Compare and contrast the pharmacology of dobutamine and levosimendan
LEVOSIMENDAN |
DOBUTAMINE |
|
Class |
Calcium sensitiser |
Synthetic catecholamine |
Pharmacokinetics |
Slower onset of action |
Onset of action in 1 – 2 min |
Mechanism of |
Increases myocyte sensitivity |
Selective beta-1 and beta-2 |
Therapeutic |
Increased cardiac |
Increased cardiac contractility |
LEVOSIMENDAN |
DOBUTAMINE |
|
Adverse effects |
Hypotension |
Drug-induced myocardial |
Contraindications |
Hypersensitivity to |
Hypersensitivity to dobutamine |
With such a detailed and comprehensive college answer, one can do nothing more than to rewrite the table with less information, so as to render the information it contains more memorable.
Features |
Dobutamine |
Levosimendan |
Class of drug |
Synthetic catecholamine |
Calcium sensitizer |
Administration |
IV infusion 5-15mcg/kg/min |
IV infusion 0.05-0.2mcg/kg/min |
Pharmacokinetics |
Rapidly metabolised by COMT; |
Excreted into the small intestine |
|
||
Mechanism of action |
Activates beta-1 adrencoeptors and increases heart rate and contractility by increasing the intracellular levels of cAMP, thus increasing the availablility of intracellular calcium. |
Enhances the affinity of contractile proteins (partiularly cardiac troponin C) for calcium, thereby increasing contractility without incurring additional ATP cost |
Clinical effects |
Increased inotoropy |
Increased inotropy |
Adverse effects |
Arrhythmia |
Arrhythmia |
Antila, Saila, Stig Sundberg, and Lasse A. Lehtonen. "Clinical pharmacology of levosimendan." Clinical pharmacokinetics 46.7 (2007): 535-552.
Papp, Zoltán, et al. "Pharmacological mechanisms contributing to the clinical efficacy of levosimendan." Cardiovascular drug reviews 23.1 (2005): 71-98.