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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.
Specifically, dobutamine selectively binds to β1 receptors located on the surface of specialised cardiac muscle cells. [16] Relative to β2 receptors, β1 is the predominant type in terms of quantity and function within the heart.
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 raise the blood pressure without any direct vasopressor activity.
Most agonists of the beta receptors are selective for one or more beta-adrenoreceptors. For example, patients with low heart rate are given beta agonist treatments that are more "cardio-selective" such as dobutamine, which increases the force of contraction of the heart muscle.
Indications for termination: A cardiac stress test should be terminated before completion under the following circumstances: [33] [34] Absolute indications for termination include: Systolic blood pressure decreases by more than 10 mmHg with increase in work rate, or drops below baseline in the same position, with other evidence of ischemia.
Very common (greater than 10%) adverse effects include fast heart beats and nausea. [2] Common (between 1% and 10%) adverse effects include tremor, headache, transient low blood pressure, vomiting, increased sweating, sepsis, sinus and nodal slow heart beat, cardiac arrest, myocardial infarction, cardiac enzyme changes, non-specific ECG changes, high blood pressure, hemorrhage, respiratory ...
The mechanisms of sympathomimetic drugs can be direct-acting (direct interaction between drug and receptor), such as α-adrenergic agonists, β-adrenergic agonists, and dopaminergic agonists; or indirect-acting (interaction not between drug and receptor), such as MAOIs, COMT inhibitors, release stimulants, and reuptake inhibitors that increase the levels of endogenous catecholamines.
Levosimendan / ˌ l iː v oʊ s aɪ ˈ m ɛ n d ən / is a calcium sensitizer used in the management of acutely decompensated congestive heart failure.It is marketed under the trade name Simdax (Orion Corporation).