Cardiac Pharmacology Week 5 KS

-olol, -lol
Propanolol (Inderal), Atenolol (Tenormin, Noten), Metoprolol (Betaloc, Lopressor)

beta-adrenergic blocker (BB)
Block the actions of catecholamines, thus blocking adrenergic stimulation to the heart, and reducing speed of conduction.
Decreases HR, myocardial contractility, CO, BP and myocardial O2 demand.
SE: hypotension, bradycardia, h

-pril
Captopril, Enalapril, Perindopril

angiotensin-converting enzyme (ACE) inhibitor
Block the angiotensin-converting enzyme required to convert angiotensin I to angiotensin II.
Angiotensin II is a vasoconstrictor that leads to an increase in BP & aldosterone release promoting Na+ & H2O retent

-sartan
Candesartan (Atacand), Irbesartan (Avapro), Losartan (Cozaar)

angiotensin-receptor blocker (ARB)
directly block vasoconstriction effects of angiotensin II
mild - moderate hypertension, HF
SE: hypotension, dizziness, insomnia, abdominal pain, rhinitis, hyperkalaemia (rare)
Care: monitor BP, serum urea & electrolytes

-dipine
Amlodipine (Norvasc), Felodepine (Plendil), Nifedipine (Adalat)

calcium channel blocker (CCB)
Calcium ions are necessary for muscular contraction = improved myocardial O2 supply & CO thus reducing cardiac workload
Negative inotropic effect
Reduce afterload, HR, slow conductino through AV node
Dilate vascular smooth mu

-statin
Atorvastatin (Lipitor), Simvastatin (Lipex, Zocor), Fluvastatin (Lescol, Vastin), Pravastatin (Pravachol)

HMG-CoA reductase inhibitors - hypolipidaemics
reduce serum cholesterol levels, inhibits HMG-CoA reductase, lowering cholesterol synthesis, increasing No. of liver LDL receptors thus lowering LDL levels
SE: gastro disturbance, headache, myalgia, insomnia,

Prazosin hydrochloride (Minipress, Pressin)

alpha adrenoreceptor blocker (alpha blocker)
block alpha I adrenergic receptor in arterioles & veins leading to reduced peripheral vascular resistance & venous return
SE: 1st dose effect; headache, drowsiness, lightheadedness, weakness, fatigue, dry mouth

peripheral vasodilators
Hydralazine (Alphapress, Apresoline), Diazozide, Minoxidil (Loniten), Sodium nitroprusside

emergency mx of hypertension
relax vascular smooth muscle to reduce peripheral resistance & lower BP
SE: headache, tachycardia, angina, nausea, vomitting, diarrhoea, anorexia
Care: monitor vitals, esp. standing & lying BP & HR; monitor serum urea & electr

antiarrhythmics

mx disturbances of cardiac rhythm
Class I: block Na+ channels during phase o of action potential, slow repolarisation & local anaesthetic effects
Class Ia: Disopyramide (Rythmodan)
Class Ib: Lignocaine (Xylocard), Phenytoin (Dilantin)
Class Ic: Flecainide

bile acid binding agents
Cholestyramine (Questran Lite)

binds cholesterol-containing bile acids within the bowel preventing them from being reabsorbed
elevated cholesterol due to high LDL level; prevention of CHD; itching due to biliary obstruction
SE: constipation, gastro disturbances, reduced absorption of f