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Inotropes and Vasopressors Overview

This document summarizes inotropes and vasopressors used to treat shock. It provides the drug name, dose range, mechanism of action, and effects on heart rate, cardiac function, oxygen demand, systemic and pulmonary vascular resistance. Dopamine, dobutamine, epinephrine, and norepinephrine are listed as inotropes. Milrinone, neosynephrine, and vasopressin are listed as vasopressors. The second table matches types of shock to recommended infusions and comments on their effects and considerations.

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Heather Porter
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97 views2 pages

Inotropes and Vasopressors Overview

This document summarizes inotropes and vasopressors used to treat shock. It provides the drug name, dose range, mechanism of action, and effects on heart rate, cardiac function, oxygen demand, systemic and pulmonary vascular resistance. Dopamine, dobutamine, epinephrine, and norepinephrine are listed as inotropes. Milrinone, neosynephrine, and vasopressin are listed as vasopressors. The second table matches types of shock to recommended infusions and comments on their effects and considerations.

Uploaded by

Heather Porter
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Table 1: INOTROPES & VASOPRESSORS

(S. Kache, MD)

Inotropes

Dose

Mechanism of Action

Heart
Rate

Systolic
Function

Diastolic
Function

Myocardial O2
demand

SVR

PVR

Dopamine

1-5 mcg/kg/min

Dopaminergic agonist

Increase

Minimal effect

No effect

Minimal Increase

Minimal increase

No effect

Dopamine

6-10 mcg/kg/min

1 agonist

Increase

Increase

No effect

Increase

Increase

Minimal
increase

Dopamine

11-20 mcg/kg/min

agonist

Increase

Increase

No effect

Increase

Significant
Increase

Minimal
increase

Dobutamine

1-10 mcg/kg/min

1 agonist, antiagonist

Increase

Increase

No effect

Increase

Decrease

Minimal
decrease

Epinephrine

0.01-1 mcg/kg/min

1 agonist > agonist

Increase

Significant
Increase

No effect

Significant increase

Increase

Minimal
increase

Norepinephrine

0.01-1 mcg/kg/min

1 agonist < agonist

Increase

Some Increase

No effect

Increase

Significant
Increase

Minimal
increase

Milrinone

0.1-1 mcg/kg/min

Phosphodiesterase
inhibitor

No
change

Increase

Improves

Minimal Increase

Decrease

Decrease

Neosynephrine

0.1 - 2 mcg/kg/min

Pure agonist

No effect

No Effect

No effect

No effect

Significant
increase

No effect

Vasopressin

0.0003 - 0.008
u/kg/min

V receptor agonist

No effect

No Effect

No effect

No effect

Significant
increase

Effect
unknown

Vasopressors

Table 2 - Shock & Inotropes


Shock

Infusions to consider

Comments

Septic

Early or warm

Dopamine
Norepinephrine

Decreased SVR
Increase CO

Late or cold

Dopamine
Epinephrine
Vasopressin

Increased SVR
Decrease CO
? Decrease in vasopressin
levels

Cardiogenic

Normotensive

Milrinone
Dobutamine

Increased SVR
Decrease CO

Hypotensive

Increased SVR
Decrease CO

Increased SVR
Decreased CO

Increased SVR
Decreased CO

Decreased SVR
Normal CO

Hypovolemic

Epinephrine
Slow addition of Milrinone
once BPs improved
Dopamine
Epinephrine

Obstructive

Dopamine
Epinephrine
Milrinone
Neosynephrine

Distributive

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