Table 2: Main Characteristics of Commonly Used Inotropes.

Inotrope	Mechanism	Dosing	Inotropy	Vasoconstriction	Vasodilation	BP	Diuresis	Recommendation/Level of Evidence	Possible Side-effects
Beta-agonists
Dobutamine	Beta-1>beta-2>alpha	2–20 μg/kg/min (−) bolus dose	++	+ High doses	+	+	Neutral	IIb/C	Tachyarrhythmias Hypotension Headache Eosinophilic myocarditis (rare) Peripheral blood eosinophilia
Dopamine	Dopa>beta, alpha in high doses	Renal effect <3 μg/kg/min Inotropic effect 3–5 μg/kg/min Vasoconstriction >5 μg/kg/min (−) bolus dose	++	++ High doses	++ Low doses	+ High doses	++ Low doses	IIb/C	Tachyarrhythmias Hypertension Myocardial ischaemia
Norepinephrine	Beta-1>alpha>beta-2	0.2–10.0 μg/kg/min (−) bolus dose	+	++	Neutral	+	+	IIb/C	Tachyarrhythmias Hypertension Headache
Epinephrine	Beta-1>beta-2>alpha	0.05–0.50 μg/kg/min (+) bolus dose: 1 mg IV every 3–5 min during resuscitation	++	++ High doses	+	Neutral/+	Neutral	IIb/C	Tachyarrhythmias Headache Anxiety Cold extremities Pulmonary oedema Cerebral haemorrhage
Phosphodiesterase III inhibitors
Milrinone	PDE3 inhibition	0.375–0.750 μg/kg/min (+) bolus dose: 25–75 μg/kg over 10–20 min (optional)	+	Neutral	++	−	Neutral	IIb/C	Tachyarrhythmias Hypotension Headache
Ca2+ sensitisers
Levosimendan	Calcium sensitiser PDE3 inhibition, opening of vascular Katp channels Inhibition in high doses	0.05–0.20 μg/kg/min (+) bolus dose 12 μg/kg over 10 min (optional, not routinely recommended)	+	Neutral	++	−	+	IIb/C	Hypotension Atrial and ventricular tachyarrhythmias Headache

BP = blood pressure; PDE3 = phosphodiesterase type 3.