The Calcium Sensitizer
Calcium sensitizer for decompensated heart failure. Inotropy without increased oxygen demand. Long-acting metabolite (5-9 days) - once started, effect lasts a week.
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Mechanism: Calcium Sensitization: Binds Troponin C, increasing sensitivity to calcium (Inotropy without Oxygen demand). K-ATP Channel Opener: Vasodilation (Smooth Muscle) + Cardioprotection (Mitochondria).
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Dosing: Loading: 12 mcg/kg over 10 min. Maintenance: 0.1-0.2 mcg/kg/min for 24 hours. Note: Active metabolite lasts 5-9 days.
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PK: Parent drug is 1h, but metabolite OR-1896 lasts 5–9 days.
indications
- Decompensated Heart Failure
- Post-Cardiac Surgery Shock
evidence & efficacy
- Likely to be licensed in Canada soon (currently Special Access).
- Neutral regarding oxygen consumption (safer for ischemic cardiomyopathy than dobutamine).
cautions
- Commitment: Once you give the 24h infusion, the effect lasts a week. You cannot “turn it off.”
- Hypokalemia: Monitor K+ closely