Cardiovascular Drugs

Cardiovascular Drugs

1. anti-hypertensive drugs

   • Calcium channel blockers
   • Angiotension-converting enzyme inhibitor and angiotensin receptor blocking drugs
     • ACE inhibitors
     • Angiotensin Receptor blockers
     • Renin inhibitors
   • peripheral vasodilators
   • Diuretics
     • مدرات البول "تعمل على زيادة خروج الماء والملح من الجسم"
     • Carbonic Anhydrase Inhibitors (site1)
       • *prototype carbonic anhydrase inhibitor.  Mechanism: inhibit carbonic anhydrase in renal proximal tubule cells. -->less  H+ for Na+/H+ exchange -->increased Na+, increased H2O retension (احتباس ) يحبسها عشان تطلع مع البول 
       • Acetazolamide
       • Brinzolamide
       • Dorzolmide
       • Therapeutic uses
         • treat chronic open-angle glaucoma
         • aqueous humor has high [HCO3-]
         • acute mountain sickness
         • treatment metabolic alkalosis
         • epilepsy
         • mostly used in combination
       • side effects
         • increase HCO3-excretion causes metabolic acidosis
         • drowsiness
         • K+wasting
         • nephrolithiasis(renal stone)
         • CNS depression
         • paresthesia (تنمل)
         • fatigue
     • Osmotic Diuretics(site2)
       • directly renal blocker mechanism: -not reabsorbed -increase Na+ and H2O excretionتسحب ماء اكثر
       • Mannitol
         • -non-toxic, freely filtered, non-reabsorbable and non-metabolized -acute renal failure secondary to trauma, CVS disease, surgery or nephrotoxic drugs -short-term treatment of acute glaucoma infused to lower intracranial pressure.
         • increased extracellular fluid volume
         • cardiac failure
         • plumonary edema
         • hypernatremia
         • hyperkalemis
         • headache
         • nausea
         • vomiting
       • Glycerol
       • Isosorbide
       • Urea
     • Loop Diuretics (site3)
       • inhibit 25% of glomerular filtrate
       • Furosemide
       • Bumetanide
       • Torsemide
       • Ethacrynic acid
       • Therapeutic uses
         • edema
         • cardic renal failure or nephrosis
         • acute &chronic hyperkalemia
       • side effects
         • ototoxicity
         • hyponatremia
         • Mg2+ depletion
     • Thiazide Diuretics(site4)
       • -inhibit Na+and Cl- transporter in distal convoluted tubule. -increased Na+ Cl- excretion. -increased HCO3 excrestion. -increased K+ /Mg2+ excretion. -decrease Ca2+ excretion.
       • Indapamide
       • HCTZ,HCT,HZT
       • Chlorothiazide
       • Chlorthalidone
       • Metolazone, Clopamide, Benzthiazide, Xipamide
       • Therapeutic uses
         • osteoporosis
           • cause decrease urine Ca excretion -> hypercalcemia
         • hypercalciuria
           • prevent excess Ca2+ excretion to form stones in ducts
         • nephrogenic diabetes insipidus
         • treatment of Li+ toxicity
       • side effects
         • hyperglycemia
           • inhibition of insulin release due to K+ depletion
         • hyperurecaemia
         • sudden cardic death
         • hyperlipidemia
           • rise to total LDL level -risk of stroke.
         • hypokalaemia
           • muscle pain and fatigue
     • Potassium Sparing Diuretics(site5)
       • Aldosterons Antagonis
         • spironolactone
           • side effects
             • gynecomastia
         • canrenone
         • eplerenone
         • Therapeutic uses
           • primary hyeraldosteronsim
           • cirrhosis
       • Direct Acting
         • pteridines
           • triamterene
             • megaloblastic anemia
         • pyrazinoylguanidines
           • amiloride
             • increase in blood urea nitrogen
   • Sympatholytic drugs
     • a1-blockers
       • doxazosin(Caradura)
         • prazosin(Minipress)
           • terazosin(hytrin)
             • Phentolamine (non selective)
               • side effects
                 • tachycardia
                 • GI stimulation
                 • hypoglycemia
               • patients with gastric &peptic ulce(X)
                 • PATIENTS WITH RENAL impairments
       • LABETALOL(MIXED)
     • beta blockers
     • a2-adrenoceptor agonists

2. anti-anginal drugs

3. anti-arrhythmis drugs

   • عدم انتظام دقات القلب

4. cardiotonic drugs

   • treatment of congestive heart failure
     • قصور القلب التاجي