Vasopressors

Updated: Jul 13, 2021
Author: Abimbola Farinde, PharmD, PhD;

Effects of Various Vasopressors

Epinephrine[1]

  • Receptors: Moderate beta-2, strong beta-1 and alpha adrenergic

  • Increased cardiac output (CO) and heart rate (HR)

  • Decreased renal perfusion

  • Increased pulmonary vascular resistance (PVR), minimally

  • Increased systemic vascular resistance (SVR)

  • Significant increase in systolic function

  • No effect in diastolic function

  • Increased oxygen demand, significantly

  • Variable blood pressure (BP)

Norepinephrine

  • Receptors: Strong alpha-1 and alpha-2, moderate beta-1

  • Increased PVR, minimally

  • Increased BP

  • Increased SVR, significantly

  • No effect on diastolic function

  • Increased oxygen demand

  • Increased systolic function, minimally

  • Decreased renal perfusion

  • Variable CO

Phenylephrine[2]

  • Receptors: Strong alpha-1

  • Increased SVR, significantly

  • No effect on PVR

  • Increased BP

  • No effect on HR

  • No effect on systolic or diastolic function

  • No effect on myocardial oxygen demand

  • Decreased CO and renal perfusion

Dopamine, low dose (1-5 µg/kg/min)

  • Receptors: Dopaminergic agonist

  • Renal and mesenteric vasodilation

  • Increased HR

  • Increased systolic function, minimal

  • No effect in diastolic function

  • Increased oxygen demand, minimal

  • Increased SVR, minimal

  • No effect on PVR

Dopamine, medium dose (6-10 µg/kg/min)

  • Receptors: Beta-1 agonist

  • Increased systolic function

  • Increased HR and CO

  • No effect in diastolic function

  • Increased myocardial oxygen demand

  • Increased SVR

  • Increased PVR, minimal

  • Renal vasodilation

Dopamine, large dose (11-20 µg/kg/min)

  • Receptors: Alpha-1 agonist

  • Increased HR, CO, PVR

  • No effect on diastolic function

  • Increased myocardial oxygen demand

  • Increased PVR, minimal

  • Increased SVR, significantly

Dobutamine[3]

  • Receptors: Strong beta-1, weak beta-2 and alpha receptors

  • Increased HR, CO

  • Increased HR

  • Increased systolic function

  • No effect on diastolic function

  • Increased in myocardial oxygen demand

  • Decreased SVR

  • Decreased PVR, minimally

Vasopressin

  • Receptors: ADH analogue

  • PVR effect unknown

  • Increased SVR, significantly

  • No effect on HR

  • No effect on systolic or diastolic function

  • No effect in myocardial oxygen demand

  • Splanchnic vasoconstriction