Inotrope

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Inotropes are drugs that are used for the management of heart failure. Drugs of this class are useful because they increase contractility and, as a result, cardiac output (stroke volume), causing regression of symptoms. Although mechanisms differ, the final mechanism involves an increase in intracellular calcium concentrations.

Problems with positive inotropic agents are that they all have the potential for toxicity; that there is a narrow therapeutic index, especially for glycosides; that they increase cardiac work and oxygen demand; that – in glycosides only – a low potassium concentration due to diuretics increases toxicity; and although inotropes can improve quality of life, recent evidence suggests possible increased mortality.