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Class
Sympathetic Agonist
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Description
Naturally occurring Catecholamine. Chemical precursor of NE. Acts on A and B1 dopaminergic receptors. Adrenergic receptors are dose dependent
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Mechanism of Action
- Increases BP acting on Alpha and Beta1 adrenergic receptors.
- Increases systolic and pulse pressure
- Beta1-positive inotropic effects on heart w/out increased myocardial O2 demand and powerful effects of drugs like Epi.
- Alpha- Adrenergic receptors causing vasoconstriction
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Onset of Action
- Onset: <5min
- Peak: 5-8min
- Duration: <10min
- Half-life: 2min
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Indications
- Hemodynamically significant hypotension NOT from hypovolemia.
- Cardiogenic shock
- Symptomatic bradycardia refractory to Atropine
- Neurogenic shock
- Distributive shock
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Contraindications
- Hypovolemic shock where complete fluid resuscitation has NOT occurred.
- Pheochromocytoma
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Precautions
- Severe tachydysrhythmias or V-Fib
- May worsen/induce SVT & ventricular arrhythmias
- Benefits lost in doses over 20ug/kg/min
- Deactivated by Sodium Bicarb
- Reduce dose if on MAOI's
- Hypotension if on Dilantin
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Side Effects
- Palpitations
- Nervousness
- Headache
- Chest pain
- Dyspnea
- Nausea
- Vomiting
- Arrhythmia
- HTN
- Tachycardia
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Adult Dose
- Renal: 1-2ug/kg/min to perfuse kidneys
- Cardiac: 2-10ug/kg/min symptomatic bradycardia refractory to Atropine, pacing, cardiogenic shock
- Vascular: 10-20ug/kg/min neurogenic shock, distributive shock. 2nd line for anaphylaxis and sepsis
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Route of Administration
IV drip only
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How Supplied
400mg vials, 800mg vials, prefilled bags
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