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Cardiovascular II

Ionotropes

TermDefinition
Cardiac Glycosides Digoxin, Digitoxin
Digoxin hydrophilic, excreted by kidney, rapid onset, HL 1.5days. Isolated from Digitalis
Digitoxin lipophilic, highly protein bound, metabolized by liver, 5 day half life.
Cardiac Glycosides SIDE FX nausea, vomiting, arrhythmia, low potassium.
Beta Agonists Dopamine, Dobutamine, Prenalterol
Dopamine increase heart rate and contractility, vasoconstriction through alpha receptors(high dose), increase renal blood flow(low dose), choice drug for shock/acute heart failure.
Dobutamine synthetic B agonist. No vasoconstriciton, increase cardiac output (little change of heart rate). Enhance AV conduction (bad for arrythmias).
Prenalterol partial B agonist, stimulates receptors but BLOCKS out natural occurring catecholamines.
Cyclic nucleotide phosphosdiesterase inhibitors Bipyridines Amrinone and milrinone: increase cAMP, increase cardiac output (by contractility). Relax smooth muscle, causes nausea, thrombocytopenia-low platelets bleeding.
Amrinone and milrinone increase cAMP, increase cardiac output (by contractility). Relax smooth muscle, causes nausea, thrombocytopenia-low platelets bleeding.
Calcium Sensitizers Sulmazole and Pimobendan
Sulmazole and Pimobendan affinity of troponin C for calcium leading to increased contractility. Main advantage: don’t get the Ca2+ overload.
Created by: vbukorovic
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