1. Common Cardiovascular Drugs

2. Inotropic agents
Vasodilators
Antiarrythmic agents

3. α receptors
↑ protein kinase C  ↑intracellular Ca  smooth muscle contraction
β receptor
↑ intracellular cAMP  relax smooth muscle, increase cardiac muscle contractility

4. α1 : peripheral vascular contraction
β1 : increase HR, contractility
β2 : 主要vasodilation, bronchodilation; 次要increase HR, contractility

5. Inotropic agents

6. Dopamine 因dose (ug/kg/min)的不同而作用在不同的receptor上
1-3  dopaminergic (DA): ↑renal and mesenteric blood flow 3-10  β 為主: increase HR, contractility; decrease SVR, but increase PVR > 10  α 為主: increase SVR and PVR; decrease renal flow

7. Levophed ( norepinepherine)
以α為主，β1為輔
Increase SVR  increase BP; may increase contractility; increase PVR
4mg/400ml 0.01 ml/ml =10ug/ml
Usual range for infusion: ug/kg/min

8. Dobutrex (dobutamine)
β為主 (尤其β1)，minimal α effects
Increase HR, contractility; decrease SVR, PVR
dobutamine is an inotrope but not a pressor !
Infusion dosage: 2-20 ug/kg/min

9. Milrinone (primacor) Phosphodiesterase inhibitor
Inhibit cAMP to breakdown  increase intracellular cAMP concentration
In cardiac muscle: increase contractility, HR
In vascular smooth muscle: vasodilation; decrease SVR, PVR

10. Loading dose: 25-75 ug/kg over 1-10 min
Infusion dose: ug/kg/min

11. Bosmin (epinephrine) 因dose (ug/kg/min)不同著重於不同的receptor
: β : β為主，α為輔 > 0.15: α為主，β為輔

12. For cardiac arrest: adult: 0
For cardiac arrest: adult: mg IV bolus pediatric : 5-15 ug/kg IV bolus may be given intratracheally in ml volume
Severe allergic reaction or bronchospasm: 10 ug/kg

13. Vasodilators

14. Nitroglycerin Direct vasodilator, venous > arterial dilation
Mainly preload reduction ; reduce PVR
large dose > 10 ug/kg/min produce arteriolar dilation
Relieve coronary spasm, increase coronary flow, decrease ischemia

15. IV bolus: ug
Infusion: 0.1 – 7 ug/kg/min
Nitroderm

16. Trandate (labetalol) α blocker: β blocker = 1:7
decrease HR; decrease BP
Long duration

17. Perdipine Ca channel blocker Arterial dilation, decrease SVR
Mild myocardial depressant: minimal in clinical dosage

18. PGE1 Selectively dilate the ductus arteriosus in neonates and infants
Potent pulmonary vascular vasodilating effects
Infusion dosage: 0.05 – 0.4 ug/kg/min

19. Antiarrythmic agents

20. Isuprel (isoproterenol)
Pure β effect
Positive inotropic and chronotropic effects
May decrease BP
Infusion: ug/kg/min

21. Esmolol Selective β1 blocker Decrease HR, BP IV: 0.25-0.5 mg/kg
Infusion: ug/kg/min
Rapid elimination

22. Amiodarone Use in Af, SVT, ventricular arrthymia
Loading: 150 mg IV for 10 min
Infusion: max mg/24hr first 24 hr, 720mg/24hr next
Potent vasodilating effects and negative inotropic effects