OBATOBAT INOTROPIK,

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)

Increased HR, contractility, and

CO; decreased SVR; PVR may rise
from early vasoconstriction

10

(plus plus
DA1)

Increased SVR, PVR; decreased

renal blood flow; increased HR,
arrhythmias. Increased afterload
may decrease CO.

Increased renal and mesenteric

blood flow

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

Usually no change; may have

slight increase at increased
doses

CO
BP
SVR and
PVR
Preload
MVO2

Increased
Variable
Decreased
Decreased
Often unchanged

Dosis : 0,375 mcg / kg / mnt minimal

0,5 mcg / kg / mnt mulai dilatasi
0,75 mcg / kg / mnt max

5. NOREPINEPHRINE/NORODRENALINE
HR

Variable; unchanged or may decrease

if BP rises (reflex); increase if BP
remains low

Contractility

Increased

CO

Increased or decreased ( depends on

SVR )

BP

Increased

SVR

Markedly increased

PVR

Increased

Perhitungan dosis
Cc / jam = (dosis x BB x 60)
80

Matur
Nuwun .
.