1. CARDIVASCULAR DRUGS

2. CARDIOVASCULAR DISEASE AND DRUGS
Basic cardiovascular physiology and pathology depends on the control of heart rate, cardiac output, blood pressure, blood flow, ionic composition, RAAS, vascular endothelium, regulation of tissue perfusion, hypertension, dislipidaemias, atherosclerosis, blood clotting, ischaemic heart disease, cardiomyopathies, cardiac arrhythmias and cardiac failure.
Cardiovascular drugs: inotropic agents, b blockers, calcium antagonists, organic nitrates, anti-arrhythmics, ACE inhibitors, ATII (=AT1) antagonists, diuretics, cholesterol lowering drugs, clot-busters, anti-coagulants, anti-platelet drugs.

4. DRUGS TO TREAT ANGINA PECTORIS
Angina pectoris refers to a strangling or pressure like pain caused by cardiac ischaemia.
It’s a pain syndrome due to induction of an adverse oxygen supply / demand situation in portion of myocardium.
Drugs used exploit two main strategies: reduction of oxygen demand and increase of the oxygen delivery to myocardium.
Three types of anginal attack: stable angina, unstable angina and variant angina.

5. ANTI ANGINAL DRUGS
1) ORGANIC NITRATES: Glyceryl trinitrate (Nitroglycerin), Isosorbide dinitrate, etc
2) BETA BLOCKERS: Propranolol, Atenolol, Metroprolol, Carvedilol, etc
3) CALCIUM ANTAGONIST: Nifedipine, Diltiazem, Verapamil
4) SELECTIVE If- INHIBITORS: Ivabradine

6. ANTI ARRHYTHMIC DRUGS
Cardiac arrythmias commonly occur in presence of pre-existing heart disease.
1) CLASS I: Membrane stabilizing drugs; sodium channel blockers-
CLASS I a- Quinidine, disopyramide
CLASS I b- Lidocaine, Phenytoin
CLASS I c- Propafenone
2) CLASS II: BETA BLOCKERS- Acebutolol, Atenolol, Esmolol,Metoprolol, Propranolol
3) CLASS III: POTASSIUM CHANNEL BLOCKERS- Amiodarone, Sotalol
4) CLASS IV: CALCIUM CHANNEL BLOCKERS- Verapamil, Diltiazem

8. CLINICAL CLASSIFFICATION OF ANTIDYSRHYTHMIC DRUGS
I GROUP: (decrease AV conductance, for treatment of SV tacharrhythmia)- Verapamil
II GROUP: (for treatment of ventricular tachyarrhythmia)- Lidocaine (i.v.), Propafenone, Phenytoin
III GROUP: (for treating SV and V tachyarrhythmia)- Amiodarone, Beta blockers
IV GROUP: (drugs for AV block)- Atropine {M-cholinolytic}, Ephedrine {indirect adrenomimetics}
V GROUP: (inhibitors of AV conduction)- Adenosine [potassium channel opener], Digoxin [cardiac glycoside]

9. ANTIHYPERTENSIVE DRUGS
DRUGS AFFECTING RAAS [renin angiotensin aldosterone system]-
RENIN INHIBITOR: Beta blockers [Propranolol, Atenolol, etc]
ACE INHIBITORS: Enalapril, Ramipril
ANGIOTENSIN II RECEPTOR [AT1-receptor] BLOCKERS: Eprosartan, Losartan
ALDOSTERONE ANTAGONIST [ potassium sparing diuretic ]: Spironolactone

11. CALCIUM ANTAGONIST: Nifedipine, Amlodipine, Diltiazem, Verapamil
DRUGS DECREASING SYMPATHETIC ACTIVITY-
BETA BLOCKERS: Nebivolol, Atenolol, Bisprolol, Pindolol, Carvedilol
ALFA BLOCKERS: Prazosin, Phentolamine
OTHER: Reserpine, clonidine
DIURETICS: Hydrochlorothiazide, Indapamide, Furosemide

12. PERIPHERAL VASODILATORS
Alfa blockers- Prazosin, Ergotoxine
Phosphodiesterase inhibitors- Pentoxifylline
Prostaglandin analogue- [activators of AC] Alprostadil (PG1), Iloprost (PG2)
CEREBRAL VASODILATORS:
Nimodipine (calcium antagonist), Naftidrofuryl (5-HT2 receptor blocker)

13. DRUGS TO TREAT HEART FALIURE
Clinical syndrome that
can result from any
structural or functional
cardiac disorder that
impairs the abilty of the
ventricle to fill with or
eject blood.

14. Therapeutic Uses of Digitalis Compounds
Heart Failure
↑ inotropy
↑ ejection fraction
↓ preload
↓ pulmonary congestion/edema
Arrhythmias
↓ AV nodal conduction (parasympathomimetic effect)
↓ ventricular rate in atrial flutter and fibrillation
Digitalis compounds have historically been used in the treatment of chronic heart failure owing to their cardiotonic effect.
Ex: Digoxin, digitoxin

15. To treat CHF:
Ionotropic drugs: Digoxin, Dobutamine
Diuretics: Furosemide, Thiazide
Vasodilators: ACE inhibitors,AT1 antagonist, Nitrate
Beta blockers: Metroprolol

16. THANK YOU