Cardiovascular Agents Intro - created from Mind Map

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Circulatory system

Electrocardiogram(ECG) P Wave-atria electrically stimulated to pump blood to ventricles. QRS complex=ventricles stimulated to pump blood. ST segment=end of ventricular contraction. T wave=recovery of ventricles

DISEASES<br><br><ul><li>-HTN

-Angina pectoris

-Myocardial Ischemia

-Arrhythmia

-Myocardial Infarction

-Chronic Heart Failure</li></ul>

Positive and Negative Inotropic Agents

MOAs of cardiovascular drugs

Heart veins and arteries

Veins=carry O2 poor blood back to the heart (Pulmonary and umbilical veins are O2 rich)

Arteries=more muscles and higher pressure than veins

Arterial HTN

Pulmonary Arterial HTN

Myocardial Ischemia<br><br><ul><li>Drugs=

•Aspirin

•Nitroglycerin

•Beta blockers

•Cholesterol-lowering

drugs

•Calcium-channel

blockers

•ACE

inhibitors

•Anti-angina meds

</li></ul>

Angina Pectoris

Arrythmia<br><br><ul><li>Drugs=

Class 1- Sodium-channel

blockers: slow electrical conduction in the heart

Class 2- Beta blockers: block impulses that cause irregular rhythm, interfere with adrenaline on heart cells, reduce blood pressure and rate.

Class 3- Potassium channel blockers: slow electrical impulses in heart

Class 4- Calcium channel blockers: block impulses that cause irregular rhythm, interfere with adrenaline on heart cells, reduce blood pressure and rate.

^Vaughan-Williams Classification scheme </li></ul>

Acute MI<br><br><ul><li>Drugs=

•Antiplatelet,e.g., Aspirin

•Oxygen

•Nitrates

(vasodilators)

•Pain

control

•Fibrinolytics

•ACE inhibitors/ARBs

•Statins

•Betablockers–Administered within 12 h–Decrease rate and force of heart’s work–Lowers oxygen demand </li></ul>

“high blood pressure” “the silent killer” Can lean to stroke, heart attack, and peripheral vascular disease Systolic (pressure against arterial wall during heart contraction) Diastolic (pressure against arterial wall at rest)

May be treated with: Beta blockers, diuretics, and ACEis.

can be caused by heart failure, COPD, embolism(block) etc. May be treated with number of agents like diuretics and vasodilators

Lack of blood flow to heart-can damage heart muscle and lead to heart failure and arrhythmia

Chest pain-hypoxia triggers pain receptors in heart;caused by partial blockage of coronary arteries (myocardial ischemia)<br><br><ul><li> Drugs=

•Calcium channel blockers

•Nitrodilators

•Beta blockers

•Ranolazine (sodium current blocker)

•Anticoagulants

•Antiplatelets</li></ul>

Tachycardia, bradycardia and A fib-irregular fast uncontrolled beats of individual muscle fibers.

Inefficient O2 delivery

Heart cells die, leading cause of US death, many types such as plaque rupture or surgery related, ST segment elevation or not

NEGATIVE

POSITIVE

Good for those with hypertension, heart failure, arrhythmia, angina, previous infarction Ex) BBs, CCBs, antiarrhythmic medicines

Good for those with weak heart(Heart failure or infarction). Ex) Digoxin

Vasodilation, diuretics, inotropic agents, angiotensin inhibition, antiplatelet therapy, anticoagulation, antithrombitic therapy, cholesterol drugs

Drug MOAs

Vasodilation<br><br><ul><li>Categories=

•Alpha-adrenergic

antagonists

(alpha-blockers)

•Beta-adrenergic

agonists

•Centrally

acting sympatholytics (a2-agonists)

•Ganglionic

blockers

•Angiotensin

converting

enzyme (ACE) inhibitors

•Angiotensin

receptor

blockers (ARBs)

•Renin

inhibitors

•Calcium-channel

blockers

(CCBs)

•Direct

acting

vasodilators

•Endothelin receptor

antagonists

•Nitrodilators

•Phosphodiesterase

inhibitors

•Potassium-channel

openers </li></ul>

Diuretics

ACE inhibs

Anticoag

Antiplatelet<br><br><ul><li>•Aspirin

•Adenosine

diphosphate (ADP) receptor inhibitors

•Adenosine

reuptake inhibitors

•Glycoprotein

IIB/IIIA inhibitors

•Phosphodiesterase

inhibitors

</li></ul>

Antithrombotic<br><br><ul><li>•Tissue

plasminogen

activators

–Alteplase (Activase)

–Reteplase (Retavase)

–Tenecteplase (TNKase)

•Anistreplase (Eminase)

•Streptokinase

(Kabikinase,

Streptase)

•Urokinase (Abbokinase)

</li></ul>

Cholesterol drugs

ionotropic agents

Relax the smooth muscles in blood vessels. Causes dilation (widening). Dilation of arteries reduces systemic vascular resistance, useful for hypertension and heart failure, not angina. Dilation of veins lowers venous blood pressure, useful for angina and heart failure, but not primarily for hypertension

Get rid of excess fluids and sodium. Renal elimination enhanced Decreased tubular reabsorption of ions This relieves pressure on the heart. Loss of fluid from lungs, legs, etc. can be helpful. Various MOAs

Osmotic diuretics, Carbonic anhydrase inhibitors, Thiazide diuretics, Loop diuretics, Potassium-sparing

Angiotensin II helps to narrow blood vessels and raise blood pressure. ACE inhibitors prevent biosynthesis of angiotensin II. Treat hypertension and heart failure Prevent stroke and kidney damage.

ARBS-Block the angiotensin II receptor. ARBs dilate blood vessels and lower blood pressure. Treat hypertension and heart failure

"blood thinners" do not dissolve existing clots, Vitamin K antagonists(warfarin), heparin, and new oral anticoagulants

Stops platelets from forming clots. Given to pets with a history of: CAD, HA, angina, stroke, or transient ischemic attacks, PVD

Work to dissolve a clot after its formed, thrombolysis. Best if administered immediately after an emergency

Statins-Hmg/CoA inhibitors, Bile sequestering agents, cholesterol absorption inhibitors, fibrates, niacin, omega 3 fatty acids