Which medication should NOT be administered together with inotropes?

Inotropes are medications used to increase the force of heart contractions, thereby improving cardiac output, which can be vital in critically ill patients with low blood pressure or heart failure. Calcium channel blockers inhibit calcium entry into cardiac and smooth muscle cells, which can lead to reduced cardiac contractility. When administered together with inotropes, they can counteract the intended effects of the inotropic agents, potentially leading to decreased effectiveness in improving heart function or even causing hypotension.

This interaction underscores the need to carefully consider the pharmacologic properties of medications used in a critical care setting. In contrast, beta blockers and ACE inhibitors, while affecting the heart and vascular system, typically do not pose the same direct antagonistic effects to inotropes as calcium channel blockers do. Additionally, IV fluids usually complement inotropic therapy by offering volume support rather than conflicting with the action of inotropes.