Medical Pharmacology:  Congestive Heart Failure Practice Questions

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Myocardial Performance Factors

  • For any given inotropic state, ventricular performance will be significantly affected by the degree of ventricular stretch as determined by ventricular end-diastolic volumes (EDV).
    Inotropic state (myocardial contractility): Factors that influence the inotropic state affect ventricular performance at a given ventricular end-diastolic volume. These factors change the concentration of Ca2+ at the myofilaments and include in part

  • Adrenergic nerve activity

  • Circulating catecholamines

  • Exogenously administered agents:

    • Cardiac glycosides

    • Dopamine/dobutamine

    • Caffeine

    • Isoproterenol

    • Theophylline

    • Calcium

    Exogenously administered agents: Drugs that decrease ventricular performance:

    • Procainamide

    • Disopyramide

    • Calcium channel blockers

    • Alcohol

    • Barbiturates

    • Local and general anesthetics



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