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Vesnarinone
Vesnarinone (INN) is a cardiotonic agent. A mixed phosphodiesterase 3 inhibitor and ion-channel modifier that has modest, dose-dependent, positive inotropic activity, but minimal negative chronotropic activity. Vesnarinone improves ventricular performance most in patients with the worst degree of heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to Cardiac cycle, fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF .... References External links * Benzylpiperazines N-benzoylpiperazines Inotropic agents PDE3 inhibitors Catechol ethers Phenylpiperazines 2-Quinolones {{cardiovascular-drug-stub ...
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Oral Administration
Oral administration is a route of administration whereby a substance is taken through the Human mouth, mouth, swallowed, and then processed via the digestive system. This is a common route of administration for many medications. Oral administration can be easier and less painful than other routes of administration, such as Injection (medicine), injection. However, the onset of action is relatively low, and the effectiveness is reduced if it is not absorbed properly in the digestive system, or if it is broken down by digestive enzymes before it can reach the bloodstream. Some medications may cause gastrointestinal side effects, such as nausea or vomiting, when taken orally. Oral administration can also only be applied to conscious patients, and patients able to swallow. Terminology ''Per os'' (; ''P.O.'') is an adverbial phrase meaning literally from Latin "through the mouth" or "by mouth". The expression is used in medicine to describe a treatment that is taken orally (but not ...
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Cardiotonic
A cardiac stimulant is a drug which acts as a stimulant of the heart – e.g., via Chronotropic#Positive chronotropes, positive chronotropic action (increased heart rate) and/or Inotrope#Positive inotropic agents, inotropic action (increased myocardial contractility). They increase cardiac output (the amount of blood pumped by the heart over time). Examples * Beta1-adrenergic agonist, β1-Adrenergic receptor agonists like epinephrine, norepinephrine, dopamine, dobutamine, denopamine, isoproterenol, and xamoterol * Adrenergic, Adrenergic agents indirectly activating beta-1 adrenergic receptor, β1-adrenergic receptors ** Norepinephrine prodrugs like droxidopa ** Norepinephrine reuptake inhibitors like atomoxetine, reboxetine, desipramine, nortriptyline, bupropion, milnacipran, methylphenidate, and cocaine ** Norepinephrine releasing agents like amphetamine, methamphetamine, ephedrine, pseudoephedrine, phenylpropanolamine, and mephentermine * Alpha-1 blocker, α1-Adrenergic receptor a ...
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Phosphodiesterase 3 Inhibitor
A PDE3 inhibitor is a drug which inhibits the action of the phosphodiesterase enzyme PDE3. They are used for the therapy of acute heart failure and cardiogenic shock. Medical uses Cardiac Amrinone, milrinone and enoximone are used clinically for short-term treatment of cardiac failure in the presence of cardiogenic shock. PDE3 inhibitors are indicated as inotropics for the therapy of acute heart failure if catecholamines are ineffective. Well controlled studies have shown that these drugs generally increase Mortality rate, mortality, when used for the therapy of acute heart failure, so they have to be applied under close observation. Peripheral artery disease Cilostazol is used for the treatment of intermittent claudication. This drug has a much weaker positive inotropic effect than those drugs used for the therapy of acute heart failure, and lacks significant adverse cardiac effects. Contraindications Cardiac Contraindications are severe obstructive cardiomyopathy, hypo ...
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Heart Failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to Cardiac cycle, fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF typically presents with shortness of breath, Fatigue (medical), excessive fatigue, and bilateral peripheral edema, leg swelling. The severity of the heart failure is mainly decided based on ejection fraction and also measured by the severity of symptoms. Other conditions that have symptoms similar to heart failure include obesity, kidney failure, liver disease, anemia, and thyroid disease. Common causes of heart failure include coronary artery disease, heart attack, hypertension, high blood pressure, atrial fibrillation, valvular heart disease, alcohol use disorder, excessive alcohol consumption, infection, and cardiomyopathy. These cause heart failure by altering the structure or the function of the heart or in some cases both. There are ...
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Inotropic Agents
An inotrope or inotropic is a drug or any substance that alters the force or energy of muscular contractions. Negatively inotropic agents weaken the force of muscle, muscular contractions. Positively inotropic agents increase the strength of muscular contraction. The term ''inotropic state'' is most commonly used in reference to various medication, drugs that affect the strength of myocardial contractility, contraction of heart muscle. However, it can also refer to pathological conditions. For example, ventricular hypertrophy, enlarged heart muscle can increase inotropic state, whereas myocardial infarction, dead heart muscle can decrease it. Medical uses Both positive and negative inotropes are used in the management of various cardiovascular conditions. The choice of agent depends largely on specific pharmacological effects of individual agents with respect to the condition. One of the most important factors affecting inotropic state is the level of calcium in the cytoplasm o ...
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PDE3 Inhibitors
PDE3 is a phosphodiesterase. The PDEs belong to at least eleven related gene family, gene families, which are different in their primary structure, substrate affinity, responses to effector (biology), effectors, and regulation mechanism. Most of the PDE families are composed of more than one gene. PDE3 is clinically significant because of its role in regulating heart muscle, vascular smooth muscle and platelet aggregation. PDE3 inhibitors have been developed as pharmaceuticals, but their use is limited by arrhythmic effects and they can increase mortality in some applications. Function PDE3 enzymes are involved in regulation of cardiac and vascular smooth muscle contractility. Molecules that inhibit PDE3 were originally investigated for the treatment of heart failure, but, because of unwanted Cardiac arrhythmia, arrhythmic adverse effect, side-effects, they are not studied for that indication (medicine), indication any longer. Nonetheless, the PDE3 inhibitor milrinone is approved ...
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Catechol Ethers
Catechol ( or ), also known as pyrocatechol or 1,2-dihydroxybenzene, is an organic compound with the molecular formula . It is the ''ortho'' isomer of the three isomeric benzenediols. This colorless compound occurs naturally in trace amounts. It was first discovered by destructive distillation of the plant extract catechin. About 20,000 tonnes of catechol are now synthetically produced annually as a commodity organic chemical, mainly as a precursor to pesticides, flavors, and fragrances. Small amounts of catechol occur in fruits and vegetables. Isolation and synthesis Catechol was first isolated in 1839 by Edgar Hugo Emil Reinsch (1809–1884) by distilling it from the solid tannic preparation catechin, which is the residuum of catechu, the boiled or concentrated juice of ''Mimosa catechu'' ('' Acacia catechu''). Upon heating catechin above its decomposition point, a substance that Reinsch first named ''Brenz-Katechusäure'' (burned catechu acid) sublimated as a white efflore ...
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