A 78-year-old man with severe dementia is brought to the emergency department after experiencing lethargy, fever, and vomiting for the previous day. The patient is in a nursing home, and his caregivers report that his oral intake has been poor over the last week. Emphysema, heart failure with reduced ejection fraction, hypertension, and type 2 diabetes are all risk factors. The patient is lethargic but arousable on physical examination. The blood pressure is 60/30 mm Hg, and the pulse rate is 120 beats per minute. The extremities are comfortable. Over the right lower lung, coarse rhonchi can be heard. Following a series of intravenous fluid boluses, the patient receives an intravenous infusion of an agent that increases peripheral vascular resistance, blood pressure, and heart rate. Which of the following agents is most likely being described?

Question

Quizplus · Accepted Answer

Eductional Objective: Phenylephrine is a selective alpha-1 agonist with no effect on alpha-2 or beta receptors.  It causes peripheral vasoconstriction that increases systemic vascular resistance and blood pressure.  It has no direct effect on the heart but stimulates a reflex-mediated decrease in heart rate and myocardial contractility.

A 78-Year-Old Man with Severe Dementia Is Brought to the Emergency