PDE3 inhibitor
Phosphodiesterase-3 inhibitor
- ↑ cAMP in myocardium and vascular smooth muscle
- Inotropy plus vasodilation — an “inodilator” for acute heart failure
- Excess cardiac stimulation → arrhythmia
- ↑ platelet cAMP → ↓ platelet aggregation
- Airway smooth-muscle relaxation → bronchodilation (inhaled)
Drugs with this mechanism (6)
- Aminophylline — Soluble theophylline; a bronchodilator with a narrow therapeutic index.
- Cilostazol — PDE3 inhibitor for intermittent claudication; contraindicated in heart failure.
- Dipyridamole — Antiplatelet vasodilator; used with aspirin and for cardiac stress testing.
- Ensifentrine — Inhaled dual PDE3/PDE4 inhibitor adding bronchodilation and anti-inflammatory activity in COPD.
- Milrinone — PDE3 inodilator; beta blockade does not block its action.
- Theophylline — Old methylxanthine bronchodilator; narrow index, largely supplanted.
Self-check
- Why is cardiac PDE3 inhibition called inodilator activity?
Inotropy plus vasodilation. - What can excessive cardiac stimulation from PDE3 inhibition cause?
Arrhythmia.
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