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Obat Inotropik-Titrasi
Obat Inotropik-Titrasi
VASOPRESSOR DAN
TEKNIK TITRASI
I. INOTROPIK
A. Treatment of Low CO
Goals :
Perfusi organ
Oksigenasi Jaringan
MAP
Myocardial O2 demand
dng : - me takhicardi
- me LV dilatation
1. DOBUTAMINE
Direct 1 Agonist
2 & 1 terbatas
Terhadap jantung : inotropik
HR
=
Contraktilitas =
CO
=
BP
=
LVEDP
=
LAP
=
SVR
=
PVR
=
PERHITUNGAN DOSIS
Dobutamin 250 mg / 50 cc
cc / jam = (dosis x BB x 60)
5000
2. DOPAMIN
- Direct action = 1, 1, 2 dan
Dopaminergic Agonist (DA1)
Dose
(g / kg
/ min)
Receptor
activated
Effect
13
Dopaminergic
(DA1)
3 10
1+ 2 (plus
DA1)
10
(plus plus
DA1)
PERHITUNGAN DOSIS
Dopamin 200 mg / 50 cc
cc / jam = (dosis x BB x 60)
4000
3. EPINEPHRINE / ADRENALIN
Actions =
- Direct agrovist 1, 2, 1 dan 2
- Contractility
- HR
- SVR ( , tetap, ) sesuai
dosis.
DOSE ( ng /
kg / min )
Receptors
Activated
SVR
10 30
May decrease
30 150
And
No change or
increase
> 150
And
Increased
PERHITUNGAN DOSIS
4 mg / 50 cc
cc/jam = (dosis x BB x 60 )
80
4. MILRINONE
HR
CO
BP
SVR and
PVR
Preload
MVO2
Increased
Variable
Decreased
Decreased
Often unchanged
5. NOREPINEPHRINE/NORODRENALINE
HR
Contractility
Increased
CO
BP
Increased
SVR
Markedly increased
PVR
Increased
Perhitungan dosis
Cc / jam = (dosis x BB x 60)
80
Matur
Nuwun .
.