Bolus Dose Pressors

1. Phenylephrine

• pure α1 agonist, no cardiac effect (does not increase heart rate, may even decrease it)
• Mix 1omg x 1 mL vial to 100mL bag of NS = 100mcg/mL
• Give 0.5-2mL (50-200mcg) every 2-5 minutes (get a 10mL syringe)
• Onset: 1 minute, duration 20 minutes
• Good for: Sepsis, Medication effect (Propofol), Crashing Af

2. Metaraminol (Aramine) another link

• α1 agonist (with some β effect) can cause reflex brady which is good for unstable Af
• Mix 10mg x 1 mL vial to 19mL of NS = 0.5mg/mL
• Give 0.5-1mL (0.5-1mg)
• Onset: 1 minutes, duration 20 minutes
• Can also give IM/SC/ETT

3. Adrenaline/Epinephrine: don't give cardiac arrest dose (1mg) to patient with pulse

• alpha and beta 1/2 effects: inopressor (inotrope + vasopressor)
• Mix 1:10,000 1mL + 9mL of NS = 10mcg/mL
• Give 0.5-2mL (50-20mcg) every 2-5 minutes (5-20mcg)
• Same concentration as lidocaine with epinephrine (no extravasation worries)