Five primary classes of drugs bear specific application to the LVAD population: (i) drugs that provide haemodynamic support; (ii) antimicrobials; (iii) anticoagulants and antiplatelets; (iv) agents that promote myocardial recovery; and (v) miscellaneous other medications. Drugs that provide haemodynamic support are subdivided into inotropes, vasopressors and pulmonary vasodilators. Some combination of these medications is usually administered within the perioperative period in order to maintain stable patient haemodynamics and assure proper LVAD function. Antimicrobials are of paramount importance in the pre-, intra- and postoperative periods to minimise the risk of infection, an unfortunately common complication of LVAD therapy that can have potentially morbid consequences. Anticoagulants and antiplatelet medications are necessary for certain types of LVADs and serve to curb the incidence of device thrombus formation and associated embolic phenomena. Pharmacotherapeutic agents that facilitate myocardial recovery are being investigated as adjuncts to LVAD support so that bridge to recovery can become a realistic outcome for a growing number of LVAD patients. The miscellaneous class of medications used with LVADs includes those that minimise the risk of bleeding in select patients and those that enhance proper vitamin and nutrient status in the postoperative period, the attainment of which may serve vital to a successful recovery.
