute, adjusted to desired pressure response. An older approach some still use is flat dosing (without regard to patient weight) of 8-12mcg/minute to start and a maintenance dose of 2-4mcg/min. ...Read more
After CABG a patient is on pressors & usually an inotrope; after a day or 2 how does the body change/adapt to titrate these dips off during recovery?
Easily explained: The heart muscle recovers its pumping strength. ...Read more
Levophed: Norepinephrine is not specifically used for treatment of head injuries per se but it is used routinely in ICU settings for maintaining blood pressure in critically ill pt's such as those suffering from acute neurologic trauma to attempt to maintain cerebral perfusion in the face of elevated intracranial pressure. ...Read moreSee 1 more doctor answer
Receptors: These three medications are used to support the heart and cardiovascular system ie. blood pressure and heart rate. They are known as sympathomimetics and have a similar response to what you would think of as adrenaline. Each has variable effect on either heart rate, heart function (in terms of strength of 'squeeze') and on blood vessels which would translate to higher blood pressure. ...Read more
I was wondering what are the differences of levophed, dopamine and dobutamine in terms of their action?
You Asked for It----: Dobutamine- direct b1 receptor stimulant or agonist in the sympathetic nervous system. Levophed- vasoconstrictor peripherally (alpha adrenergic effects) and beta adrenergic stimulant at the level of the heart and coronary vessels dopamine- dual b1 and Alpha adrenergic effects. Useful in hypovolemic shock because of conservancy of renal blood flow. Also, works centrally in other complex ways. ...Read more
Unless it is contraindicated for some reason, if inotropes cannot be administered because a patient is nil by mouth can they be administered via IV?
Vasopressors: Necessary cardiovascular medications can be given via IV. ...Read more
Norepi, probably: Norepinephrine or Dopamine would be typical first line choices to treat the hypotension and hypoperfusion of cardiogenic shock. Would guide further additions and titration with swan ganz catheter and arterial line. Titration depends on cardiac function, patient's comorbidities, and arrhythmias from inotrope. ...Read moreSee 1 more doctor answer
Low cardiac output: Cardiogenic shock occurs because of a low output state causing significant low blood pressure. The decrease in cardiac output results from congestive heart failure and or an abrupt insult the cardiac muscle resulting in less cardiac function and this less output. The management involves mess lie, dobutamine, as well as BP raising rx such as Dopamine or levophed. Balloon pump insertion may help. ...Read more