Ask an easy question why don't ya!
I'll try my best to give you a brief answer, cause dinner's almost ready
It sounds like you already have it down. Maybe you are trying to figure out when you would choose one over another?
For me that would depend on the hemodynamic parameters, and not all pt's have swans.
Basically, we leave levophed as a last resort, though I know in other units they do not. This drug is more commonly known as "Levophed leave 'em dead," for that reason. If we put someone on levophed, it is unlikely that they will survive, since everything else has been tried. I have seen powerful alpha effects of this drug in the form of black shriveled up toes.
Norepi, or Neo, some of our docs swear it constricts the renal arteries too much as contributes to renal failure. This is the drug we usually use in septic shock, since in septic shock, originally there is too much vasodilation, and the neo helps this nicely. We also keep neo in syringes @ a conc of 1cc=100mcg to use in codes, or BP crashes post op open heart.
Dopa, is becoming not as popular around here, and if immediate response isn't seen in CO, it is reduced to renal, and another drug is tried, usually dobutamine. You have to be careful useing dobut if low BP. I have seen neo added to the dopa dobut combo to maintain the BP. But I am not sure I agree with that, I think maybe dobut is not the correct choice then, but some docs like this. It doesn't hurt, but it seems like overkill to me.
Epi, I have seen mostly in peds, or in adults as the drug used before levophed if needed in drip form. Of course it is a great drug for codes. I have seen many pt's need insulin drip if on epi drip for any period of time, even if not diabetic, since the epi stimulates gluconeogenesis, and blood sugars get wacky. Of course pt's will also become extremely tachy on epi, and it is very arrhythmagenic.
OK, I guess that's it for me. I am working very little in the cardiac unit these days, so hope that helps.