Table 1.

Inotropes and vasopressors use in cardiogenic shock

Agents	Mechanism of action	Main effects	Indications	Side effects
Norepinephrine	α1+  > Β1 +	Vasoconstriction	First-line vasopressor in cardiogenic shock	Excessive vasoconstriction, immunomodulation
Dobutamine	Β1+	Ionotropy, moderate vasodilatation	First-line inotropic agent in cardiogenic shock	Tachycardia, hypotension (excessive vasodilatation)
Milrinone	PD-3 inhibitor	Ionotropy	Second-line inotropic agent in CS	Tachyarrhythmias, hypotension, headache
Levosimendan	Myofilament calcium sensitizer	Ionotropy and inodilator	Second-line inotropic agent in cardiogenic shock (patients under betablockers)	Hypotension, atrial and ventricular tachyarrhythmias, headache