G7i / 17B15: List the properties of an ideal inotope. How does adrenaline compare to these ideal properties
17B15: Exam Report
List the properties of an ideal inotrope (50% of marks). How does adrenaline compare to these ideal properties (50% of marks)?
98% of candidates passed this question.
Many candidates scored very highly on this core topic. It was expected information be included on pharmaceutics, cost, availability and compatibilities. Relevant pharmacokinetics (onset/offset, titratability) and pharmacodynamics (including relevant receptors, nuances of haemodynamic effects e.g. effect on diastolic pressure and regional perfusion) should have been detailed. Adverse effects and safety profile (e.g. use in pregnancy, therapeutic index) should also have been included.
Good answers were structured and highlighted differences with specific facts and data.
G7i / 17B15: List the properties of an ideal inotrope (50 marks). How does adrenaline compare to these ideal properties (50 marks)?
Ceutics
Ideal
Adrenaline
Non toxic
Y
Stable in solution
Y
No reconstitution before use
N – inotropy requires infusion / reconstitution
Stable in air & light
N
Long shelf life
Y
Compatible w all fluids/drugs
N
No additives
N
Cost effective
Y
Does not support bacterial growth
Y – contains sodium metabisulphite
Standard dose (no dose calculation required)
N – requires titration
PD
Ideal
Adrenaline
Y
Works on one receptor
Alpha and beta agonist, depending on dose
Cardiovascular only
Multiple sites of action
+ve inotropy
Y
No effect on myocardial O2 consumption
N
Increases MAP
Y
Maintains DBP
Y
Non-arrythmogenic
N
Improves regional perfusion
Y
PK
Ideal
Adrenaline
Rapid onset / offset
Y
Completely metabolised, organ independent
N
Inactive metabolites
Y
No tolerance
N
No concentration monitoring requirement
Y
Adverse Effects
Ideal
Adrenaline
None
Many
Safe in pregnancy
Can cause fetal HR acceleration
Wide therapeutic index
Dose dependant PD profile
- Author: Krisoula Zahariou