Sympathomimetic

Dobutamine is a synthetic catecholamine and beta agent that increases the strength of cardiac contraction without appreciably increasing rate.

To increase cardiac output in CHF and cardiogenic shock

• 1. Hypersensitivity to sympathomimetic amines
• 2. Ventricular tachycardia
• 3. hypovolemia without fluid resuscitation

Atrial fibrillation or pre-existing hypotension

2-20 mcg/kg/min IV

• Dopamine is a naturally occurring catecholamine that increases cardiac output without appreciably increasing myocardial oxygen consumption.
• - maintains renal and mesenteric blood flow while inducing vasoconstriction and increasing systolic blood pressure

• 1. Non-hypovolemic hypotension (70-100 mmHg)
• 2. Cardiogenic shock

• 1. Tachydysrhythmias
• 2. Ventricular fibrillation
• 3. pheochromocytoma

Ensure adequate fluid resuscitation of the hypovolemic patient

2-5 mcg/kg/min up to 20 mcg/kg/min

• Epinephrine is a naturally occuring catecholamine that :
• -INCREASES heart rate, cardiac contractile force, myocardial electrical activity, systemic vascular resistance, and systolic blood pressure.
• -DECREASES overall airway resistance and automaticity.

- Through bronchial artery constriction, may reduce pulmonary congestion and increase tidal volume and vital capacity

Cardiac arrest & severe allergic reactions

• 1. Narrow angle glaucoma
• 2. Hemorrhagic, traumatic or cardiac shock
• 3. during labor

Cardiac Arrest : 1mg of 1:10,000 IV/3-5min

Allergic Reaction : 0.3-0.5mg of 1:1,000 subQ/5-15min as needed OR 0.5-1mg of 1:10,000 IV if subQ dose ineffective

Isoproterenol is a synthetic sympathomimetic that results in increased cardiac output by increasing the strength of cardiac contraction and somewhat increasing rate.

Bradycardia refractory to atropine when pacing is not available

Cardiogenic shock

Tachydysrhythmias and those associated with digitalis and acute myocardial infarction

Bradycardia : 2-10 mcg/min titrated to cardiac rate