Chapter 47. Vasoactive Medications Ruchir Gupta, MD View Full Chapter Figures Only Tables Only Videos Only Print Share Email Twitter Facebook Linkedin Reddit Get Citation Citation AMA Citation Gupta R. Gupta R Gupta, Ruchir.Chapter 47. Vasoactive Medications. In: Atchabahian A, Gupta R. Atchabahian A, Gupta R Eds. Arthur Atchabahian, and Ruchir Gupta.eds. The Anesthesia Guide New York, NY: McGraw-Hill; 2013. http://accessanesthesiology.mhmedical.com/content.aspx?bookid=572§ionid=42543632. Accessed May 22, 2018. MLA Citation Gupta R. Gupta R Gupta, Ruchir.. "Chapter 47. Vasoactive Medications." The Anesthesia Guide Atchabahian A, Gupta R. Atchabahian A, Gupta R Eds. Arthur Atchabahian, and Ruchir Gupta. New York, NY: McGraw-Hill, 2013, http://accessanesthesiology.mhmedical.com/content.aspx?bookid=572§ionid=42543632. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Tools Search Book Top Return Clip Autosuggest Results ++ See following table. ++Table Graphic Jump LocationFavorite Table | 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 LocationFavorite Table | 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 ... GET ACCESS TO THIS RESOURCE Sign In Username or Email Please enter User Name Password Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. What is MyAccess? Create a FREE MyAccess profile to: Use this site remotely Bookmark your favorite content Track your self-assessment progress and more! GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessAnesthesiology 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessAnesthesiology Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options Pop-up div Successfully Displayed This div only appears when the trigger link is hovered over. Otherwise it is hidden from view. Please Wait