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Milrinone, sold under the brand name Primacor, is a pulmonary vasodilator [2] used in patients who have heart failure. It is a phosphodiesterase 3 inhibitor that works to increase the heart's contractility and decrease pulmonary vascular resistance.
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 decreases the pulmonary capillary wedge pressure while increasing cardiac output, as it functions as an arterial vasodilator and increases venous capacitance while decreasing venous return. [5] There is a net decrease in myocardial wall tension, and O 2 consumption when using amrinone.
Nonetheless, the PDE3 inhibitor milrinone is approved for use in heart failure in intravenous form. [1] Both PDE3A and PDE3B are expressed in vascular smooth muscle cells and are likely to modulate contraction. Their expression in vascular smooth muscle is altered under specific conditions such as elevated cAMP and hypoxia. [1]
Vasodilation plays a major role in immune system function. Wider blood vessels allow more blood containing immune cells and proteins to reach the infection site. Vasodilation occurs as part of the process of inflammation, which is caused by several factors including presence of a pathogen, injury to tissues or blood vessels, and immune ...
Neurogenic shock is a distributive type of shock resulting in hypotension (low blood pressure), often with bradycardia (slowed heart rate), caused by disruption of autonomic nervous system pathways. [1] It can occur after damage to the central nervous system, such as spinal cord injury and traumatic brain injury.
When the blood vessels suddenly relax, it results in vasodilation. In vasodilatory shock, the blood vessels are too relaxed leading to extreme vasodilation and blood pressure drops and blood flow becomes very low. Without enough blood pressure, blood and oxygen will not be pushed to reach the body's organs.
Vascular smooth muscle is innervated primarily by the sympathetic nervous system through adrenergic receptors (adrenoceptors). The three types present are: alpha-1, alpha-2 and beta-2 adrenergic receptors|. The main endogenous agonist of these cell receptors is norepinephrine (NE).