Cardiotoxicodynamics : Toxicity of Cardiovascular Xenobiotics - 29/07/15

Doi : 10.1016/j.emc.2015.04.007

Nathan B. Menke, MD, PhD ^a,^⁎ , Steven J. Walsh, MD ^b, Andrew M. King, MD ^c
^a Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh Medical Center, 3600 Forbes Avenue, Iroquois Building, Suite 402, Pittsburgh, PA 15213, USA
^b Division of Medical Toxicology, Department of Emergency Medicine, Einstein Medical Center, Korman Research Building, Suite B9, 5501 Old York Road, Philadelphia, PA 19141, USA
^c Department of Emergency Medicine, Detroit Medical Center, Children's Hospital of Michigan Regional Poison Control Center, Detroit Receiving Hospital, Wayne State University School of Medicine, 4201 St Antoine Street, Suite 3R, Detroit, MI 48201, USA

^∗Corresponding author.

Résumé

Maintaining adequate tissue perfusion depends on a variety of factors, all of which can be influenced by xenobiotics (substances foreign to the body, including pharmaceuticals, chemicals, and natural compounds). Volume status, systemic vascular resistance, myocardial contractility, and cardiac rhythm all play a significant role in ensuring hemodynamic stability and proper cardiovascular function. Direct effects on the nervous system, the vasculature, or the heart itself as well as indirect metabolic effects may play a significant role in the development of cardiotoxicity. This article is dedicated to discussion of the disruption of cardiovascular physiology by xenobiotics.

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Keywords : Cardiac electrophysiology, Antidysrhythmics, β-blockers, Calcium channel blockers, Cardioactive steroids, β-agonists, Methylxanthines, Central α₂-agonists