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    Drugs Affecting The Cardiovascular System

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    Celestino Kuchena
    The document discusses classes of drugs used to treat angina and hypertension. It describes the main anti-anginal drug classes as organic nitrates, beta blockers, and calcium channel blockers. These drugs work by increasing coronary blood flow and reducing myocardial oxygen demand. The mechanisms, uses, and side effects of nitrates, calcium channel blockers, and beta blockers are explained. The document also covers the main antihypertensive drug classes of ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics. Their mechanisms of action and side effect profiles are outlined.

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    Drugs Affecting The Cardiovascular System

    Uploaded by

    Celestino Kuchena
    636 views27 pages
    The document discusses classes of drugs used to treat angina and hypertension. It describes the main anti-anginal drug classes as organic nitrates, beta blockers, and calcium channel blockers. These drugs work by increasing coronary blood flow and reducing myocardial oxygen demand. The mechanisms, uses, and side effects of nitrates, calcium channel blockers, and beta blockers are explained. The document also covers the main antihypertensive drug classes of ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics. Their mechanisms of action and side effect profiles are outlined.

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    Pharmacology

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    Drugs affecting the Cardiovascular system.ppt

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    The document discusses classes of drugs used to treat angina and hypertension. It describes the main anti-anginal drug classes as organic nitrates, beta blockers, and calcium channel blockers. These drugs work by increasing coronary blood flow and reducing myocardial oxygen demand. The mechanisms, uses, and side effects of nitrates, calcium channel blockers, and beta blockers are explained. The document also covers the main antihypertensive drug classes of ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics. Their mechanisms of action and side effect profiles are outlined.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    636 views27 pages

    Drugs Affecting The Cardiovascular System

    Uploaded by

    Celestino Kuchena
    The document discusses classes of drugs used to treat angina and hypertension. It describes the main anti-anginal drug classes as organic nitrates, beta blockers, and calcium channel blockers. These drugs work by increasing coronary blood flow and reducing myocardial oxygen demand. The mechanisms, uses, and side effects of nitrates, calcium channel blockers, and beta blockers are explained. The document also covers the main antihypertensive drug classes of ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics. Their mechanisms of action and side effect profiles are outlined.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
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    The key takeaways are the different classes of drugs used to treat angina and hypertension including nitrates, beta blockers, calcium channel blockers, ACE inhibitors and diuretics as well as their mechanisms of action and side effects.

    The main classes of drugs used to treat angina are organic nitrates, beta blockers, and calcium channel blockers.

    Calcium channel blockers work to treat angina by blocking L-type voltage gated calcium channels in arterioles, reducing intracellular calcium levels and causing smooth muscle relaxation. They also depress cardiac pacemaker cells and have negative inotropic and chronotropic actions.

    Objectives

    Name the main classes of Anti anginal and anti

    hypertensive drugs Describe the principles of drug action in the treatment of Angina and Hypertension Describe the mechanism of action of the above drugs Name the adverse effects of each of the drugs

    Angina Pectoris

    Main anti anginal drug classes


    Organic Nitrates
    Beta blockers Calcium Channel blockers (Antiplatelet drugs)

    Angina Pectoris
    SUPPLY DEMAND

    Principals of drug Action in Angina

    SUPPLY

    Dilates Coronaries
    Slows Heart Rate

    DEMAND

    Reduces Preload
    Reduces Afterload Slows heart rate

    Reduces contractility

    The Nitrates
    Cause Vasodilatation
    Dilates Venules >> Arterioles Veno dilatation

    Preload

    O2 Demand

    Coronary dilatation Coronary

    Improves
    Flow

    Mechanism of action Releases NO intracellulary


    Activates Guanylate cyclase cyclic GMP free intracellular Ca vascular smooth muscle relaxation

    The Nitrates Oral / Sublingual / Transdermal / IV


    GTN Sublingual spray usually

    Short half life- few minutes Immediate relief of angina ISMN/ISDN Tablets Longer half life Continuous cover

    The Nitrates
    Nitrate Tolerance

    Nitrate free period needed


    Adverse Effects

    Headache Hypotension Collapse

    Calcium Channel blockers


    Vasodilators,

    arterioles >> venules Depress myocardium, slow cardiac conduction Varying selectivity to the above Arteriolar dilatation Afterload

    cardiac conduction cardiac contractility

    Heart rate

    Mechanism of action
    Block L type voltage gated Calcium channels in

    arterioles Reduced Intracellular Calcium Smooth muscle relaxation Depress cardiac pacemaker cells Negative inotropic and chronotropic action

    Calcium Channel blockers


    Dihydropyridines Less effects on myocardium

    nifedipine, amlodipine
    Non- dihydropyridines More effects on

    myocardium verapamil, diltiazem

    Adverse effects of Ca ch. blockers


    Ankle oedema

    Flushing
    Headache Hypotension

    Palpitations

    The Beta Adrenoreceptor blockers


    Block cardiac 1 adrenoreceptor

    Heart
    rate

    cardiac contractility

    cardiac O2 demand

    Also reduces renin secretion from the kidney

    Beta Blockers
    All betablockers have both 1 (cardiac) and 2

    (peripheral) receptor blocking effects


    Those which are more selective to 1 receptors

    (cardioselective ) are more appropriate ie metoprolol, bisoprolol, atenolol Relatively non selectives may have more adverse effects ie propranolol

    Adverse drug effects of Beta blockers


    Bronchoconstriction

    Caution in asthma Cold extremities Fatigue Bradycardia Hypoglycaemia Precipitation of cardiac failure Bad dreams

    A bad dream..??

    Drugs used in Hypertension

    Principal Antihypertensive drugs

    A -Angiotensin Converting Enzyme Inhibitors (ACE inhibitors) & Angiotensin II blockers


    B -Beta adrenoreceptor blockers C - Calcium Channel blockers D Diuretics (thiazide diuretics)

    Factors affecting blood pressure

    BLOOD = CARDIAC PERIPHERAL PRESSURE OUTPUT RESISTANCE (vascular tone) Heart Rate Stroke Volume

    Renin Angiotensin-Aldosterone System

    Low renal bloof flow


    renin Angiotensinogen ACE Angiotensin I Angiotensin II Angiotensin I

    Angiotensin II is a powerful vasoconstrictor Stimulates Aldosterone release Na retension

    ACE Inhibitors- mechanism

    Inhibit synthesis of Angiotensin II


    vascular resistance Blood Pressure Reduced aldosterone

    Na/H2O retension

    Stroke Vol
    BP

    ACE Inhibitors

    ACE I s

    captopril, ramipril, lisinopril Angiotensin Receptor blockers losartan, candesartan Particularly useful in diabetic nephropathy

    Adverse effects?? find out!

    Thiazide diuretics

    Inhibits Na reabsorption in distal tubule of nephron Blood volume


    Cardiac Output

    Hydrochlorothiazide, Bendrofluazide

    Adverse drug effects

    Weakness Hypokalaemia Hyperuricaemia Skin rashes Glucose intolerance Increased cholesterol

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