Understand the detailed pharmacology of inotropes and vasopressors

Inotropes are agents which alter myocardial contractility.

  • Positive inotropes increase contractility
  • Negative inotropes decrease contractility

Classes of Positive Inotrope

Classes Class I: Increase Intracellular Calcium Class II: Calcium Sensitisers Class III: Metabolic/Endocrine
Examples Adrenaline, milrinone, glucagon, digoxin Levosimendan T3, Insulin
General Mechanism of Action Increase intracellular Ca2+ by a variety of different pathways Increase sensitivity of actomyosin to Ca2+ Variable. T3 potentiates the effect (or increases expression of) cardiac β1 receptors


  1. Leslie RA, Johnson EK, Goodwin APL. Dr Podcast Scripts for the Primary FRCA. Cambridge University Press. 2011.
  2. Tielens ET, Forder JR, Chatham JC, Marrelli SP, Ladenson PW. Acute L-triiodothyronine administration potentiates inotropic responses to P-adrenergic stimulation in the isolated perfused rat heart. Cardiovascular Research 32 (1996) 306-310.
Last updated 2017-09-18

results matching ""

    No results matching ""