Inotropic

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Inotropic refers to the force of contraction of the heart muscle. It is a term used in pharmacology to describe the increase or decrease in the strength of contraction of the heart. Inotropic agents, or inotropes, are drugs that change the force of your heart's contractions.

Mechanism of Action[edit | edit source]

Inotropic agents work by altering the calcium sensitivity of the contractile proteins within the heart muscle cells. They can either increase the force of contraction (positive inotropes) or decrease it (negative inotropes). Positive inotropes increase the strength of the heartbeat, while negative inotropes decrease the strength of the heartbeat.

Types of Inotropic Agents[edit | edit source]

There are several types of inotropic agents, including:

  • Digitalis Glycosides: These are derived from the foxglove plant and have been used for centuries to treat heart conditions. They work by increasing the amount of calcium in the heart muscle cells, which increases the force of contraction.
  • Beta-Adrenergic Agonists: These drugs mimic the action of adrenaline and noradrenaline in the heart, increasing the force of contraction.
  • Phosphodiesterase Inhibitors: These drugs increase the amount of cyclic AMP in the heart muscle cells, which increases the force of contraction.

Clinical Uses[edit | edit source]

Inotropic agents are used in a variety of clinical settings, including:

  • Heart Failure: Inotropic agents are often used to increase the force of contraction in patients with heart failure, improving the heart's ability to pump blood.
  • Cardiogenic Shock: Inotropic agents can be used to increase the force of contraction in patients with cardiogenic shock, a condition where the heart is not pumping enough blood to meet the body's needs.
  • Cardiac Surgery: Inotropic agents are often used during and after cardiac surgery to improve the heart's ability to pump blood.

Side Effects[edit | edit source]

Like all medications, inotropic agents can have side effects. These can include:

  • Arrhythmias: Because inotropic agents affect the electrical activity of the heart, they can cause abnormal heart rhythms.
  • Ischemia: By increasing the force of contraction, inotropic agents can increase the heart's demand for oxygen, potentially leading to ischemia, or insufficient oxygen supply to the heart.


Inotropic Resources

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Contributors: Prab R. Tumpati, MD