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- positive inotropic: phosphodiesterase inhibitor: used for refractory CHF. short term therapy.
- Increases cardiac cAMP -> activation of protein kinase allows phosphorylation of cellular proteins (i.e. slow Ca2+ channel) --> increase Ca2+ influx, more Ca in SR --> increased CO.
- In vascular SM, cAMP promotes direct relaxation.
positive inotropic: B-adrenoceptor agonist -> increase cAMP --------> increase cardiac output.
- synthetic brain natriuretic peptide (===ANP)
- increases cGMP in smooth muscle cells -> decrease Ca, decrease force of contraction, leads to SM relaxation.
- Reduces venous and arteriolar tone --> powerful vasodilator.
- Also causes diuresis.