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Specifically, in patients experiencing inadequate blood perfusion (with blood pressure below 80 mmHg), the American Heart Association / American College of Cardiology (ACC/AHA), recommends the use of Dobutamine and Milrinone. [75] Whereas in clinically stable patients with sufficient perfusion, cardiac inotrope use is advised against. [76]
Milrinone is a commonly used therapy for severe pulmonary arterial hypertension (PAH), [14] often in combination with other medications such as sildenafil. [15] Targeting PDE3 with optimal doses and timing, milrinone prevents allergic inflammation in HDM-driven models of allergic airway inflammation.
Amrinone, milrinone and enoximone are used clinically for short-term treatment of cardiac failure in the presence of cardiogenic shock. [1]PDE3 inhibitors are indicated as inotropics for the therapy of acute heart failure if catecholamines are ineffective. [2]
Amrinone, also known as inamrinone, and sold as Inocor, is a pyridine phosphodiesterase 3 inhibitor. [1] It is a drug that may improve the prognosis in patients with congestive heart failure. [2]
Dobutamine is a medication used in the treatment of cardiogenic shock (as a result of inadequate tissue perfusion) and severe heart failure. [2] [3] It may also be used in certain types of cardiac stress tests. [2] It is given by IV only, as an injection into a vein or intraosseous as a continuous infusion. [2]
The mechanisms of sympathomimetic drugs can be direct-acting (direct interaction between drug and receptor), such as α-adrenergic agonists, β-adrenergic agonists, and dopaminergic agonists; or indirect-acting (interaction not between drug and receptor), such as MAOIs, COMT inhibitors, release stimulants, and reuptake inhibitors that increase the levels of endogenous catecholamines.
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PDE3 inhibitors like amrinone, milrinone, and pimobendan [1] [2] [3] Cardiac glycosides like digoxin [2] Other agents like hydralazine, levosimendan, and cannabinoids [3] Exercise is also a cardiac stimulant by increasing levels of the sympathomimetic catecholamines epinephrine and norepinephrine. [4] [5]