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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 ...
Negative inotropes improve left ventricular (LV) obstruction by decreasing LV ejection acceleration and hydrodynamic forces on the mitral valve. Disopyramide's particular efficacy is due to its potent negative inotropic effects; in head-to-head comparison, it is more effective for gradient reduction than either beta-blocker or verapamil. [16]
Their inotropic properties make cardiactonic agents critical in addressing inadequate perfusion, and acute heart failure conditions including cardiogenic shock, as well as for long-term management of heart failure. These conditions arise when the heart's ability to meet the body's needs is compromised.
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Medications used include: diuretic agents, vasodilator agents, positive inotropes, ACE inhibitors, beta blockers, and aldosterone antagonists (e.g., spironolactone). Some medications which increase heart function, such as the positive inotrope milrinone, lead to increased death, and are contraindicated. [9] [10]
In children epinephrine or norepinephrine is generally preferred while in adults norepinephrine is generally preferred for very low blood pressure. [ 6 ] [ 7 ] In those with low blood volume or septic shock , this should be corrected with intravenous fluids before dopamine is considered.
Class II agents do not depress conduction or contractility. Class III agent has negligible inotropic effect and causes almost no reflex tachycardia. Examples include Class I agents (e.g., verapamil), Class II agents (e.g., amlodipine, [4] nifedipine), or the Class III agent diltiazem. Nifedipine is more a potent vasodilator and more effective ...
Isoprenaline is used to treat heart block and episodes of Adams–Stokes syndrome that are not caused by ventricular tachycardia or fibrillation, in emergencies for cardiac arrest until electric shock can be administered, for bronchospasm occurring during anesthesia, and as an adjunct in the treatment of hypovolemic shock, septic shock, low cardiac output (hypoperfusion) states, congestive ...