vasoactiva

Vasoactiva refers to substances that influence the tone and caliber of blood vessels, thereby altering blood flow and blood pressure. In medicine, vasoactive agents can produce vasoconstriction, increasing systemic vascular resistance, or vasodilation, reducing resistance and redistributing perfusion. They may act directly on vascular smooth muscle, modify endothelial signaling, or alter autonomic regulation of the vessels.

Major groups include vasopressors, which raise blood pressure by constricting vessels (examples: norepinephrine, epinephrine, dopamine, phenylephrine); vasodilators, which relax vascular smooth muscle (examples: nitroprusside, nitroglycerin, nicardipine, clevidipine); inotropics with vasodilatory effects (milrinone); prostacyclin analogs (epoprostenol, iloprost); and endothelin receptor antagonists (bosentan) used in pulmonary arterial hypertension. Vasopressin and its analogs also serve as potent vasoconstrictors in shock.

Clinical use: Vasoactives are central to the management of acute hemodynamic instability, septic or cardiogenic shock, perioperative hypotension, severe hypertension, and pulmonary arterial hypertension. They are typically administered by continuous IV infusion in monitored settings, with titration based on blood pressure, heart rate, and organ perfusion.

Monitoring and safety: Use requires careful monitoring of arterial pressure, central venous pressure, urine output, and signs of tissue ischemia. Adverse effects include arrhythmias, excessive hypertension, reflex tachycardia, and local tissue injury from IV extravasation. Drug choices and dosing depend on clinical context and patient comorbidities.