Common Cardiovascular Medications – indications and effects of use – An Overview 

1. Inotropes 

Primary effect: 
Increase the force of cardiac contraction → improves cardiac output. 

Common examples (UK): 
Dobutamine 
Milrinone 
(Adrenaline has inotropic effects but is often classed as a vasopressor) 

Indications: 
Acute heart failure 
Cardiogenic shock 
Low cardiac output states (e.g. post-MI, post-cardiac surgery) 

Nursing considerations: 
Usually IV infusion (via central line) 
Continuous ECG monitoring 
Monitor BP, heart rate, urine output 
Risk of arrhythmias and hypotension 

2. Vasopressors 

Primary effect: 
Cause vasoconstriction → increase systemic vascular resistance and blood pressure. 

Common examples: 
Noradrenaline
Adrenaline 
Vasopressin 
Phenylephrine 

Indications: 
Septic shock 
Severe hypotension 
Anaphylaxis 
Cardiac arrest (ALS) 

Nursing considerations: 
Central line preferred (risk of extravasation) 
Strict BP monitoring (arterial line often used) 
Monitor peripheral perfusion 
Risk of tissue ischaemia, arrhythmias 

3. Anti-arrhythmics 
Primary effect: 
Restore or control heart rhythm and/or heart rate. 

Common examples: 
Amiodarone 
Digoxin 
Flecainide 
Adenosine (SVT) 
Beta-blockers (e.g. bisoprolol) 

Indications: 
Atrial fibrillation/flutter 
SVT 
Ventricular arrhythmias 
Rate control or rhythm control 

Nursing considerations: 
ECG monitoring required 
Check electrolytes (K⁺, Mg²⁺) 
Monitor for bradycardia and hypotension 
Amiodarone: long-term toxicity (thyroid, lungs, liver) 

4. Anti-hypertensives 
Primary effect: 
Lower blood pressure via different mechanisms. 
Main classes seen in practice: 
ACE inhibitors (ramipril) 
ARBs (losartan) 
Calcium channel blockers (amlodipine) 
Beta-blockers (bisoprolol) 
Alpha-blockers (doxazosin) 

Indications: 
Hypertension 
Heart failure 
Post-MI 
Stroke prevention 
Chronic kidney disease (BP control) 

Nursing considerations: 
Monitor BP and renal function 
ACE inhibitors: risk of persistent cough, hyperkalaemia 
CCBs: ankle oedema, flushing 
Educate patients about postural hypotension 

5. Diuretics 
Primary effect: 
Increase urine output → reduce fluid overload and BP. 

Common types: 
Loop diuretics: furosemide 
Thiazides: bendroflumethiazide 
Potassium-sparing: spironolactone 

Indications: 
Heart failure 
Pulmonary oedema 
Oedema (renal, liver disease) 
Hypertension 

Nursing considerations: 
Monitor fluid balance and daily weights 
Check electrolytes (especially potassium) 
Risk of dehydration and hypotension 
IV furosemide often used acutely 
 
Summary Table