Disadvantages

Indications

• Septic shock with low SVR

• Treatment of hypotension caused by vasodilation, e.g. regional anaesthesia

Disadvantages

• Excessive vasoconstriction

• Myocardial ischaemia

• Bradyarrhythmias and tachyarrhythmias

Table 6.3 Summary of inotrope actions

Inotropes

a

ß1

ß2

DA

Dobutamine

+++

++

Adrenaline

+ to +++

+++

++

Dopamine

0-3 micrograms kg-1 per minute

+++

2-5-10 micrograms kg-1 per minute

++

+

++

> 10 micrograms kg-1 per minute

++

++

+

+

Dopexamine

+

+++

++

Noradrenaline

+++

+

All these drugs are short-acting and their effects on the circulation are seen immediately (however, a CVP line has a 1 ml dead space capacity so there is a delay before onset of action unless the drug is bolused along the line first). They should be increased at frequent intervals (for example, every 15 minutes) until either the desired effect has occurred or an optimum dose has been reached. A summary of inotrope actions on different receptors is shown in Table 6.3.

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