[Positive inotropic substances. Possible use in heart failure in the aged].
In the treatment of heart failure-also in the aged-digitalis preparations remain indispensable. At the present time, in particular in combination with diuretics and ACE inhibitors, they are experiencing a revival in the treatment of severe stages (NYHA stages III and IV). In addition, a spectrum of newly developed positive inotropic substances of various classes is now available. Among the catecholamines, apart from dopamine, dobutamine and their derivatives, new drugs with a beta-adrenergic agonistic effect are presently undergoing clinical testing. Another heterogeneous group of substances combine positive inotropic with vasodilatory properties. In this connection, mention might be made of the phosphodiesterase inhibitors, the H2 receptor antagonists, and certain catecholamine derivatives. However, digitalis remains the only substance that can be given orally over the long-term without tolerance developing. Particular aspects of the use of digitalis in geriatric patients are discussed.
Michel
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D000368:Aged; D002316:Cardiotonic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects* / Q000502:physiology
D002316:Cardiotonic Agents
Positiv-inotrope Substanzen. Möglicher Einsatz bei Herzinsuffizienz im Alter.