Inotropes and vasopressors

Abstract Inotropes are often used to offer haemodynamic support to patients with decompensated heart failure and cardiogenic shock. Although several drugs with inotropic activity are available, it has become increasingly evident that these drugs are associated with important negative effects. The positive inotropic actions of many of these agents are based on increased intracellular calcium concentrations, which may enhance myocardial energy consumption and arrhythmias. This chapter describes the pharmacology and evidence base for the use of inotropes in patients with heart failure.