Chronotropes vs. Inotropes

This week  we’re going to talk about Chronotropic vs. Inotropic medications. These two terms come from the Greek root words chrono and ino, which respectively mean language and that you don’t understand. This is frustrating because the time it took you to look up those terms could have been spent on eBay in a bidding war for the Deadpool action figure with the manufacturing defect that caused it to be produced with Wolverine’s claws instead of his Katanas,  or Googling “Kate Beckinsale naked,” like you were planning to do.

Just so we’re clear. These two terms refer to categories of medications primarily affecting the heart. You’ll often see them used in cases where Grandpa Zed ate too much fried turkey on Thanksgiving which caused his heart to say, “You know what, Zed? Fuck off.” Chances are if Grandpa Zed survives, he’ll be on one chronotrope/inotrope or another from the time after the heart surgeons have cut through his blubber to get his heart going again, until the day his heart, scheming and plotting ever since being forced to resume its hard labor in the concentration camp of Zed’s chest, decides to opt out forever.

Chronotropes

Think of these guys like your high school track coach.  The aging, overweight guy with enough gin blossoms on his cheeks that the 90s band of the same name you don’t remember was considering a lawsuit for slander. The one so high strung he watched R. Lee Emery’s scenes from Full Metal Jacket to unwind. He was so unathletic that you wondered how he managed to find his way to coaching  actual athletes. You remember him, right?

Chronotropes are like the track coach because they’re concerned with time.  They have the stopwatch out and are screaming at the heart to do it fasterFASTER, YOU LAZY FUCK! LOOK AT THEM DUMPLING ROLLS JIGGLE! I’VE SEEN DIABETICS MOVE FASTER TO INJECT INSULIN AFTER BEING FORCE-FED CHOCOLATE CAKE! I’VE SEEN MY WIFE MOVE FASTER TRYING TO GET AWAY WHEN I SURPRISED HER BY TYING MYSELF NAKED TO THE BED!

Turns out the coach was arrested because you can’t say things like that to students. Which is just as well because at this point the comparison breaks down.

See, there are two types of chronotropes. Positive and negative.  The coach is the positive chronotrope because he always wants things done faster.  A negative chronotrope is more like that nagging old woman you call your wife whom you wed decades ago and can’t for the life of you remember why. Say you’re out on a Sunday afternoon drive. God knows why, though. What is it about Sunday that says you have to go driving together? Why can’t you just sit around at home watching reruns of NCIS? It’s less hazardous.

Anyway, you’re out driving – it was probably her idea – and she’s screaming at you to slow down.  You’re driving like a pie-eyed maniac! The Hometown Buffet is coming up and we’re going to miss the turn! SLOW DOWN!

Traffic has backed up for miles behind you.  News copters are circling your location trying to report on what exactly the traffic hazard is, but all they see is you crawling along considering if driving off the overpass is morally justifiable under the circumstances.

The takeaway here is that chronotropes are all about speed, be it faster or slower.  If nothing else works, go to the prefix: chrono.  You know, chronological, chronology etc.  Stuff to do with time.  Don’t go all Greek myth on me.  We’re not talking about Kronos, the dickhead Titan who was imprisoned in Tartarus by his equally dickish son, Zeus.  Fuck those guys.

Inotropes

Inotropes are more like that sex partner you had.  You know, the one who wouldn’t shut up about doing it harder until you were going at it so hard that you were pretty sure you felt something break but kept going because you didn’t want to seem like you weren’t into it. The positive Inotropes are like that.  Always screaming at the heart to do it harder, baby, harder. Oh yeah. Just like that. Keep going…

Negative inotropes are the lovers that are so vanilla that every time you get naked it’s missionary with the lights out.  And it must be gentle, because you’re making love.  They want to gaze into your eyes because of all the love and the gentleness in the room (except it’s dark, so they can’t gaze anywhere expect the blackness in front of their face). Cupid vomits because even he can’t stand the mush going on here.  Gently, this person says.  Gently.  Even their voice is gentle.  A whisper.

“Jesus,” says Cupid, “I never should have fired those arrows I–BLEEEAAARRGH!” as he yarks all over his quiver… if you know what I mean.

For the TL;DR crowd:

Chronotropes: heart go fast or slow.
Inotropes: heart beat hard or soft.

Next week we dissect Bob Barker to see if he was a robot.

4 thoughts on “Chronotropes vs. Inotropes

  1. Pingback: Dromotropes and the AV Node. Or: How Many Sub-Categories Can We Think Of? | Cliff Notes: Medicine for the Rest of Us

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