Reference — Critical Care
Vasopressor Quick Reference
Drug-by-drug quick lookup for vasoactive medications — receptor profiles, hemodynamic effects, dose ranges, indications, and nursing monitoring priorities.
Educational use only. Vasoactive medication selection, dosing, and titration are provider decisions requiring current orders, pharmacy verification, and continuous hemodynamic monitoring. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
| Drug (Brand) | Receptors | CO | SVR | HR | Typical Dose | Primary Indication |
|---|---|---|---|---|---|---|
| NorepinephrineLevophed | α1 >> β1 | ↔ / mild ↑ | ↑↑ | ↔ / mild ↑ | 0.01–3 mcg/kg/min | Septic shock (first-line) |
| EpinephrineAdrenalin | α1 + β1 + β2 | ↑↑ | ↑ | ↑↑ | 0.01–1+ mcg/kg/min | Anaphylaxis, cardiac arrest, refractory shock |
| DopamineIntropin | DA → β1 → α1 (dose-dependent) | ↑ (mid dose) | ↑ (high dose) | ↑ | 2–20 mcg/kg/min | Cardiogenic shock with bradycardia (second-line) |
| DobutamineDobutrex | β1 >> β2; minimal α | ↑↑ | ↓ (mild) | ↑ | 2–20 mcg/kg/min | Cardiogenic shock, low CO states |
| VasopressinPitressin | V1 (non-adrenergic) | ↔ | ↑ | ↓ (reflex) | 0.03–0.04 units/min fixed | Adjunct in septic shock; catecholamine sparing |
| PhenylephrineNeo-Synephrine | α1 only | ↔ / ↓ | ↑↑ | ↓ (reflex bradycardia) | 0.4–9.1 mcg/kg/min | Hypotension with tachycardia; neurogenic shock |
CO = Cardiac Output | SVR = Systemic Vascular Resistance | HR = Heart Rate | ↑↑ = significant increase | ↑ = increase | ↔ = no significant change | ↓ = decrease
Nursing Monitoring Priorities
| Drug | Key Monitoring | Critical Nursing Note |
|---|---|---|
| Norepinephrine | Art-line BP, UO, peripheral perfusion | First-line for septic shock; requires central access |
| Epinephrine | Serial lactate, HR, glucose, BP | Elevates lactate directly — do not interpret alone as worsening shock |
| Dopamine | Continuous cardiac monitoring (dysrhythmia risk), BP | Higher dysrhythmia risk than norepinephrine; monitor cardiac rhythm continuously |
| Dobutamine | BP (may drop), HR, signs of improved perfusion | Inotrope — may drop BP; often combined with a vasopressor |
| Vasopressin | Skin perfusion, Na+, UO, extremity ischemia | Fixed rate only (0.03–0.04 units/min) — never titrated; ischemia risk |
| Phenylephrine | HR (reflex bradycardia), peripheral perfusion, CO | Pure alpha-1 — raises MAP without increasing HR; avoid in cardiogenic shock |
Quick Reference: MAP Goals
- ›General septic shock: MAP ≥65 mmHg (Surviving Sepsis Campaign)
- ›Chronic hypertension: MAP ≥70–80 mmHg (autoregulatory shift)
- ›TBI / elevated ICP: MAP ≥80 mmHg (protect cerebral perfusion pressure)
- ›Post-cardiac arrest (ROSC): MAP 65–100 mmHg (avoid extremes during reperfusion)
- ›All vasopressors: prefer central venous access to prevent extravasation necrosis
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with Society of Critical Care Medicine (SCCM) · Surviving Sepsis Campaign · American Association of Critical-Care Nurses (AACN). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →