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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. Positive inotropes usually increase this level, while negative inotropes decrease it.
Cardiotonic agents, also known as cardiac inotropes or stimulants, have a positive impact on the myocardium (muscular layer of the heart) by enhancing its contractility. . Unlike general inotropes, these agents exhibit a higher level of specificity as they selectively target the myocar
Lusitropy or lucitropy is the rate of myocardial relaxation. The increase in cytosolic calcium of cardiomyocytes via increased uptake leads to increased myocardial contractility (positive inotropic effect), but the myocardial relaxation, or lusitropy, decreases.
Drugs that positively render the effects of catecholamines such as norepinephrine and epinephrine that enhance contractility are considered to have a positive inotropic effect. The ancient herbal remedy digitalis appears to have both inotropic and chronotropic properties that have been recorded encyclopedically for centuries and it remains ...
The effects of amrinone vary widely with species and experimental condition; therefore, its inotropic effects are variable. [3] A loss in sensitivity to phosphodiesterase 3 inhibitors, including amrinone, has been observed in end stage heart failure in humans; other treatment options may be more useful for improvement in these stages. [3]
Epinephrine (adrenaline). Activation of β 1 receptors induces positive inotropic, chronotropic output of the cardiac muscle, leading to increased heart rate and blood pressure, secretion of ghrelin from the stomach, and renin release from the kidneys.
A "heterocycle-phenyl-imidazole" (H-P-I) pattern has been considered to be necessary for positive inotropic activity in cardiac muscle and many second generation inhibitors fit this pattern. [ 6 ] The heterocycle region : Within each heterocycle there is the presence of a dipole and an adjacent acid proton (an amide function).
It primarily works by direct stimulation of β 1 receptors, which increases the strength of the heart's contractions, leading to a positive inotropic effect. Generally it has little effect on a person's heart rate. [2] Dobutamine was approved for medical use in the United States in 1978. [2] It is available as a generic medication. [5]
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