Inotropic agents (HF)

Question 1

What are the 2 types of inotropic agents?

Answer 1

cardiac glycosides

phosphodiesterase inhibitors

Question 2

example of cardiac glycoside and PDE inhibitor

Answer 2

digitalis - digoxin

milrinone, enoximone

Question 3

What cardiac mechanical effects does digitalis have?

Answer 3

increases myocardial contractility
inhibits Na/K pump
which increases Ca

Question 4

What cardiac electrical effects does digoxin have?

Answer 4

indirect
low doses - increases PN activity
high doses - increases SN activity
direct
increases automaticity

Question 5

What does an increase in contractility cause? (digoxin)

Answer 5

decreases hypoperfusion symptoms

Question 6

What does natriuresis in digoxin cause?

Answer 6

decreased congestive symptoms

Question 7

adverse effects of digoxin

Answer 7

arrhythmias
neurological disturbances
GIT disturbances

Question 8

What do PDEIs inhibit?

Answer 8

PDE III

Question 9

What does inhibiting PDE III cause?

Answer 9

increases intracellular cAMP

Question 10

What does increasing contractility cause in PDEIs?

Answer 10

decreases hypoperfusion symptoms

Question 11

What does increased peripheral vasodilation cause in PDEIs?

Answer 11

decreases congestive symptoms

Question 12

What type of HF are PDEIs used for?

Answer 12

severe HF (short term management)
acute decompensated HF

Question 13

adverse effects of PDEIs

Answer 13

increased risk of:
angina
arrhythmias

Question 14

What can inotropic therapy cause? (exception)

Answer 14

increased mortality (except digoxin)

Question 15

What types of HF is inotropic therapy used for?

Answer 15

chronic HF (short term therapy)
exacerbations of chronic HF

Question 16

What can inotropic therapy not be used in?

Answer 16

long term therapy in chronic HF (except digoxin)