Inotropic Flashcards
What is the class for Diuretics
Diuretics
What is the mechanism for Diuretics
Decrease volume and preload
What are the therapeutics for Diuretics
Improve arterial distensibility; reduce preload
What are the important side effects for Diuretics
Causes neurohormonal activation
What are the miscellaneous for Diuretics
Contraindication in hypovolemic patients
What is the class for Bisoprolol, carvedilol, sustained release metoprolol
?-blockers
What is the mechanism for Bisoprolol, carvedilol, sustained release metoprolol
Blocks high circulating levels of catecholamines
What are the therapeutics for Bisoprolol, carvedilol, sustained release metoprolol
Dramatically decreases mortality in CHF patients
What are the miscellaneous for Bisoprolol, carvedilol, sustained release metoprolol
Should be started at very low dose and slowly ratchet up; do not stop suddenly
What is the class for Digoxin (Lanoxin)
Cardiac glycoside
What is the mechanism for Digoxin (Lanoxin)
Inhibits Na/K/ATPase (increases contractility d/t more Ca); increases vagal activity to heart (reduces SA firing rate, conduction through AV node)
What are the therapeutics for Digoxin (Lanoxin)
Improves LV function, decreases neurohormonal activation, increases vagal tone, normalizes arterial baroreceptors; decreases hospitalizations in CHF (no mortality benefit)
What are the important side effects for Digoxin (Lanoxin)
Very narrow therapeutic-toxic window (mostly arrhythmias)
What are the miscellaneous for Digoxin (Lanoxin)
Eliminated in kidneys, so dose according to renal function
What is the class for Dobutamine (Dobutrex)
?1 receptor agonist
What is the mechanism for Dobutamine (Dobutrex)
Positive inotrope and chronotrope
What are the therapeutics for Dobutamine (Dobutrex)
Acutely decompensated patients (about half will die after 6 months)
What are the important side effects for Dobutamine (Dobutrex)
Quick acting, but can develop tachyphylaxis after 48 hours
What are the miscellaneous for Dobutamine (Dobutrex)
No NE release; given IV
What is the class for Milrinone (Primacor)
Phosphodiesterase IIIa inhibitor
What is the mechanism for Milrinone (Primacor)
Inhibits cAMP breakdown
What are the therapeutics for Milrinone (Primacor)
Inotropy, chronotropy, lusitropy, vasodilation
What are the important side effects for Milrinone (Primacor)
Increased hypotensive and atrial arrhythmia events acutely. 2 month mortality nearly 50% higher than placebo
What are the miscellaneous for Milrinone (Primacor)
Given IV, depends on renal clearance, no tolerance after 72 hours
What is the class for Nesiritide (Natrecor)
Synthetic BNP
What are the therapeutics for Nesiritide (Natrecor)
Doesn’t really do much
What are the miscellaneous for Nesiritide (Natrecor)
Given IV
