Which inotropic drugs are safe for use in elderly patients with mild congestive heart failure in the postoperative period?

B. Dopamine.

C. Amrinone.

D. Melrinone.

E. Dobutamine.

DISCUSSION: Dopamine and dobutamine stimulate cardiac beta-receptors and are very useful in providing inotropic support for patients in the postoperative period. Melrinone and amrinone are phosphodiesterase inhibitors that have strong inotropic effects while causing arterial and venous dilation. Melrinone and amrinone are useful in patients with low cardiac output, especially in the setting of congestive heart failure. Digitalis compounds can be troublesome in the postoperative period owing to the toxic effects of these agents. Furthermore, perioperative hypoxia and hypokalemia increase myocardial susceptibility to digitalis-induced ventricular arrhythmias.