Milirinone is listed in the chapter as a adenylyl cyclase inhibtor. This would decrease cAMP. I think it is a phosphodiesterase inhibitor, which would decreases cAMP breakdown.

is isoproterenol the same as isoprenaline? if so you’ll be happy to hear its used regularly in Australia, i don”t know how much it costs but there is usually plenty of it available

Any new thoughts on angiotensin II since your last post on it? When I use heroic doses of norepi, epi, and phenyl plus vaso, I wonder if it would benefit Would good equipoise gives it a niche in some scenarios? I haven’t had access yet since it’s either not on formulary or very restricted by pharmacy.

Do you use metaraminol? Often seems to be peripheral agent of choice in major trauma in London.

Vasopressin is apparently sometimes administered subcutaneously for diabetes insipidus, so I’d assume that it can’t be that dangerous to administer peripherally? If you can just jam 10 units SQ (or IM), I don’t see how extravasation can cause any significant harm.

https://www.ncbi.nlm.nih.gov/pubmed?term=28377801 (see fig 2)
https://www.drugs.com/pro/vasopressin.html#s-34068-7

I’d check your dosing for the epinephrine infusion in the text. I think you mean 5-10 mcg/min, not 5-10 mcg/kg/min.