Table 10 ICU drugs associated with hypotension . Common ICU drug classes are listed with examples of generic drugs implicated. Mechanism of hypotension included hypovolemia, distributive (vasodilation), and/or cardiogenic (decreased CO)
Classification | Generic name | Mechanism | |||
|---|---|---|---|---|---|
Hypovolemia | Vasodilation | Decreased CO | |||
Beta-blockers | Selective | Atenolol, bisoprolol, esmolol, and metoprolol | B1B | ||
Nonselective | Carvedilol | A1B, B2B | B1B | ||
Labetalol | A1B, B2B | B1B | |||
Propranolol | B2B | B1B | |||
Nadolol | B2B | B1B | |||
Sotalol | B2B | B1B | |||
CCB | Dihydropyridine | Amlodipine, nicardipine, and nifedipine | L-type CCB | ||
Non-dihydropyridine | Diltiazem and verapamil | L-type CCB | L-type CCB | ||
Diuretics | Thiazide | Hydrochlorothiazide | inh. Na/Cl symporter | ||
Thiazide-like | Metolazone | inh. Na/Cl symporter | |||
Potassium sparing | Spironolactone | inh. Na/K exchanger and competitive aldosterone ant. | |||
Loop | Bumetanide and furosemide | inh. Na-K-2Cl symporter | |||
Imidazolines | Clonidine and dexmedetomidine | A2A | |||
Nitrates | Isosorbide dinitrate and nitroglycerine | NO | |||
Opioids | Morphine, codeine, hydromorphone, meperidine, fentanyl | Decrease sympathetic outflow, H2 | Decreased sympathetic outflow | ||
Renin–angiotensin antagonists | ACEI | Benazepril, fosinopril, lisinopril, and ramipril | Bradykinin natriuresis | Bradykinin | |
ARBs | Candesartan, irbesartan, losartan, and valsartan | ARB | |||
Sedative/hypnotics | Propofol | Decreased sympathetic outflow | Decreased sympathetic outflow | ||
Barbiturates | Phenobarbital and pentobarbital | Decreased sympathetic outflow | Decreased sympathetic outflow | ||
Benzodiazepines | Lorazepam and midazolam | Decreased sympathetic outflow | Decreased sympathetic outflow | ||
Vasodilators | Hydralazine | ||||