IV Vasodilators and Inotropic Drugs Used in Acute MI
Drug | Usual Dosage Range | Comment |
---|---|---|
Nitroglycerin | 5-100 µg/min | May improve coronary blood flow to ischemic myocardium |
Nitroprusside | 0.5-10 (µg/kg)/min | More 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) | ||
Dobutamine | 2-20 (µg/kg)/min | Results in ↑ cardiac output, ↓ PCW, but does not raise bp |
Dopamine | 2-20 (µg/kg)/min | More appropriate than dobutamine if hypotensive |
Hemodynamic effect depends on dose: (µg/kg)/min | ||
<5: ↑ renal blood flow | ||
2.5-10: positive inotrope | ||
>10: vasoconstriction | ||
Norepinephrine | 0.5-30 µg/min | Less likely than dopamine to cause arrhythmias in cardiogenic shock |