Cardiac stimulant
Class of chemical compound
From Wikipedia, the free encyclopedia
A cardiac stimulant is a drug which acts as a stimulant of the heart to increase cardiac output. They can work via positive chronotropic action (increased heart rate) and/or positive inotropic action (increased myocardial contractility).
Within positive inotropes, there are calcium mobilizers and calcium sensitizers.[1][2][3] Calcium mobilizers are conventional positive inotropes that elevate intracellular calcium, whereas calcium sensitizers do not elevated intracellular calcium but instead increase sensitivity to it.[1][2][3]
Cardiac stimulants are known to be used (and banned) as performance-enhancing drugs, including for doping in sport.[4][5]
Examples
- Sympathomimetics
- β1-Adrenergic receptor agonists like epinephrine, norepinephrine, dopamine, dobutamine, denopamine, isoproterenol, and xamoterol[6][7]
- Indirectly acting adrenergic agonists (via activation of β1-adrenergic receptors)[8]
- Norepinephrine prodrugs like droxidopa (L-DOPS)
- Norepinephrine reuptake inhibitors like atomoxetine, reboxetine, desipramine, nortriptyline, bupropion, milnacipran, methylphenidate, and cocaine[8]
- Norepinephrine releasing agents like amphetamine, methamphetamine, ephedrine, pseudoephedrine, phenylpropanolamine, and mephentermine[8]
- Sympatholytics
- Antimuscarinic anticholinergics like atropine[8]
- Adenosine receptor antagonists like caffeine, theophylline, and aminophylline[8]
- Phosphodiesterase PDE3 inhibitors like amrinone, milrinone, and pimobendan[6][7][8]
- Cardiac glycosides like digoxin[7]
- Calcium sensitizers like levosimendan, pimobendan, and omecamtiv mecarbil
- Other agents like hydralazine and cannabinoids[8]
Exercise is a cardiac stimulant by increasing levels of the sympathomimetic catecholamines epinephrine and norepinephrine.[9][10]
