ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

VAZOACTIVE AND INOTROPIC AGENTS

Aslıhan Aykut

Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation, Ankara, Türkiye

Aykut A. Vazoactive and Inotropic Agents. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.161-169.

ABSTRACT

  • Vasopressor and inotropic agents are indicated when mean arterial pressure (MAP) is <60 mmHg, accompanied by signs of end-organ dysfunction due to hypoperfusion.
  • The selection of the initial agent should be guided by the suspected underlying cause of shock. While individualized patient treatment remains a priority, dobutamine is generally preferred for cardiogenic shock without significant hypotension, norepinephrine for septic and cardiogenic shock with hypotension, and epinephrine for anaphylactic shock.
  • Although vasopressor and inotropic agents are essential for managing hypotension, identifying and addressing other potential causes (e.g., hypovolemia) is critical to reducing the required dosage and duration of these medications.
  • Due to their high-risk nature, vasopressor and inotropic infusions demand precise administration to prevent medication errors and patient harm. Establishing standardized protocols detailing the preparation and administration process is crucial for patient safety.
  • These agents have the potential to cause severe complications, including life-threatening hypertension, dysrhythmias, and myocardial ischemia. Thus, they should only be administered by trained clinicians skilled in dose titration, with continuous monitoring of hemodynamic parameters and overall patient condition.

Keywords: Cardiotonic agents; Vasoconstrictor agents; Vasodilator agents; Epinephrine; Norepinephrine

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