Commonly used Inotropic & Vasopressor Agents:
Ref. Braunwald Heart disease 12th Ed.
| DRUG | CLINICAL INDICATION | DOSE |
|---|---|---|
| CATECHOLAMINES: | |
|
| Dopamine* | Shock (vasodilatory, cardiogenic) |
2 - 20 μg /kg/min (Max-50) |
| Dobutamine* | Low CO (decompensated HF, cardiogenic shock, sepsis induced cardiac dysfunction) |
2 - 20 μg /kg/min (Max-40) |
| Norepinephrine |
Shock (vasodilatory, cardiogenic) |
0.01 - 3 μg /kg/min |
| Epinephrine | Cardiac arrest Anaphylaxis Shock (vasodilatory, cardiogenic) |
Infusion: 0.01 - 0.10 μg /kg/min Bolus: 1 mg IV q 3-5 mins (max 0.2 mg/kg) IM: [1:1000] 0.1 -0.5 mg (max 1 mg) |
| Isoproterenol | Bradyarrhythmias Brugada syndrome |
Infusion: 2 - 10 μg /min |
| Phenylephrine | Hypotension (vagal shock, medication induced, Aortic stenosis, HOCM) |
Bolus: 0.1 - 0.5 mg IV q 10 to 15 mins Infusion: 0.4 - 10 μg /kg/min |
| OTHER AGENTS: | ||
| Vasopressin | Shock (vasodilatory, cardiogenic) Cardiac arrest |
Bolus: 40 U IV bolus Infusion: 0.01 - 0.1 U/min (Common fixed dose 0.04 u/min) |
| Levosimendan | Decompensated HF | Loading dose: 12 - 24 μg /kg over 10 mins Infusion: 0.05 - 0.2 μg /kg/min |
| Phosphodiesterase inhibitors: |
||
| Milrinone | Low CO (decompensated HF, after cardiotomy) |
Infusion: 0.375 - 0.75 μg /kg/min (Dose adjustment needed for renal failure) |
* For symptomatic bradycardia unresponsive to atropine or pacing - Use dopamine / dobutamine
