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Table 119-1

IV Vasodilators and Inotropic Drugs Used in Acute MI

DrugUsual Dosage RangeComment
Nitroglycerin5-100 µg/minMay improve coronary blood flow to ischemic myocardium
Nitroprusside0.5-10 (µg/kg)/minMore potent vasodilator, but improves coronary blood flow less than nitroglycerin
With therapy >24 h or in renal failure, watch for thiocyanate toxicity (blurred vision, tinnitus, delirium)
Dobutamine2-20 (µg/kg)/minResults in cardiac output, PCW, but does not raise bp
Dopamine2-20 (µg/kg)/minMore appropriate than dobutamine if hypotensive
Hemodynamic effect depends on dose: (µg/kg)/min
<5: renal blood flow
2.5-10: positive inotrope
>10: vasoconstriction
Norepinephrine0.5-30 µg/minLess likely than dopamine to cause arrhythmias in cardiogenic shock