Dare Ogunlade, MBChB, FWACP Lecturer/Consultant Cardiologist Department of Physiological Sciences Obafemi Awolowo University, Ile-Ife


CLASSIFICATION OFCARDIOVASCULAR DRUGS 1. Antihypertensive drugs 2. Antiarrhythmic drugs 3. Antianginal drugs 5. Lipid-lowering agents 6. Anti heart failure drugs . Antithrombotic drugs 4.

ANTIHYPERTENSIVE DRUGS  Antihypertensive drugs are blood pressure lowering agents  They are indicated in the management of hypertension. .

Classification of Antihypertensive Drugs 1. 5. 2. 3. 4. 7. 8. 6. Thiazide diuretics Calcium channel blockers (CCBs) Beta blockers(Beta adrenergic receptor blockers) Angiotensin Conversion Enzyme inhibitors (ACEI) Angiotensin Receptor Blockers (ARBs) Alpha blockers Centrally acting drugs Vasodilators .

enalapril ARBs Alpha blockers Centrally acting drug Valsartan. hepatitis. Propranolol CCBs Beta blockers Cardioselective B-blocker Atenolol. vasodilation Captopril. promote renal excretion of Na Block calcium channels. angioedema. hyponatraemia. hyperuricaemia. polythiazide Nifedipine. tachycardia bradycardia.metoprolol bradycardia Cough. nighmares. Methyl dopa First dose hypotension Impotence. vasodilation Angiotensin II receptor blocker. Dyslipidaemia. pedal oedema. impotence Headache. lisinopril. vasodilation Non-selective B-blocker Examples Hydrochlorothiazide. amlodipine.metallic taste ACEIs Inhibition of ACE.bronchoconstricti ons bendrofluazide.first dose hypotension. Side-Effects Hypokalaemia. losartan Prazosin.Antihypertensive Drugs Class Thiazide Mechanism of Action Reduce Na contents of vascular wall. postural hypotension Alpha adrenergic blockers False transmitters . doxazosin. Hyperglycaemia.

a combination of hydrochlorothiazide(50mg) and amiloride (5mg). Example: Moduretic.Fixed Drug Combinations    Fixed Drug Combinations: two or more drugs with different mechanisms of action combined in a fixed dosage. Hydrochlorothiazide is a thiazide diuretic while amiloride is a potassium-sparing diuretic .

Other examples of fixed drug combinations  Co-diovan:   diovan(valsartan) + hydrochlorothiazide Zestoretic : lisinopril(zestril) + hydrochlorothiazide Minizide: prazosin + polythiazide dihydroergocristine  Brinerdin: Reserpine + clopamide + .

. Calcium channel blockers 1& 2 are considered first in initiation of drug therapy unless there is contraindication or compelling indications for the use of other antihypertensive medications.  New cases of hypertension in blacks usually respond to . Thiazide diuretics 2. 1.Choice of antihypertensive drugs  Hypertension in Blacks is volume dependent.

ANTIARRHYTHMIC DRUGS Drugs useful in the treatment of cardiac arrhythmias(disorders of cardiac rhythm) .

Vaughan Williams’Classifications of Antiarrhythmic Drugs CLASS Class I Ia CHARACTERISTICS Na channel blocker Lengthens AP duration DRUGS Disopyramide. dronedarone. propanolol. Class II Beta Blockers Atenolol. bretylium Verapamil. procainamide. esmolol Class III K channel blockers Amiodarone. sotalol. quinidine Ib Ic Shortens AP duration No effect on AP duration Lidocaine. adenosine . phenytoin Flecainade. diltiazem Class IV Calcium channel blockers Others - Digoxin. propafenone. mexiletine.

Amiodarone 1. . Beta blockers 3.Examples of Commonly Used Antiarrhythmic Drugs Digoxin 2.

Inhibition of Na-K ATPase pump. Slow down conduction through atrioventricular node 3. .Digoxin  Digoxin is a cardiac glycoside  Mechanisms of action Stimulations of parasympathetic dischargeresulting in decrease heart rate 2.increase myocardial contractility 1.

Warfarin Warfarin is an oral anticoagulant that is useful in prevention of intramural thrombus formation in patient with dilated cardiac chambers  Fibrinolytic agents e.tissue plasminogen activator (tPA). tenecteplase(TNK) Fibrinolytic agents are useful in indicated in the treatment of acute myocardial infarction.g Heparin.g aspirin. .g streptokinase.ANTITHROMBOTIC DRUGS  Antiplatelets e. clopidogrel.g hypertension  Anticoagulants e. dipyridamole Low dose aspirin -75mg daily reduces platelet aggregation and is useful in prevention of cerebrovascular disease in patients with cardiovascular disease e.

Calcium channel blockers 4. Nitrates 2. 1. Antiplatelets . Beta blockers 3.ANTIANGINAL DRUGS  Drugs useful in the management of angina include.

isosorbide dinitrate and isosorbide mononitrate  Mechanism of action: systemic venodilation . nitroglycerin. dilation of epicardial coronary vessels  Indication. myocardial ischaemia .Nitrates  Nitrates include.

LIPID-LOWERING AGENTS  Statins : HMG CoA reductase inhibitor  It reduces plasma level of low density lipoprotein(LDL) cholesterol. atorvastatin. simvastatin. a primary risk factor in coronary artery disease. rosuvastatin and fluvastatin . lovastatin.  It increases plasma level of HDL  Examples include.

10. Loop diuretics e. 8. 7. eplerenone Vasodilators e. 9.g digoxin. amiodarone Aldosterone receptor antagonists e.g statins Oxygen therapy .g spironolactone.g digoxin.g sodium nitroprusside.g warfarin Lipid-Lowering agents e.g frusemide ACEIs/ARBs Beta blockers e. 3. dopamine. 5. 4. carvedilol Positive inotropes e. dobutamine Antiarrhythmic drug e. 6.g bisoprolol. 2.ANTIHEART FAILURE DRUGS 1. nitrates Anticoagulants e. metoprolol.

CONCLUSION  Cardiovascular drugs are very important in medical practice. combination therapy is the rule. Thank you for listening . mechanisms of action.  Although a group of drug may be used to manage more than one cardiovascular diseases. contraindications.  Mastery of the various groups of drugs with regards to classification. indications. dosage. side-effects is required of a student in quest for academic excellence.

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