What's the difference?????

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    Can anyone please tell me the difference between dopamine, dobutamine, levophed, epinephrine, and neosynephrine? Know that dopamine has renal action up to 2mcg's; above that stimulates beta-1 and alpha-adrenergic receptors (positive inotropic and chronotropic effects); dobutamine is a pure beta-1 agonist (inotrope with mild chronotropic effects); levophed (norepinephrine) is a potent alpha-receptor agonist causing peripheral vasoconstriction, with minimal effect on beta receptors, and a positive inotrope (dilates coronary arteries), while at the same time increases myocardial oxygen demand and may therefore decrease cardiac output; epinephrine has both alpha and beta adrenergic activity (increases systemic vascular resistance, B/P, and heart rate); and neosynephrine is an alpha agonist, useful in septic shock. Please, please, please, all you experienced critical care nurses, relate your own perceptions and experiences with these drugs. Differences that just aren't found in the drug book. THANKS!!!!!
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    In my experience, when you use one over the other is often purely physician preference. Many of our physicians for example prefer the DOP/DOB cocktail instead of using epinephrine which could give you both effects. I am not sure that there is a good answer to your question, I guess, outside of the specific actions of each drug!


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