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Cardiotonic agents are typically employed as short-term and non-routine therapies for heart failure patients. [71] They are specifically reserved for those with contractile dysfunction in the left ventricles (lower chambers of the heart), low cardiac output, and low blood pressure, placing them at risk of inadequate organ perfusion. [72]
Negative inotropic agents decrease myocardial contractility and are used to decrease cardiac workload in conditions such as angina. While negative inotropism may precipitate or exacerbate heart failure in the short term, certain beta blockers (e.g. carvedilol , bisoprolol and metoprolol ) have been believed to reduce long-term morbidity and ...
PDE3 inhibitors are indicated as inotropics for the therapy of acute heart failure if catecholamines are ineffective. [2] Well controlled studies have shown that these drugs generally increase mortality , [ 3 ] when used for the therapy of acute heart failure, so they have to be applied under close observation.
Sleep apnea is an under-recognized risk factor for heart failure. Uncontrolled sleep apnea may increase the risk of heart failure by up to 140%. [4] Weight reduction – through physical activity and dietary modification, as obesity is a risk factor for heart failure and left ventricular hypertrophy. Effective weight management has been shown ...
Levosimendan is a calcium sensitizer — it increases the sensitivity of the heart to calcium, thus increasing cardiac contractility without a rise in intracellular calcium. Levosimendan exerts its positive inotropic effect by increasing calcium sensitivity of myocytes by binding to cardiac troponin C in a calcium
Inotropic agents. Inotropes are indicated if low blood pressure ( SBP < 90 mmHg ) is present. The National Institutes for Health and Care Excellence (NICE) guidelines do not recommend routinely offering inotropes in acute heart failure. [12] However, they recommend it be considered in patients with ADHF and potentially reversible caradiogenic ...
Dobutamine is a direct-acting agent whose primary activity results from stimulation of the β 1-adrenoceptors of the heart, increasing contractility and cardiac output. Since it does not act on dopamine receptors to inhibit the release of norepinephrine (another α 1 agonist), dobutamine is less prone to induce hypertension than is dopamine .
Heart rate (Tachycardia) / Systolic blood pressure (Hypotension) / Decreased urine output: Intravenous fluid / Intraosseous infusion / Blood transfusion with packed red blood cells: Cardiogenic shock: Cardiac output: Positive inotropic agents / Chronotropes: Distributive shock: Sepsis (Septic shock) Vascular permeability: Vasopressors ...
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