Cardiotonics and Miscellaneous Inotropic Drugs

The cardiotonics are dm used to increase the efficiency and improve the contraction of the heart muscle which leads to improved blood flow to all tissues of the body. The drug s have long been used to treat congestive heart failure (CHF), a condition in which the heart cannot pump enough blood to meet the tissue needs of the body. While the term congestive heart failure continues to be used by some, a more accurate term is simply heart failure.  

About 4.5 million Americans have heart failure (HF). It is the most frequent cause of hospitalization for individuals older than 65 years. Some patients, with treatment, may lead nearly normal lives, whereas more than 50% of individuals with severe HF die each year. HF is a complex clinical syndrome that can result from any number of cardiac or metabolic disorders such as ischemic heart disease, hypertension, or hyperthyroidism. Any condition that impairs the ability of the ventricle to pump blood can lead to HF In HF, die heart 

DISPLAY 39-1 Neurohormonal Responses Affecting Heart Failure 

The most common symptoms associated with HF include  

Left ventricular dysfunction, also called left ventricular systolic dysfunction, is the most common fonn of heart failure and results in decreased cardiac output and decreased ejection fraction (the amount of blood that the ventricle ejects per beat in relationship to the amount of blood available to eject). Typically, the ejection fraction should be greater than 60%. With, left 

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Unit VI covers drag s that affect the cardiovascular system. This unit is divided into five chapters cardiotonics and miscellaneous inotropic drag s, antiar-rhythmic drugs, antianginal and peripheral dilating dragp, antihypertensives, and antihyperlipidemics. 

Miscellaneous dru witli positive inotropic action such as inamrinone and milrinone (Primacor) are nonglycosides used in the short-term management of HE. AMiough in tlie past the cardiotonics were the mainstay in the treatment of HE, currently tliey are used as the fourtli line of treatment for patients who continue to experience symptoms after using the ACE inhibitors, diuretics, and beta blockers. See the Summary Drug Table Cardiotonics and Miscellaneous Inotropic Dru for infonnation concerning tliese dru. ... 

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