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Dr.Vivek on Instagram: "Inotropes are used to support perfusion in shock — not to replace the actual treatment. So selection depends on the type of shock and hemodynamics. 1) Norepinephrine (Noradrenaline) Start when: Septic shock with low MAP < 65 after giving adequate fluids. • Preparation: 4 mg Norad in 50 mL NS → 80 mcg/mL • Dose: 0.05–0.1 mcg/kg/min, titrate to MAP ≥ 65 • Effect: Restores vascular tone. • Note: First-line in septic shock. Can start peripherally while securing central access
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Dr.BelleHeart —Cardiologist on Instagram: "What are inotropes? Inotropes are medications that we use to help the heart squeeze better when it is weak! Dobutamine Function: Strong ↑ contractility (β1), mild ↓ afterload (β2) → often increases cardiac output Use case: Low-output heart failure/cardiogenic shock with adequate BP (can drop BP) Watch-outs: Tachycardia, arrhythmias Milrinone Function: ↑ contractility + vasodilation (“inodilator”) → ↓ afterload, can drop BP Use case: HF with pulmonary HT
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