MICU intern's survival guide vasopressors: Difference between revisions
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==Overview== | ==Overview== | ||
===Norepinephrine=== | ===Norepinephrine=== | ||
====Mechanism of action==== | |||
Acts on both alpha1 (vasoconstriction of blood vessels) and beta1 receptors (increases cardiac output). | |||
====Indications==== | |||
* [[Septic shock]] | |||
* [[Cardiogenic shock]] - Recent studies have shown that [[norepinephrine]] may be better than [[dopamine]] in [[cardiogenic shock]] due to a decreased risk of [[tachyarrhythmia]]s. | |||
* In cases where the type of shock is unclear, [[norepinephrine]] can be tried as a first line agent. | |||
* Doses - 1-30 mcg/min. | |||
===Dobutamine=== | ===Dobutamine=== | ||
Revision as of 14:28, 28 December 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Norepinephrine
Mechanism of action
Acts on both alpha1 (vasoconstriction of blood vessels) and beta1 receptors (increases cardiac output).
Indications
- Septic shock
- Cardiogenic shock - Recent studies have shown that norepinephrine may be better than dopamine in cardiogenic shock due to a decreased risk of tachyarrhythmias.
- In cases where the type of shock is unclear, norepinephrine can be tried as a first line agent.
- Doses - 1-30 mcg/min.
Dobutamine
Vasopressin
Dopamine
- Mechanism of action
- Acts on alpha1 (vasoconstriction of blood vessels), beta1 (increases cardiac output) and dopamine receptors (scattered throughout the body).
- Its action is dose dependent. At low doses it predominantly acts on cardiac receptors (1-10 mcg/min) with less vasoconstriction activities. At higher doses it has both vasoconstriction and cardiac activities.
- Indications:
- Cardiogenic shock
- Septic shock - second line treatment for septic shock
- Side-effects
- Arrhythmogenic. Avoid in patients prone to arrhythmias.
- Doses
- 1-20 mcg/min.