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Cardiac Pharmacology

Cardiovascular module

What are three main classes of cardiac drugs 1. Drugs that directly affect myocardial cels 2. Drugs that have an indirect effect on cardiac function (e.g. Organic Nitrates) 3. Calcium Antagonist
What are the four main types of drugs that act directly on myocardial cells 1. Autonomic neurotransmitter & related drugs 2. Antidysarrthymics 3. Cardiac Glycosides and other Inotropic Drugs 4. Miscellaneous drugs and endogenous substances
What are the four classes of anti-dysrhythmic drugs Class I - Sodium channel blockers Class II - beta-blockers Class III - Potassium Channel BLockers Class IV- Calcium Channel BlockersWhat are the types of Class I anti-dysarhythmics
What are the types of Class I anti-dysarhythmics Class IA - intermediate onset Class IB - fast onset Class IC- slow onset
What are some class II drugs Beta blockers: Propanalol, metoprolol, esmolol
What are some Class III drugs K+ channel blockers: Amiodarone, Sartalol
What are some Class IV drugs Verapamil, diltiazem
What are Cardiac Glycosides Drugs that increases inotropy and cardiac output. E.g. Digoxin Used for congestive heart failure and arrhythmias
How do Calcium Antagonists work? They prevent Ca+ entry into cells by blocking L-type Ca2+ channels --> slows conduction and causes casodilation Indications: HTN, Angina, arrhythmias
How do Organic Nitrates work? 1. They cause vasodilation which decreases arterial and venous pressure --> leads to decreased TPR and venous return as well as afterload --> decreases work of the heart and O2 consumption 2. Decrease platelet aggregation 3. Dilates Collateral vessels
How do Beta-blockers work? They block beta-adrenoceptors which are part of the sympathetic NS --> in heart (B1), causes decreased HR and Inotropy + Increases diastolic time which increases time for coronary flow Also causes vasodilation as B2 receptors are found in smooth musc
What are the two main classes of lipid lowering drugs 1. Statins 2. Anion-exchanging resins
What are anion-exchanging resins? Binds to bile salts to prevent their circulation in the GI tract --> increases hepatic LDL receptors which uptakes plasma LDL
What are statins? They inhibit HmG-CoA reductase which is the rate limiting step in intracellular cholesterol synthesis --> upregulate LDL receptors --> inc uptake of plasma LDL Also inc epithelial function, dec inflammation & platelet aggregation and incr fibronolysis
What are the three types of thrombolytics? 1. Anti-coagulant 2. Anti-platelet 3. Fibrinolytics
What are the types of anti-coagulant Heparin - inhibits coagulation by inactivating thrombin and factor Xa and ATIII Direct Thrombin Inhibitors - binds to thrombin to prevent fibrin formation Vitamin K antagonist (warfarin) - binds to Vitamin K reductase to prevent synthesis of vitamin
What are the different types of anti-platelets Aspirin - Inhibits COX Glycoprotein IIb/IIIa inhibitors - inhbits integrins GPIIb and GPIIIa which are what fibrinogen binds to to convert into fibrin P2& antagonist- Targets P2Y receptors that prevents platelet aggregation
How do fibrinolytics work They convert plasminogen into plasmin which degrades fibrin products, fibronogen, ECM proteins and clotting factors E.g. Streptokinase, tPa
Created by: 17Hazelwood