jumba j05H

goDaddy🐳 tweets!

[jumba j05H @jumbajosh]

You can do it! Aja! -Elle & Caleb

[Qasem Ahmed @QAlmulihi]

Vasopressors and Inotropes - Summary Sheet

1️⃣ Norepinephrine (Levo)
💉 Action: α1 > β1 agonist → ↑↑ SVR, ↑ CO, reflex brady may negate ↑ HR
📌 Uses: Septic shock (1st), Cardiogenic shock (1st), Hypovolemic shock (1st)

2️⃣ Phenylephrine (Neo)
💉 Action: Pure α1 agonist → ↑↑ SVR
📌 Uses: Septic shock with ↑ HR or ↓ BP; AFRVR, HOCM, AS, RV failure

3️⃣ Vasopressin (Vaso)
💉 Action: V1 (↑ SVR), V2 (↑ renal H2O reabsorption)
📌 Uses: Septic shock (2nd line), Anaphylaxis (2nd line), RV failure

4️⃣ Epinephrine (Epi)
💉 Action:
•Low dose: β1 > β2 > α1 → ↑ CO, neutral SVR
•High dose: α1 > β1 > β2 → ↑ CO, ↑ SVR
📌 Uses: ACLS (1st), Anaphylaxis (1st), Symptomatic bradycardia (2nd), Septic shock, Bronchospasm

5️⃣ Dopamine (Dopa)
💉 Action:
•Low: D1 > β1 → ↑ CO, ↑ UOP
•Medium: β1 > D1 → ↑ CO, ↑ SVR
•High: α1 > β1 > D1 → ↑ SVR
📌 Uses: Symptomatic bradycardia, Septic shock with bradycardia (↑ mortality vs. Levo in septic and cardiogenic shock)

6️⃣ Methylene Blue
💉 Action: ↓ NO and cGMP → ↑ smooth muscle tone, ↑ SVR
📌 Uses: Refractory sepsis/anaphylaxis, post-cardiopulmonary bypass, amlodipine overdose, methemoglobinemia

7️⃣ Dobutamine (Dobuta)
💉 Action: β1 > β2 > α1 agonist → ↑ CO, ↓ SVR
📌 Uses: Cardiogenic shock, Add to Levo in septic shock with ↓ LVEF

8️⃣ Milrinone
💉 Action: PDE inhibitor → ↑ cAMP → ↑ inotropy, vasodilation → ↑ CO, ↓ PVR/SVR
📌 Uses: Cardiogenic shock, RV failure (↓ PVR, ↓ LVEDV)

9️⃣ Isoproterenol (Isuprel)
💉 Action: β1 = β2 agonist → ↑ HR, ↓ SVR
📌 Uses: Symptomatic bradycardia, Mg-refractory Torsades

[jumba j05H @jumbajosh]

Exhausting :(

[jumba j05H @jumbajosh]

@elonmuskADO The right twix.

[jumba j05H @jumbajosh]

Called out for my dad bod 😂😂😂. Work out era was 5 years ago pows.

[Pi Network @PiCoreTeam]

We’re proud to announce our first ever Pi Powered Commerce event, PiFest! This December 6-11, join Pioneers worldwide to shop local and support Pi-integrated businesses in your community. Learn about the global event and how to participate here: https://t.co/WFdnSCNGjD

[The Sigma Mindset @thesigmamindset]

STOICISM.

5 Principles to become unshakeable:

[jumba j05H @jumbajosh]

Sinking feeling. Again.

[jumba j05H @jumbajosh]

Tengene. Tried our new coffee. True to it’s claim. Kapeng pang duty. The dilemma: hindi ako duty. FML

[jumba j05H @jumbajosh]

Exhausting :(

[jumba j05H @jumbajosh]

S/P 32/30. Still clueless.

[jumba j05H @jumbajosh]

PR 2/30. Dead tired. Still clueless.

[jumba j05H @jumbajosh]

S/P 1 month Pre res. Pre, rest naman next.

[Oren Gottfried, MD @OGdukeneurosurg]

Cranial nerve testing

[jumba j05H @jumbajosh]

Trust the process.

-Che, 2023

[jumba j05H @jumbajosh]

PR 2/30. Dead tired. Still clueless.

[jumba j05H @jumbajosh]

@iantapac Nengyere

[jumba j05H @jumbajosh]

@Mr_SexAppeal @datumx11 Ff

[jumba j05H @jumbajosh]

@roadtowhitecoat Where did you buy it doc?

[jumba j05H @jumbajosh]

@2022_ple Pashare doc

[jumba j05H @jumbajosh]

@pichipichimd22 @Medikwaksis Currentlly doing mine doc

[PLE QBank 🇵🇭 @pleqbank]

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