6 ( ) ICU Dopamine Dobutamine Levophed Adrenaline ?Dopamine immediate precursor norepinephrine (NE) drip push dopamine ampule 1 amp 250mg 1:1 2:1 mg:mL1:1 250mg 1 amp 250 mL 2:1 2 amp 250 mL D5W, D10W NSS, D5NSS RLS Levophed dopamine 10 mcg/kg/min 50 kg 500 mcg/min 60 x 500 = 30,000 mcg/h 1:1 1 ml 1000 mcg 30,000/1000 = 30 ml/h dopamine alpha 1 receptor reuptake norephinephrine (NE) sympatheticsynapse endogenous NE dopamine >10 mcg/kg/min intermediate dose 3 - 10 mcg/kg/min alpha1 beta 1 receptor myocardial contractility heart rate volume heart dose alpha 1 3 mcg/kg/min Dopaminergic receptor D1 D2 synapse vasodilation renal dose urine output dopamine heart rate beta 1 dobutamine drip dobutamine symptomatic bradycardia dopamine dopamine shock vasodilatory cardiogenic HF symptomaticbradycardia 20 - 30 mcg/kg/min max 50 mccg/kg/min endogeneous NE sympathetic synapse 30

Dobutamine catecholamine beta 1 beta 2 receptor 3:1 dopaminergic receptor alpha 1 receptor beta 1 contractility cardiac outout beta 2 vasodilatory effect 15 - 20 mcg/kg/minalpha 1 beta 2 SVR dopaminedobutamine vial 1 vial 20ml 250 mg dopamine 1 amp dopa dopa dobu shock HF LV systolic function dobutamine augment cardiac output pressorsLevophed norepinephrine exogenous NE alpha 1 receptor potent beta receptor heart rate contractility distributive vasodilatory shock sepsis dopa levo levophed vial 1 vial 4 mg 2 8 mg 250 ml saline 1:31 100 ml 1:12 1:10 12 1:10 0.01 - 3 mcg/kg/minrange 0.2 mcg/kg/min 10 mcg/min 1:31 20 ml/h levophed 2 vial 250 mldrip 15-20 ml/h Adrenaline Epinephrine alpha beta receptor drip arrestadrenaline 1 amp 1 ml 1 mg arrest adrenaline 1 amp 1 amp 1 ml NSS 9ml 10 ml 1 mg drip post resuscitation adrenaline push CPR 10 amps 10mg saline 100 ml rate 0.01 - 0.10 mcg/kg/min dopamine epinephrine VT/VF scenario post arrest anaphylactic shock1. Lancet 2000;356:2139-21432. Am J Med Sci 1987;294:244-2483. Am J Med 1980;69:262-2664. Circulation 2008;118:1047-10565. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine 10th edition6. The ICU Book. Paul L. Marino. 3rd edition