Question on gtts

I rarely use Dobutamine.

But I have used an epi gtt the last 2 shifts I have worked.

Last shift, we used it along with a few other pressors to get any kind of BP (vaso, levo, neo and epi with a BP of 32/20)

Previous shift we used it when the neo was maxed out and levo maxed out.

I titrate it to the MAP.

Other instances where I've used the gtt was in anaphalytic shock pts...

Dobutamine is dosed similar to dopamine- mcg/kg/min with nearly exact same range. It has fallen out of favor in most areas due to the fact that although it is an inotrope you will usually have to add another pressor to counteract the net hypotension Dobutamine causes. (Usually the other pressor is either epi,norepi, or dopamine.) So, if you are going to have to hang two, might be better to hang one with all the effects you are looking for:Epi.

Epi is a great drug for the sick heart population, or the profoundly catecolamine depleted population and is dosed in mcg/min. Usual adult range is .03-.3mcg/kg/min some references include .01-.5mcg/kg/min (ex.100kg person = 3-30mcg/min)

I dont' see dobutamine to often but we had it last week in the unit for a pt who had a massive MI, she also had a IABP and other stuff. It has set parameters like dopamine mcg/kg/min. Epi, I usually only see on our post op CABG pts. titrate it slowly, to the MAP desired.