Inotropes can be divided into the following classes:
cardiac glycosides
catecholamines
phosphodiesterase inhibitors
calcium entry promoters - opposite of calcium channel blockers. Act on nitrendipine receptors. Good intropy in vitro, but in vivo, vasoconstriction precludes increase in mechanical activity.
calcium
calcium sensitizers - increase affininty of troponin for calcium (depressed by hypoxia and acidosis). These are a potential future developement, with the added potential advantage that they would not increase myoplasmic calcium, therefore perhaps less problem with arrhythmias.
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