micrograms/mL).

Adrenalin 1 to 15 1 to 40 40 to 160 Initial vasopressor of

 mcg/minute mcg/minute mcg/minute choice in anaphylactic
(0.01 to 0.5 (0.5 to 2 shock.
(0.01 to 0.2
mcg/kg mcg/kg Typically an add-on
 mcg/kg/minute) /minute) agent to norepinephrine
/minute)
in septic shock when an
additional agent is
required to raise MAP to
target and occasionally
an alternative first-line
agent if norepinephrine
is contraindicated.
Increases heart rate;
may induce
tachyarrhythmias and
ischemia.
For inotropy, doses in
the higher end of the
suggested range is
needed  
Elevates lactate
concentrations during
initial administration (ie,
may preclude use of
lactate clearance goal);
 May decrease stroke
volume and cardiac
output in patients with
cardiac dysfunction.
May be given as bolus
dose of 50 to 100 mcg
to support blood
pressure during rapid
sequence intubation.
Must be diluted; eg, a
usual concentration is
10 mg in 250 mL D5W
or NS (40 mcg/mL).

Inotropin 2 to 5 mcg/kg 5 to 20 mcg/kg 20 to >50 An alternative to

/minute /minute mcg/kg norepinephrine in septic
/minute shock in highly selected
patients (eg, with
compromised systolic
function or absolute or
relative bradycardia and
a low risk of
tachyarrhythmias).
More adverse effects
(eg, tachycardia,
arrhythmias particularly
 should be replacement for a first-
reserved for line vasopressor.
salvage Pure vasoconstrictor;
therapy may decrease stroke
volume and cardiac
output in myocardial
dysfunction or
precipitate ischemia in
coronary artery disease.
Must be diluted; eg, a
usual concentration is
25 units in 250 mL D5W
or NS (0.1 units/mL).

adrenergic)

Dobutrex 0.5 to 1 mcg/kg 2 to 20 mcg/kg 20 to 40 Initial agent of choice in

/minute /minute mcg/kg cardiogenic shock with
(alternatively, 2.5 /minute; low cardiac output and
mcg/kg/minute Doses >20 maintained blood
in more severe mcg/kg pressure.
cardiac /minute are Add-on to
decompensation) not norepinephrine for
recommended cardiac output
in heart failure augmentation in septic
and should be shock with myocardial
reserved for dysfunction (eg, in
 Increases cardiac
contractility and
modestly increases
heart rate at high doses;
may cause peripheral
vasodilation,
hypotension, and/or
ventricular arrhythmia.
Renally cleared; dose
adjustment in renal
impairment needed.
Must be diluted; eg, a
usual concentration is
40 mg in 200 mL D5W
(200 micrograms/mL);
use of a commercially
available pre-diluted
solution is preferred.

es shown are for intravenous (IV) administration in adult patients. The initial doses
n this table may differ from those recommended in immediate post-cardiac arrest
ement (ie, advanced cardiac life support). For details, refer to the UpToDate topic
of post-cardiac arrest management in adults, section on hemodynamic

essors can cause life-threatening hypotension and hypertension, dysrhythmias, and

dial ischemia. They should be administered by use of an infusion pump adjusted
963 Version 15.0