OBAT–OBAT INOTROPIK,

VASOPRESSOR DAN
TEKNIK TITRASI

Ari Setiyajati,S.Kep,Ns.,M.Kes
I. INOTROPIK
A. Treatment of Low CO
Goals :  Perfusi organ 
 Oksigenasi Jaringan 
 MAP 
 Myocardial O2 demand 
dng : - meΘ takhicardi
- meΘ LV dilatation
1. DOBUTAMINE
 Direct 1 Agonist
 2 & 1 terbatas
 Terhadap jantung : inotropik 
 HR = 
 Contraktilitas = 
 CO = 
 BP = 
 SVR = 
 PVR = 
PERHITUNGAN DOSIS
Kemasan 250 mg
Dobutamin 250 mg / 50 cc
cc / jam = (dosis x BB x 60)
5000
250 mg =250.000 micro/50cc=5000
Contoh:
Pasien mendapatkan dosis 10 micro
Cc/Jam = (10 micro X 50X60)
5000
2. DOPAMIN
- Direct action = 1, 1, 2 dan
Dopaminergic Agonist (DA1)

PERHITUNGAN DOSIS
• Dopamin 200 mg / 50 cc
• 200.000 micro/ 50 = 4.000
• cc / jam = (dosis x BB x 60)
4000
Dose (g Receptor Effect
/ kg / activated
min)
1–3 Dopaminergic Increased renal and mesenteric blood
(DA1) flow

3 – 10 1+ 2 (plus DA1) Increased HR, contractility, and CO;

decreased SVR; PVR may rise from
early  vasoconstriction
10  (plus  plus Increased SVR, PVR; decreased renal
DA1) blood flow; increased HR, arrhythmias.
Increased afterload may decrease CO.
3. EPINEPHRINE / ADRENALIN
Actions =
- Contractility 
- HR 
- SVR ( , tetap, ) sesuai dosis.
DOSE ( ng / kg Receptors SVR
/ min ) Activated
10 – 30  May decrease
30 – 150  And  No change or
increase
> 150  And  Increased

PERHITUNGAN DOSIS
Kemasan 1 amp = 1mg/ml
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 Increased
BP Variable
SVR and Decreased
PVR
Preload Decreased
MVO2 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
kemasan 4 mg atau 8 mg
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 : 0,1 – 0,3 dst

Cc / jam = (dosis x BB x 60)
80
 Matur
Nuwun ..