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Diltiazem has negative inotropic, chronotropic, and dromotropic effects. This means diltiazem causes a decrease in heart muscle contractility – how strong the beat is, lowering of heart rate – due to slowing of the sinoatrial node , and a slowing of conduction through the atrioventricular node – increasing the time needed for each beat.
Side effects, caution & contraindications Remarks Beta-blockers: Metoprolol; Atenolol; Bisoprolol; Block beta-1 receptors in the heart → stop the effects of catecholamines on the heart→ reduce heart rate, heart contractility and conduction velocity → reduce the workload of the heart [15] Side effects [16] Bradycardia; Hypotension; Heart Block
Metoprolol is a beta blocker, or an antagonist of the β-adrenergic receptors. It is specifically a selective antagonist of the β 1-adrenergic receptor and has no intrinsic sympathomimetic activity. [37] Metoprolol exerts its effects by blocking the action of certain neurotransmitters, specifically adrenaline and noradrenaline.
They act by blocking the effects of catecholamines at the β 1-adrenergic receptors, thereby decreasing sympathetic activity on the heart, which reduces intracellular cAMP levels and hence reduces Ca 2+ influx. These agents are particularly useful in the treatment of supraventricular tachycardias. They decrease conduction through the AV node.
The choice between the drugs is to a large degree determined by the characteristics of the patient being prescribed for, the drugs' side effects, and cost. Most drugs have other uses; sometimes the presence of other symptoms can warrant the use of one particular antihypertensive. Examples include: Age can affect the choice of medications.
Amiodarone is indicated for the treatment of refractory VT or VF, particularly in the setting of acute ischemia.Amiodarone is also safe to use in individuals with cardiomyopathy and atrial fibrillation, to maintain normal sinus rhythm.
Both positive and negative inotropes are used in the management of various cardiovascular conditions. 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 ...
Dihydropyridine calcium channel blockers are derivatives of 1,4-dihydropyridine that are used as L-type calcium channel blockers. [1] They are used in the treatment of hypertension.
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