title: Digitalis and other positive catecholamine-like inotropic agents in the management of congestive heart failure.
abstract: Positive inotropic agents are used to improve the impaired cardiac contractility that characterizes chronic heart failure. Digitalis is the traditional drug given for this purpose. However, there is controversy about the effectiveness of digitalis in chronic heart failure. Analysis of the available data indicates the efficacy of digoxin in mild heart failure (i.e., New York Heart Association functional classes I and II) and the relative lack of efficacy in advanced heart failure (i.e., NYHA functional class IV). Further, digoxin can be stopped in a substantial number of patients without recurrence of congestive heart failure. In selected patients whose condition no longer responds to digoxin, the long-term administration of dobutamine may be an effective alternative approach.
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000188:drug therapy; D002301:Cardiac Glycosides / Q000008:administration & dosage* / Q000494:pharmacology; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D004071:Digitalis Glycosides / Q000627:therapeutic use*; D004077:Digoxin / Q000627:therapeutic use / Q000633:toxicity; D004280:Dobutamine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006333:Heart Failure / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007263:Infusions, Parenteral / Q000191:economics; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D011897:Random Allocation; D012306:Risk; D000254:Sodium-Potassium-Exchanging ATPase / Q000037:antagonists & inhibitors; D013318:Stroke Volume / Q000187:drug effects
chemical_list: D002301:Cardiac Glycosides; D002316:Cardiotonic Agents; D004071:Digitalis Glycosides; D004280:Dobutamine; D004077:Digoxin; D000254:Sodium-Potassium-Exchanging ATPase