Vasopressor Drugs

Fluid and vasopressors are the backbone of all cases presenting to the critical care units. Vasopressors increase the vascular tone, and this effect is variable in different vascular beds of the body. Inotropes differ from vasopressors as they increase the cardiac contractility, however many drugs categorised as inotropes has both isotropic and vasopressor effects. Many a times terms vasopressor and inotrope are used interchangeably in clinical practice. These vasoactive drugs act via various adrenergic and dopaminergic receptors, spread widely throughout the body. Each drug has variable effect on the receptor subtype and thus has different vasospastic/ hemodynamic effect. These physiologic effects of vasoactive drugs are also associated with metabolic effects. The dose, rate, and duration of these agents to be used have been debated in various studies. In order to use vasopressors, one must have basic knowledge of these agents so that vasopressors can be used appropriately for the situation in hand. We, in this article, will be discussing different vasopressors and inotropes and their mechanism of action and uses in neurocritical care settings.