Vasopressors 101

The purpose of these drugs is to increase blood pressure

Norepinephrine (LEVOPHED)

• Alpha 1 and Beta 1 agonist

• Ideal for septic shock/cardiogenic shock

• Should be given through a central line, although okay to give peripherally for a short term

• Not the best drug to use as a 'push' dose

  

Phenylephrine (NEO)

• Alpha 1 agonist

• Ideal for sedation related hypotension

• Also useful in hypotension related to tachycardic states

• Can be given push dose routinely

Vasopressin

• Works on vasopressin receptors

• Usually a fixed dose

• Used primarily as an adjunct when other vasopressors have not worked or been escalating in dose

• Also used in GI bleeds

Epinephrine

• Alpha 1, Beta 1, and Beta 2 agonist

• Used as a second line for blood pressure

• Useful in cardiogenic shock

• Has several 'non-pressor' uses, including anaphylaxis and asthma

• Risky in those with CAD

Dopamine

• Alpha 1, Beta 1, Dopamine agonist

• Not commonly used

• Effect is based on dose range given

• Causes tachycardia, which can be of clinical benefit

All of these drugs help to fix our patients with low blood pressure states, but many of them have other uses too. These drugs require critical monitoring and are not 'set and forget' drugs like an antibiotic would be.