Vasopressor use in adult patients.

Vasopressors are a heterogeneous potent class of medications designed to increase blood pressure in emergent hypotensive situations. The goal of therapy is to increase blood pressure and maintain adequate perfusion, allowing nutrient and oxygen delivery to vital organs. Norepinephrine, phenylephrine, dopamine, epinephrine, and vasopressin are five vasopressors available in the United States. All vasopressors, with the exception of vasopressin, are titratable and dosed on a continuum according to clinical effect. With their different clinical features, adverse effects, and range of potency, the clinical situation usually guides therapy. Outcome data comparing different vasopressors have not demonstrated a clear mortality benefit of any one vasopressor over another, and physician preference also guides therapy. Norepinephrine, nonetheless, remains one of the preferred choices for a variety of hypotensive states, including cardiogenic and septic shock.