Question on gtts

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I have had absolutely no experience yet with an epi gtt. Could someone give me some situations that might warrent an epi gtt? And how do you titrate it, according to what?

And there's also dobutamine, I don't know much about. I know it's an inotrope, probably does some good w/ CHF pts. But how do you titrate this? ... according to any hemodynamic parameters? Also... are there any hemodynamic parameters that would you make you think to NOT use dobutamine? like... being too tachy or anything?

Thanks in advance... Looking forward to the info!

Thank goodness I LOVE to learn... cuz I have TONS more of it to get through :)

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Specializes in Cardiac.

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...

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Specializes in ICU, currently in Anesthesia School.

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)

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Specializes in SICU/Trauma.

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. ;)

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