Truncus Arteriosus Medication

Updated: Dec 31, 2019
  • Author: Doff B McElhinney, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Medication

Medication Summary

Pharmacologic therapy in patients with truncus arteriosus depends on various factors, including clinical status, associated lesions, and where in the course of management (eg, preoperative, early postoperative) the patient is when drug therapy is provided. The major classes of cardiac drugs administered to patients with truncus arteriosus include diuretics, digoxin, afterload reducing agents, inotropic medications, and antiarrhythmics if necessary. Consultation with a cardiologist is imperative before beginning, changing, or discontinuing cardiac medications in these patients.

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Inotropic agents

Class Summary

These agents provide inotropic and chronotropic support in the early postoperative period, when postoperative myocardial edema and ischemia-reperfusion injury may result in varying degrees of residual ventricular dysfunction. Also used at low doses to optimize renal perfusion to facilitate diuresis.

Dopamine (Intropin)

Stimulates adrenergic and dopaminergic receptors, with a predominant dopaminergic effect at low doses, beta-adrenergic and dopaminergic effects at intermediate doses, and primarily alpha-adrenergic effects at high doses.

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Diuretic agents

Class Summary

These medications are used to mobilize edema in the early postoperative period and facilitate fluid homeostasis. They are also used for treatment of hypertension.

Furosemide (Lasix)

Increases excretion of water by interfering with chloride-binding cotransport system, which, in turn, inhibits sodium and chloride reabsorption in ascending loop of Henle and distal renal tubule.

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Cardiac glycoside, antiarrhythmic

Class Summary

These agents are used to increase myocardial contractility, to slow atrioventricular node conduction time, and to potentiate the effects of furosemide.

Digoxin (Lanoxin, Lanoxicaps)

Acts directly on cardiac muscle, increasing myocardial systolic contractions. Its indirect actions result in increased carotid sinus nerve activity and enhanced sympathetic withdrawal for any given increase in mean arterial pressure.

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ACE inhibitor, afterload reducing agent

Class Summary

These agents are used to decrease systemic vascular resistance, which is beneficial in patients with hypertension, impaired ventricular function, or aortic/truncal valve regurgitation.

Captopril (Capoten)

Inhibits activity of the angiotensin-converting enzyme, preventing conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor. Decreased levels of angiotensin II lead to increased plasma renin activity and decreased circulating aldosterone.

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