Cardiovascular pharmacotherapy update for the intensive care unit.
Pharmacologic agents including vasodilators, inotropes, and vasopressors are frequently used in the critical care setting for management of the unstable cardiac patient. These medications are used to elicit varying effects on vascular resistance, myocardial contractility, and heart rate to help achieve desired hemodynamic and clinical endpoints. Therefore, it is important for the critical care nurse to have a practical understanding and working knowledge of cardiovascular pharmacotherapy in the intensive care unit setting. This article reviews the pharmacology and clinical utility of commonly used intravenous "vasoactive" medications encountered in the intensive care unit. We also highlight innovations in pharmacotherapy for this patient population, and provide practical considerations for the most appropriate and safe use of these medications.
Coons
James C
JC
Department of Pharmacy, Allegheny General Hospital, Pittsburgh, PA 15212, USA. jcoons@wpahs.org
Seidl
Edward
E
D002316:Cardiotonic Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods*; D004280:Dobutamine / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D004837:Epinephrine / Q000627:therapeutic use; D006331:Heart Diseases / Q000188:drug therapy* / Q000451:nursing; D006801:Humans; D020105:Milrinone / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use; D005996:Nitroglycerin / Q000627:therapeutic use; D009599:Nitroprusside / Q000627:therapeutic use; D009638:Norepinephrine / Q000627:therapeutic use; D009730:Nursing Assessment; D010656:Phenylephrine / Q000627:therapeutic use; D017751:Safety Management; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D002316:Cardiotonic Agents; D002317:Cardiovascular Agents; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D009599:Nitroprusside; D010656:Phenylephrine; D004280:Dobutamine; D005996:Nitroglycerin; D020105:Milrinone; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine