Vasopressors and Inotropes - Pharmacology Summary
Vasopressors
Phenylephrine ...
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Vasopressors and Inotropes - Pharmacology Summary

Vasopressors

Phenylephrine (alpha-1)

 • Increases BP, SVR

 • Risk of reflex bradycardia due to increased MAP

Norepinephrine (Levophed, alpha-1 / beta1, beta1 > beta2)

 • Increases BP, SVR, CO

 • Preferred first agent in shock

Epinephrine (beta1 > beta2 / alpha1)

 • Increases HR, SVR, CO, BP

 • Higher doses cause more alpha-effect

 • 1st agent in anaphylaxis, 2nd line in septic shock

Vasopressin (V1, V2)

 • Increases BP, SVR, not inotropic/chronotropic

 • V1, vessel constriction

 • V2 antidiuretic effect at kidney

Dopamine (D1 > beta1 > alpha1)

 • Dose dependent receptor activation

 • D1 (1-2 mcg/kg/min): renal artery dilation

 • beta /mild alpha (5-10 mcg/kg/min): increases HR, contractility, CO

 • a (>10 mcg/kg/min): vasoconstriction, SVR

Inotropes

Dobutamine (beta1 > beta2 > alpha1)

 • Increases CO, less of a BP effect

Milrinone (PDE3)

 • Phosphodiesterase inhibitor > increases cAMP/cGMP

 • Causes vasodilation and increased contractility



- Rebecca Steinberg @RebeccaSteinb17



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Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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