Canonical Question
Inotrope / Vasopressor
Master answer
An Ideal Inotrope is pharmaceutically suitable, has beneficial pharmacodynamic properties, has an excellent pharmacokientic profile.
PHARMACEUTIC
| IDEAL INOTROPE | ADRENALINE |
|---|---|
| Non-toxic | Y |
| Cost effective | Y |
| Stable preparation | Y |
| Compatible with other drugs | Y |
| Peripherally deliverable | Y |
| Multiple preparations | Y |
| Stable in all solutions | N (Oxidises to adenochrome in alkaline solutions, turns pink) |
PHARMACODYNAMIC
| IDEAL INOTROPE | ADRENALINE |
|---|---|
| Increases contractility | Y |
| Increases mean arterial pressure, Maintenance of diastolic blood pressure | Y |
| Increases cardiac output | Y |
| Improves regional perfusion, without pharmacodynamic costs | N |
| No increase in myocardial oxygen consumption | N (increases myocardial oxygen consumption) |
| Avoidance of tachycardia, Non-arrhythmogenic | N (causes tachyarrhythmias) |
| Suitable in pregnancy and paediatric populations | Y |
| No Adverse effects | N (hyperglycaemia, lactic acid production, worsens pulm HTN, Peripheral necrosis) |
PHARMACOKINETIC
| IDEAL INOTROPE | ADRENALINE |
|---|---|
| Does not develop tolerance | N |
| Titratable | Y |
| Rapid onset, Rapid termination of action | Y |
| Metabolised independent of liver and kidney function | N (some hepatic metabolism) |
| Doesn’t require concentration monitoring | Y |
JC 2019
Exam appearances
| Exam | Exact wording | Relationship | Success |
|---|---|---|---|
| 2012B Q18 | List the properties of the ideal inotrope (50% of marks). How does adHine compare with Fect to these ideal properties? (50% of marks) | historical_member | — |
| 2017B Q15 | List the properties of an ideal inotrope (50% of marks). How does adrenaline compare with respect to these ideal properties? (50% of marks). | historical_member | — |