Adrenergic Drugs
Posted: Tuesday, April 28th, 2020 | Updated: Tuesday, February 8th, 2022
Posted: Tuesday, April 28th, 2020 | Updated: Tuesday, February 8th, 2022
Dopamine
Endogenous catecholamine (precursor to norepinephrine)
Dose dependent action:
Low doses act on dopaminergic receptors which increase renal and mesenteric perfusion
Moderate doses yield beta 1 stimulation (positive inotrope)
High doses produce alpha 1 stimulation (vasoconstriction)
Avoid high doses in renal failure, mitral regurge, DCM, CHF
Higher doses cause vasoconstriction and reduce renal perfusion. Additionally, increased afterload results in decreased cardiac performance
Receptor Effects: Alpha +++ at higher doses, Beta +++ at moderate doses
View a Dopamine CRI calculation
Dobutamine
Synthetic catecholamine
Primarily stimulates beta 1 receptors (positive inotrope) to increase contractility
Weak effect on alpha 1 and beta 2 receptors
Generally acceptable to use in hypotensive patients with chronic renal failure, mitral regurge, DCM, and CHF
Receptors Effects: Alpha +, Beta +++
View a Dobutamine CRI calculation
Epinephrine
Endogenous catecholamine
Potent alpha and beta effects (positive inotrope, chronotrope, with vasoconstriction) causing peripheral vasoconstriction, bronchodilation, and increased cerebral/coronary perfusion
Mainly used with CPR
Receptors Effects: Alpha +++, Beta +++
Norepinephrine
Endogenous catecholamine
Strong alpha 1 effect (vasoconstriction), moderate beta 1 effect, and weak beta 2 effect
Can be used with a positive inotrope like Dobutamine
Avoid in chronic renal failure, DCM, mitral regurge, CHF
Receptors Effects: Alpha +++, Beta +
View a Norepinephrine CRI calculation
Endogenous catecholamine (precursor to norepinephrine)
Dose dependent action:
Low doses act on dopaminergic receptors which increase renal and mesenteric perfusion
Moderate doses yield beta 1 stimulation (positive inotrope)
High doses produce alpha 1 stimulation (vasoconstriction)
Avoid high doses in renal failure, mitral regurge, DCM, CHF
Higher doses cause vasoconstriction and reduce renal perfusion. Additionally, increased afterload results in decreased cardiac performance
Receptor Effects: Alpha +++ at higher doses, Beta +++ at moderate doses
View a Dopamine CRI calculation
Dobutamine
Synthetic catecholamine
Primarily stimulates beta 1 receptors (positive inotrope) to increase contractility
Weak effect on alpha 1 and beta 2 receptors
Generally acceptable to use in hypotensive patients with chronic renal failure, mitral regurge, DCM, and CHF
Receptors Effects: Alpha +, Beta +++
View a Dobutamine CRI calculation
Epinephrine
Endogenous catecholamine
Potent alpha and beta effects (positive inotrope, chronotrope, with vasoconstriction) causing peripheral vasoconstriction, bronchodilation, and increased cerebral/coronary perfusion
Mainly used with CPR
Receptors Effects: Alpha +++, Beta +++
Norepinephrine
Endogenous catecholamine
Strong alpha 1 effect (vasoconstriction), moderate beta 1 effect, and weak beta 2 effect
Can be used with a positive inotrope like Dobutamine
Avoid in chronic renal failure, DCM, mitral regurge, CHF
Receptors Effects: Alpha +++, Beta +
View a Norepinephrine CRI calculation
Sources:
Bill, Robert L. Clinical Pharmacology and Therapeutics for the Veterinary Technician. 3rd ed., Mosby, 2006.
Ford, Richard B., and Elisa M. Mazzaferro. Kirk and Bistner's Handbook of Veterinary Procedures and Emergency Treatment. 8th ed., Saunders Elsevier, 2006.
Pablo, Luisito S. “Using Inotropes and Vasopressors in Anesthesia (Proceedings).” DVM360, 1 Aug. 2011, www.dvm360.com.
Poli, Gerardo. MiniVet Guide: Companion Animal Medicine. InHouse Publishing, 2016.
Bill, Robert L. Clinical Pharmacology and Therapeutics for the Veterinary Technician. 3rd ed., Mosby, 2006.
Ford, Richard B., and Elisa M. Mazzaferro. Kirk and Bistner's Handbook of Veterinary Procedures and Emergency Treatment. 8th ed., Saunders Elsevier, 2006.
Pablo, Luisito S. “Using Inotropes and Vasopressors in Anesthesia (Proceedings).” DVM360, 1 Aug. 2011, www.dvm360.com.
Poli, Gerardo. MiniVet Guide: Companion Animal Medicine. InHouse Publishing, 2016.