| Pressor |
Initial Dose |
Max Dose |
Cardiac Effect |
BP Effect |
Arrhythmias |
Special Notes
|
| Dobutamine |
3-5 mcg/kg/min |
5-15 mcg/kg/min (as high as 200) [1] |
Strong ß1 agonist +inotrope +chronotrope, Weak ß2 agonist +weak vasodilatation ) |
alpha effect minimal |
HR variable effects. |
indicated in decompensated systolic HF, Debut Research 1979[2] Isoproterenol has most Β2 vasodilatory and Β1 HR effects
|
| Dopamine |
2 mcg/kg/min |
20-50 mcg/kg/min |
β1 and NorEpi release |
α effects if > 20mcg/kg/min |
Arrhythmogenic from β1 effects |
More adverse events when used in shock compared to Norepi[3]
|
| Epinepherine |
0.1-1 mcg/kg/min |
|
+ inotropy, + chronotropy |
|
|
|
| Norepinephrine |
0.2 mcg/kg/min |
0.2-1.3 mcg/kg/min (5mcg/kg/min) [4] |
mild β1 direct effect |
β1 and strong α1,2 effects |
Less arrhythmias than Dopamine[3] |
First line for sepsis. Increases MAP with vasoconstriction, increases coronary perfusion pressure, little β2 effects.
|
| Milrinone |
50 mcg/kg x 10 min |
0.375-75 mcg/kg/min |
Direct influx of Ca2+ channels |
Smooth muscle vasodilator |
|
PDE Inhibitor which increases Ca2+ uptake by sarcolemma. No venodilatory activity
|
| Phenylephrine |
100-180 mcg/min then 40-60 mcg/min |
0.4-9 mcg/kg/min |
|
Alpha agonist |
|
Long half life
|
| Vasopressin |
Fixed Dose |
0.01 to 0.04 U/min |
unknown |
increases via ADH peptide |
|
should not be titrated due to ischemic effects
|
| Methylene blue[5] |
IV bolus 2 mg/kg over 15 min |
1-2 mg/kg/hour |
Possible increased inotropy, cardiac use of ATP |
Inhibits NO mediated peripheral vasodilation |
|
Don't use in G6PD deficiency, ARDS, pulmonary hypertension
|
