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Unlike general inotropes, these agents exhibit a higher level of specificity as they selectively target the myocardium. They can be categorised into four distinct groups based on their unique mechanisms of action: cardiac glycosides , beta-adrenergic agonists , phosphodiesterase III inhibitors , and calcium sensitizers.
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Both positive and negative inotropes are used in the management of various cardiovascular conditions. The choice of agent depends largely on specific pharmacological effects of individual agents with respect to the condition. One of the most important factors affecting inotropic state is the level of calcium in the cytoplasm of the muscle cell ...
This is different from inotropes which increase the force of cardiac contraction. Some substances do both (e.g. dopamine , dobutamine ). If low blood pressure is due to blood loss, then preparations increasing volume of blood circulation—plasma-substituting solutions such as colloid and crystalloid solutions (salt solutions) [ 1 ] —will ...
Although both vasopressors, vasopressin and epinephrine differ in that vasopressin does not have direct effects on cardiac contractility as epinephrine does. [18] Thus, vasopressin is theorized to be of increased benefit over epinephrine in cardiac arrest due to its properties of not increasing myocardial and cerebral oxygen demands. [18]
Side effects of metaraminol include reflex bradycardia among others. Metaraminol is a norepinephrine releasing agent and at high doses a α 1-adrenergic receptor agonist with some β-adrenergic effect. [6] [7] [8] It is a substituted amphetamine and is closely related to phenylpropanolamine, ephedrine, and oxilofrine. [4] [5]
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]
Side effects of isoprenaline include rapid heart beat, heart palpitations, and arrhythmias, among others. [9] Isoprenaline is a selective agonist of the β-adrenergic receptors, including both the β 1-and β 2-adrenergic receptors. [9] By activating these receptors, it increases heart rate and the force of heart contractions. [10]