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The term inotropic state is most commonly used in reference to various drugs that affect the strength of contraction of heart muscle. However, it can also refer to pathological conditions. For example, enlarged heart muscle can increase inotropic state, whereas dead heart muscle can decrease it.
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Disopyramide (INN, trade names Norpace and Rythmodan) is an antiarrhythmic medication used in the treatment of ventricular tachycardia. [2] It is a sodium channel blocker and is classified as a Class 1a anti-arrhythmic agent. [3] [4] Disopyramide has a negative inotropic effect on the ventricular myocardium, significantly decreasing the ...
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.
The class of CCBs known as dihydropyridines mainly affect arterial vascular smooth muscle and lower blood pressure by causing vasodilation. The phenylalkylamine class of CCBs mainly affect the cells of the heart and have negative inotropic and negative chronotropic effects. The benzothiazepine class of CCBs combine effects of the other two classes.
Itraconazole (Onmel/Sporanox) exhibits a negative inotropic effect on the heart and thus could spur an additive effect when used concomitantly with isradipine. Itraconazole also inhibits an important cytochrome liver enzyme ( CYP 450 3A4) which is needed to metabolize isradipine and other calcium channel blockers .
Negative cardiac inotropes; Central agents; Mechanical device; Discontinuation of medications known to lower blood pressure may be helpful, but stopping antihypertensive drugs can also be dangerous in some people. Taking antihypertensive drugs may worsen the syncope, as the hypertension may have been the body's way to compensate for the low ...
The inotropic agent dobutamine is advised only in the short-term use of acutely decompensated heart failure, and has no other uses. [ 13 ] Phosphodiesterase inhibitors such as milrinone are sometimes utilized in severe cardiomyopathy.