37
Table
23.
Intravenous
Inotropic
Agents
Used
in
Management
of
HF
a
Inotropic Agent
Dose,
mcg/kg
Drug
Kinetics
&
Metabolism
Effects
Adverse
Effects
Special Considerations
Bolus
Infusion, min
CO
HR
SVR
PVR
Adrenergic
Agonists
Dopamine
N/A
5–10
t½:
a
2–20
min;
renal,
hepatic,
plasma
↑
↑
↔
↔
Tachyarrhythmias, headache,
nausea,
tissue
necrosis
Caution:
MAO-I
N/A
10–15
↑
↑
↑
↔
Dobutamine
N/A
2.5–5
t½:
2–3
min;
hepatic
↑
↑
↓
↔
↑/↓
BP,
headache,
tachyarrhythmias,
nausea,
fever,
hypersensitivity
Caution:
MAO-I
CI:
sulfite
allerg
y
N/A
5–20
↑
↑
↔
↔
PDE
Inhibitor
Milrinone
N/R
0.125– 0.75
t½:
2.5
h;
hepatic
↑
↑
↓
↓
Tachyarrhythmias,
↓BP
Renal
dosing,
monitor
LFTs
a
t½
indicates
elimination
half-life;
BP,
blood
pressure;
CI,
contraindication;
CO,
cardiac
output;
HF,
heart
failure;
HR,
heart
rate;
LFT,
liver
function
test;
MAO-I,
monoamine
oxidase
inhibitor;
N/A,
not
applicable;
N/R,
not
recommended;
PDE,
phosphodiesterase;
PVR,
pulmonary
vascular
resistance;
SVR,
systemic
vascular
resistance.
