Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ See following table. ++Table Graphic Jump Location | Download (.pdf) | PrintVasopressors and InotropesDrugsReceptors activatedHemodynamic effectsDilution (in 250 mL)Final concentrationIV infusion rate (μg/kg/min)IV bolus (if applicable)Special precautions/commentsAdrenergic agonistsEpinephrineα1, α2, β1, β2, β3HR ↑MAP ↑CO ↑PVR ↑–4 mg16 μg/mL0.02–0.3 (2–20 μg/min)Variable, from 5 μg to 1 mgNorepinephrine (Levophed®)α1, α2, β1HR ↓MAP ↑↑CO –PVR ↑↑4 mg16 μg/mL0.05–0.5Phenylephrine (Neosynephrine®)α1, weak α2, weak β1HR ↓MAP ↑↑CO ↓PVR ↑↑10 or 20 mg40 or 80 μg/mL0.15–0.7540–80 μgEphedrineα1 (indirectly), β1, β2HR ↑MAP ↑CO ↑PVR ±5–10 mgRepeated doses less effective (tachyphylaxis)DopamineDA1, DA2RBF ↑↑200 mg800 μg/mL0.5–3 (“renal” dose)β1, β2HR ↑↑MAP ↑CO ↑↑PVR –400 mg1.6 mg/mL3–10 (β dose)α1, α2, β1, β2HR ↑↑MAP ↑↑CO ↑↑PVR ↑↑800 mg3.2 mg/mL10–20 (α + β)Fenoldopam (Corlopam®)DA1HR MAP ↓CO ↑PVR ↓↓10 mg40 μg/mL0.1Increase by 0.1 q15–20 min until target MAP reachedRenal vasodilatorDobutamine (Dobutrex®)β1, weak β2HR ↑MAP ↑CO ↑↑PVR ↓250 mg1 mg/mL2–30Isoproterenol (Isuprel®)β1, β2HR ↑↑MAP ↓CO ↑↑PVR ↓↓2 mg8 μg/mL0.01–0.5PhotosensitiveOtherVasopressin (arginine vasopressin, Pitressin®)HR 0MAP ↑↑CO ↓PVR –100 U in 100 mL1 U/mL0.1–0.4 U/minMilrinone (Primacor®)Phosphodiesterase inhibitorHR –↑MAP 0CO ↑↑PVR ↓↓50 mg200 μg/mL0.375–0.75N/AInamrinone (Inocor®)Phosphodiesterase inhibitorHR –↑MAP 0CO ↑↑PVR ↓↓100 mg0.4 mg/mL5–100.75 μg/kg (load)Levosimendan (Simdax®)Weak PDE inhibitor, mainly calcium sensitizerCO ↑↑SV ↑↑MAP ↓PVR ↓12.5 in 500 mL of D50.025 mg/mL0.05–2 μg/kg/minPhotosensitive, but does not need to be kept from light during infusion++Table Graphic Jump Location | Download (.pdf) | PrintMedications Used to Lower the Blood PressureDrugsIV infusion (μg/kg/min)Dilution (in 250 mL)Final concentrationBolus (if applicable)Special precautions/commentsVasodilatorsNitroglycerin0.1–750 mg200 μg/mL50–100 μgNitroprusside (Nipride®)0.1–1050 mg200 μg/mLPhotosensitive, protect from light during infusionCan result in:• Thiocyanate toxicity (slurred speech, dizziness, stupor)• Cyanide toxicity (metabolic acidosis, tachyphylaxis, increased MVO2)Fenoldopam (Corlopam®)0.1–0.210 mg40 μg/mLHydralazine (Apresoline®)2.5–20 mgTakes 15 min for full effect; ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth