Vasopressors, vasodilators, and antithrombotics in the catheterization laboratory

This chapter provides an overview of medications commonly used during cardiac catheterization and interventional procedures. It focuses on medications that provide hemodynamic optimization during procedures, as well as agents used to prevent thrombotic complications. In critically ill patients, hemodynamic stability can be achieved using mechanical support with intra-aortic balloon pumps and mechanical assist devices. Vasodilator therapy is most frequently used in the treatment of hypertension. During cardiac catheterization, it may be necessary to provide temporary hemodynamic support for a patient in shock or experiencing severe hypotension. This sometimes requires use of vasopressors, most commonly dopamine, norepinephrine, epinephrine, or phenylephrine. The chapter examines currently approved US Food and Drug Administration (FDA) antithrombotic medications that are used to manage acute coronary syndrome (ACS) and support cardiac catheterization. Antiplatelet medications can protect against platelet activation, aggregation, adhesion, and platelet-induced vasoconstriction.