Which medications in the drug class Inotropic Agents are used in the treatment of Calcium Channel Blocker Toxicity?

Updated: Jan 04, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Answer

Inotropic Agents

In hypotensive patients, dopamine can be administered to support the heart rate. Failure to respond to the maximal dose of dopamine should prompt the addition of norepinephrine.

Dopamine

Dopamine activates dopamine receptors first, then beta1 receptors, and then alpha1 receptors. A low dose of 0.5-3 mcg/kg/min activates dopamine receptors and causes splanchnic vasodilation. An intermediate dose of 3-7.5 mcg/kg/min activates beta1 receptors, increasing cardiac inotropy and chronotropy. High doses of 7.5 mcg/kg/min or greater activate alpha1 receptors, causing vasoconstriction.

Doses of greater than 20 mcg/kg/min are unlikely to produce additional effects; therefore, the addition of a second agent (eg, norepinephrine) is probably indicated at that time. Mix 400 mg of dopamine in 250 mL D5W to yield 1600 mcg/mL.


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