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ALLAH
THE MOST BENEFICIENT,
THE MOST MERCIFUL
CARDIAC DRUGS
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Congestive Heart Failure
(CHF)
It refers to failure of the heart to pump enough blood to
meet the needs of the tissue, following myocardial damage.
DRUGS: (Inotropic, Vasodilators, Diuretics)
A) Inotropic Drugs
1. Cardiac Glycosides (Digitalis)
Digoxin, Digitoxin.
2. Phosphodiesterase inhibitors
Bipyradines :Amrinone, Milrinone
Methylxanthines: Aminophyline, Theophyline
3. B1 Adrenoceptor Agonists
Dobutamine, Dopamine
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B) Vasodilators
1. ACE inhibitors
Captopril, Enalapril, Lisinopril
2. Direct vasodilators
Hydralazine, Nitroprusside
3. Alpha-adrenoceptor Blockers
Prazosin, Doxazosin
C) Diuretics
Furosemide, Bumetanide
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Cardiac Glycosides
Obtained from various plants (Digitalis
purpurea, Digitalis lanata)
Increase the force of myocardial contraction
(positive ionotropic effect)
Used in case of congestive heart failure
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Important members
1. Digitalis leaf powder
2. Digitoxin
3. Digoxin
4. Ouabain
5. Digitalin
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Mechanism of action
Digitalis inhibits Na+-K+ ATPase resulting
in intracellular accumulation of Na+ ( and
loss of K+)
It leads to influx of Ca++ secondary to
activation of membrane Na+-Ca++ carrier
It increases intracellular free Ca++.
Ability of ER to bind Ca++ is also decreased
leading to more intracellular free Ca++
It increases intensity of interaction of actin
and myosin filaments.
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Ion movements during the contraction of cardiac muscle.
ATPase = adenosine triphosphatase
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Antiarrythemic Drugs
Used for the treatment of cardiac arrythemia
Class I agents: Block Na+ channels
Local anesthetics (membrane stabilizers)
1. Quinidine
2. Procainamide
3. Lidocaine (Lignocaine)
Class II agents:
Beta blockers
1. Propranolol (Inderal)
2. Atenolol
3. Metoprolol
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Class III agents
K+ channel blockers
Prolong action potential
1. Bretylium
2. Sotalol
Class IV agents
Calcium channel blockers
1. Verapamil
2. Diltizem
3. Nifedipine
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Antihypertensive drugs
Beta blockers
– Propranolol
– Atenolol
Diuretics
– Furosemide
– Hydrochlorothiazide
Vasodilators
– Captopril (ACE inhibitors)
– Hydralazine
– Prazosin (Alpha blocker)
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Calcium channel blockers
– Verapamil
– Diltizem
– Nifedipine
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Drugs Effecting Blood
Blood Coagulation
It occures in three stages
1. Formation of active thromboplastin
From platelet or tissues