Cardiotonic: an overview of the preparations, performance and reviews

Cardiotonic are drugs that increase the activity of cardiac muscle, its contractility and is applied in the therapy of heart failure. The group includes a significant number of drugs that have different active ingredients and different mechanisms of action. Kardiotoniki used to treat acute and chronic forms of heart failure.

Cardiotonic: classification

The Total effect of all the drugs included in the group, based on the ability to increase contractility of the myocardium, thereby increasing cardiac output of blood and shock volume. Cardiotonic drugs reduce diastolic volume, pulmonary and systemic pressures in veins and also the pressure during the filling of the ventricles.

1. Cardiac glycosides – “Strophanthin”, “Korglikon”, “Somebody”.
2. Adrenergic drugs – “Izadrin”, “Dobutamine”, “Release”.
3. Non-adrenergic non-synthetic drugs – “Inamrinone”, “Milrinone”.

The Choice of drugs is associated with the severity of the condition of the patient and the form of the disease.

Cardiac glycosides

The Group is represented by means of vegetable or synthetic origin. Drugs based on plant substances derived from digitalis, Adonis, Lily of the valley spring, oleander, strophanthus, etc.

The Duration of therapeutic action, the effect of accumulation in the body and neurotoxicity of drugs are entirely dependent on their ability to form complexes with proteins of blood plasma. The stronger such linkages are, the higher the efficiency of the glycoside. Cardiotonic this group have an activity that is based on the following mechanisms:

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• There is a shortening of systole with its simultaneous enhancement;
• The rest period of the heart muscle is lengthened;
• Decreases heart rate;
• Enhanced the ability of the muscle of the myocardium to the excitation;
• Overdose of drugs developing ventricular arrhythmias.

“Somebody”

The Drug is synthesized from the leaves of digitalis. Refers to the glycosides long-acting, giving no serious side effects. It is used for complex treatment of chronic heart failure, and arrhythmias tahisistolicescie.

Available in form of tablets and injection solution. The dose necessary to select carefully for each patient individually. In the case of other cardiac glycosides in front of "Digoxin" the dosage is reduced.

“Strophanthin”

Is a cardiac glycoside short-acting used in the case of acute forms of disease. “Strofantina” tend not to accumulate in the body. The preparation enhances the contractile function of the myocardium and increase cardiac output. There is also a parallel reduction in the size of the heart muscle and reducing its oxygen demand.

It is Used intravenously, intramuscularly, in some cases – inside. Drinking large amounts can lead to overdose. The use of other drugs changes the effectiveness of the glycoside:

• With the barbiturates the effect is reduced;
• "Reserpine", sympathomimetics and antidepressants can cause the development of cardiac arrhythmias;
• Reception with tetracyclines, "Chloramphenicol", "Amiodarone" and "Captopril" enhances cardiotonic action;
• Magnesium sulfate contributes to the development of heart atrioventricular block.

Adrenergic drugs

Neglikozidnye cardiotonic, having a short-term effect. The group applied during acute course of heart failure to support important body functions.

“Izadrin” is a stimulator of the adrenergic receptors of blood vessels, bronchi and heart. The drug has a hypotensive effect, increases contractility of cardiac muscle. Used in cardiac surgery with a sharp decrease in contractility during operating events as well as in cardiogenic shock. The doctors warned: an incorrectly applied or excess dosage can cause ventricular fibrillation of the heart.

“Dobutamine” - neglikozidnye cardiotonic agent structures that have a stimulating effect on the heart muscle, as well as normalizing coronary blood flow. The risk of developing arrhythmias when using this tool quite low, since “Dobutamine” has virtually no effect on cardiac automaticity.

Appointed in quick need for increased myocardial contractility. In some cases, can cause the development side effects:

• Nausea;
• Headache;
• Hypertension;
• Palpitations;
• Chest pain.

“Release” is a catecholamine that stimulates the adrenergic receptors. The drug increases blood pressure, increases coronary blood flow. Appointed in acute myocardial failure, shock. Caution should be used in myocardial infarction, pregnancy, thyroid disease, arrhythmias.

Non-adrenergic synthetic kardiotoniki

This is used in cases of acute coronary insufficiency cardiotonic. Drugs act on the contractility of the heart muscle, strengthening it. Can trigger the development of arrhythmias and lowering blood pressure, disorders of the kidney.

Cardiotonic drugs of this group should not be used in heart disease, and cardiomyopathy, heart rhythm disturbances, aortic aneurysm, kidney failure, heart attack and in the period of carrying a child.

Means “Inamrinone” is used exclusively in intensive care, the patient was constantly under special control devices, signaling his condition. In addition to increasing heart rate, the drug dilates blood vessels, increases the ejection of blood during systole, decreases pulmonary pressure.

Comes in the form of a solution. For intravenous injection is diluted exclusively in a physiological solution of sodium chloride. Do not mix with other drugs. With the introduction of a possible sharp decline in pressure, acceleration of heart rate, heart palpitations, headache, gastro-intestinal disorders.

“Milrinone” is more active than the first representative of the group, and according to reviews it is better tolerated by patients. Contraindicated use of the medication during pregnancy and the development of myocardial infarction. One of the preparations of group A. the Need for treatment is determined solely by the doctor.

Conclusion

Cardiotonic proved the efficacy of a few generations ago. Reviews indicate that these drugs help to cope with heart failure. However, the intake of such medicines in the form of self-medication is strictly contraindicated because of possible complications, side effects or overdose. The choice of drug and dose, is determined by the cardiologist in each clinical case individually.