L’uso dei farmaci inotropi. Una revisione narrativa della letteratura

Introduction. Inotropic drugs aim to improve the performance of myocardial contractility, beyond changes in heart rate and loading conditions. The specificity of the drug's action, together with its specific undesirable and/or side effects, impose on the nursing professional an adequate knowledge of the pharmacokinetics and pharmacodynamics of the drug itself as well as in-depth knowledge with respect to the possible early symptoms of side effects. This review of the literature aims to explore the specifici-ties of the pharmacological management process of inotropic drugs, with particular attention to the methods for the replacement of the infusion and the monitoring of possible side effects. Methods. The following Databases were consulted: PubMed, Scopus, Cochrane Library, Cumulative In-dex to Nursing and Allied Health Literature (CINAHL), Web of Science, Biological Science Index, Bi-oMed Central and Google Scholar. The search string launched was "Inotropes AND drug administration and Nursing". Results. From a total of 1538 articles, 17 articles were included. Of these, five papers aim at hemody-namic monitoring, five papers analyze the importance of a continuous knowledge and education of the nursing figure on this topic, six papers evaluate the influence that the infusion change maneuver can have on the hemodynamics of the patient hospitalized for critical situations and one study examines the management even at home. Discussion. It is essential to have excellent skills with respect to cardiac physiology and pharmacologic affects; the same applies to dilution, infusion administration, and infection control of the devices used for infusions. However, the nurse must be knowledgeable about the inotrope, the individual patient response, and the infusion device being used while paying particular attention to possible patient harm. There must be constant work to reduce errors and develop safe routines for medication handling and learning about technology.