30:718:409 Lecture 21: CHF and PAH ver 1.0 Sakai 2018
27 Dec 2018
School
Department
Course
Professor
Document Summary
Inotropes used for the treatment of congestive heart failure. Treats chf by inhibiting the na/k-atpase in the heart. Concern: increased serum k (can lead to arrhythmia) Gi upset, anorexia, n/v, affects color vision (you seen yellow/green) Can also see flickering dots or flashes of lights. Because high hl, we have fragments antibodies (fab) to recognize and bind to digoxin and expedite elimination. Can be used in accidental overdose of digoxin. Both of these treat shock due to inadequate tissue perfusion. Bulky substituent on the n, but still affects beta1 (so exception) Iv only, quick onset (1-2mins, hl: 2 mins) Produces less tachycardia but greater increase in force of contraction. To reduce blood volume and get renal perfusion. Not daily, used for short period as an inotrope. Eliminated unchanged in urine (dose-adjust for renal dysfunction) Milrinone is viewed as an inotropic dilator (inodilator)
