Course Credit: 1 hour
The contents of the traditional “vasopressors and inotropes” pharmacology textbook consist of a brief discussion about mechanisms of action, a bit of pharmacokinetics, some structures sprinkled in for confusion, and a table with +++s or —s denoting receptor affinities. While this information can be useful, it is critical to recognize that the literature feeding these texts is largely based on animal models, often with open chest physiology and may not reflect patients with shock in the emergency department, ICU, or anywhere else.
Similarly, understanding the physiologic effects of these drugs to reach a resuscitationist’s knowledge level requires an exceptional foundational knowledge base upon which to build pharmacotherapeutic understanding. Please review these:
- Starling curves and central venous pressure [Critical Care]
- The Role of Venous Return in Critical Illness and Shock—Part I: Physiology [EMCrit blog]
- Use of inotropes and vasopressor agents in critically ill patients [British Journal of Pharmacology]
| Role | Name | Affiliation |
|---|---|---|
| Author | Craig Cocchio, PharmD, BCPS @iEMPharmD | Emergency Medicine Pharmacist, Trinity Mother Frances Hospital |
| Author | Douglas Gowen, PharmD, BCPS @DougEDPharm | Emergency Medicine Pharmacist, Glens Falls Hospital (Glens Falls, New York) |
| Reviewer | Jill Logan, PharmD, BCPS @EMPharm | Emergency Medicine Pharmacist, University of Maryland Medical Center |
| Reviewer | David Juurlink, BPharm, MD, PhD, FRCPC @DavidJuurlink | Professor of Medicine, University of Toronto |
| Lead Editor | Bryan Hayes, PharmD, FAACT @pharmertoxguy | Emergency Medicine Pharmacist, Clinical Associate Professor; University of Maryland |
Thank you!
This was amazing. I’ve learned a lot. Thanks for the effort in producing such high-quality content.
I don’t think that Phentolamine is available anymore.
https://cantrelldrug.com/media/wysiwyg/Drug-Shortage-Order-Form.pdf I haven’t used this company but on our pharm forums some pharmacists have said they received the product.
Be sure to track drug shortages in the USA on this site: https://www.ashp.org/menu/DrugShortages/ResolvedShortages/Bulletin.aspx?id=349
Phentolamine was gone from the market for a few months but Westward picked it up. We have in stock with a good exp. date.
Thank You, yall rock
Hey Thad, we’re thrilled that you like the series!