ER IV DRUG MEDICATION CHART – CV Effects
Alpha 1 – Agonists cause peripheral vasoconstriction. Antagonists cause vasodilation
Alpha 2 – CNS mediated, agonists cause hypotension, sedation
Beta 1 – Heart effects: inotropic (strength of contraction), chronotropic (heart rate), dromotrophic (‘conduction’)
Beta 2 – Lung effects: Agonists cause bronchodilation, Antagonists cause bronchoconstriction
1 1
Drug Inotr Chron Dromo 2 V/C V/D
Phenylephrine / +++Epinephrine / ++ / +++ / ++ / ++ / ++
Norepinephrine / +++ / ++ / ++ / ++ / +
Dobutamine / ++ / ++ / +
Dopamine
Dopaminergic :
0.5-2 mcg/kg/min
Beta1 effects: 2-10 mcg/kg/min
Alpha effects: >10 mcg/kg/min / + / + / + / + renal
Digoxin / + / _
Amiodarone / + / -SA/AV
Atropine / + / +SA/AV
Ca Chloride/Gluconate / +
Dihydropyridone – Amlodipine,Nifedipine / Arterial V/D
No venous V/D / _ / _ / -SA/AV / +
Non-dihyd - Phenylakytlamine
Verapamil / Min. Art V/D / _ _ / _ / -SA/AV
Non-dihyd. - Benzothiazepine
Diltiazem / Arterial V/D / _ / _ / -SA/AV / +
Beta Blockers / _ / _ / _ _ / -SA/AV / +
Nitroglycerine / Low dose ven V/D
High dose art V/D / + / + / ++
ACE Inhibitors / - / +
Phentolamine / ++
Mg Sulfate / +
Ketamine * / _ / + / +
Fentanyl ** / _
Morphine *** / _ / ++
Propofol **** / ++
Midazolam #
*ketamine – negative inotrope but due to secondary CNS simulation causes increase in pulmonary BP, heart rate, cardiac output and myocardial O2 demand. Usually there will be no change in systemic vascular resistance. Has bronchodilator properties.
**Fentanyl – Usually has minimal or no effect on BP, LV Pressure and cardiac output. Initial boluses can decrease MAP. May have some negative Chronotropy (decrease HR) that can be treated with atropine.
***Morphine – lowers BP via decreasing alpha adrenergic tone mediated through the CNS.
****Propofol – can cause large reduction in MAP via venous and arterial vasodilation. It also blocks normal baroreceptor mediated tachycardia which would normally counteract these changes.
#Midazolam – has minimal CV effects.