53
Table
20.
Intravenous
Inotropic
Agents
Used
in
the
Management
of
HF
Inotropic
Agent
Dose
(mcg/kg)
Drug
Kinetics
and
Metabolism
Effects
Adverse
Effects
Special
Considerations
Bolus
Infusion
(/min)
CO
HR
SVR
PVR
Adrenergic
agonists
Dopamine
NA
5–10
t½:
2–20
min
↑
↑
↔
↔
T,
HA,
N,
tissue
necrosis
Caution:
MAO-I
NA
10–15
R,
H,
P
↑
↑
↑
↔
Dobutamine
NA
2.5–20
t½:
2–3
min
H
↑
↑
↔
↔
↑/↓BP,
HA,
T,
N,
F,
hypersensitivity
Caution:
MAO-I;
CI:
sulfite
allerg
y
PDE
3
inhibitor
Milrinone
NR
0.125–0.75
t½:
2.5
h
H
↑
↑
↓
↓
T,
↓BP
Accumulation
may
occur
in
setting
of
renal
failure;
monitor
kidney
function
and
LFTs
Vasopressors Epinephrine
NR
5–15
mcg/
min
t½:
2–3
min
↑
↑
↑(↓)
↔
HA,
T
Caution:
MAO-I
15–20 mcg/min
t½:
2–3
min
↑
↑↑
↑↑
↔
HA,
T,
Caution:
MAO-I
Norepinephrine
NR
0.5–30 mcg/min
t½:
2.5
min
↔
↑
↑↑
↔
↓
HR,
tissue
necrosis
Caution:
MAO-I
↑
=
increase;
↔
=
no
change;
↓
=
decrease;
↑↓
=
either
increase
or
decrease
