Cardiovascular drugs

1. Submitted to: Dr. Riffat Iqbal

2. Cardiovascular diseases
 Cardiovascular disease (CVD) is a general term for conditions affecting the heart
or blood vessels.
 It's usually associated with a build-up of fatty deposits inside the arteries
(atherosclerosis) and an increased risk of blood clots.
 CVD includes heart attack, stroke, heart failure, arrhythmia, heart valve
complcations etc.
 The risk of certain cardiovascular diseases may be increased by smoking, high
blood pressure, high cholesterol, unhealthy diet, lack of exercise, and obesity.
 The severity of CVD can also lead to the death.

3. Cardiovascular Drugs
 There are ways to prevent and manage many types of heart disease.
 Many types and combinations of drugs used to treat coronary vascular disease (CVD) doctor
or other health care provider will decide the best treatment combination for the related
situation.
 cardiovascular drug, any agent that affects the function of the heart and blood vessels.
 Drugs that act on the cardiovascular system are among the most widely used in medicine.
 Examples of disorders in which such drugs may be useful include hypertension (high blood
pressure), angina pectoris (chest pain resulting from inadequate blood flow through
the coronary arteries to the heart muscle), heart failure (inadequate output of the heart
muscle in relation to the needs of the rest of the body), and arrhythmias (disturbances of
cardiac rhythm).

4. Effects on heart function
 Drugs affect the function of the heart in three main ways.
 They can affect the force of contraction of the heart muscle, inotropic effects.
 They can affect the frequency of the heartbeat, or heart rate, chronotropic effects.
 They can affect the regularity of the heartbeat rhythmic effects.

5. Anticoagulants
 Also known as Blood Thinners.
 Reason for Medication
 Helps to prevent harmful clots from forming in the blood vessels.
 May prevent the clots from becoming larger and causing more serious problems.
 Often prescribed to prevent first or recurrent stroke.
 What Medication Does
 Decreases coagulating ability of the blood. They do not actually thin the blood. They do NOT dissolve existing
blood clots.
 Used to treat certain blood vessel, heart and lung conditions.
 Commonly prescribed include:
 Apixaban (Eliquis)
 Dabigatran (Pradaxa)
 Edoxaban (Savaysa)
 Heparin (various)
 Rivaroxaban (Xarelto)

6. Angiotensin-Converting Enzyme Inhibitors
 Reason for Medication
 Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and
heart failure.
 What the Medication Does
 Expands blood vessels and decreases resistance by lowering levels of angiotensin II.
 Allows blood to flow more easily and makes the heart's work easier or more efficient.
 Commonly prescribed include:
 Benazepril (Lotensin)
 Captopril (Capoten)
 Enalapril (Vasotec)
 Fosinopril (Monopril)
 Lisinopril (Prinivil, Zestril)
 Moexipril (Univasc)
 Perindopril (Aceon)

7. Angiotensin II Receptor Blockers (Inhibitors)
 Also known as ARBs.
 Reason for Medication
 Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and heart failure.
 What the Medication Does
 Rather than lowering levels of angiotensin II (as ACE inhibitors do) angiotensin II receptor blockers prevent this
chemical from having any effect on the heart and blood vessels.
 This keeps blood pressure from rising.
 Commonly prescribed include:
 Azilsartan (Edarbi)
 Candesartan (Atacand)
 Eprosartan (Teveten)
 Irbesartan (Avapro)
 Losartan (Cozaar)

8. Angiotensin Receptor-Neprilysin Inhibitors
 ARNIs are a drug combination of a neprilysin inhibitor.
 Reason for Medication
 For the treatment of heart failure
 What the Medication Does
 Neprilysin is an enzyme that breaks down natural substances in the body that open narrowed
arteries.
 By limiting the effect of neprilysin, it increases the effects of these substances and improves artery
opening and blood flow, reduces sodium (salt) retention, and decreases strain on the heart.
 Commonly prescribed include:
 Sacubitril/valsartan (Entresto)

9. Beta Blockers
 Also known as Beta-Adrenergic Blocking Agent
 Reason for Medication
 Used to lower blood pressure.
 Used for cardiac arrhythmias (abnormal heart rhythms)
 Used to treat chest pain (angina)
 Used to help prevent future heart attacks in patients who have had a heart attack
 What the Medication Does
 Decreases the heart rate and force of contraction, which lowers blood pressure and makes the heart beat
more slowly and with less force.
 Commonly prescribed include:
 Acebutolol (Sectral)
 Atenolol (Tenormin)
 Betaxolol (Kerlone)
 Bisoprolol/hydrochlorothiazide (Ziac)
 Bisoprolol (Zebeta)

10. Combined Alpha and Beta-Blockers
 Combined alpha and beta-blockers are used to treat high blood pressure and heart
failure.
 Reason for Medication:
 May cause a drop in blood pressure when you stand up
 Commonly prescribed include:
 Carvedilol (Coreg, Coreg CR)
 Labetalol hydrochloride (Normodyne, Trandate)

11. Calcium Channel Blockers
 Also known as Calcium Antagonists or Calcium Blockers.
 Reason for Medication
 Used to treat high blood pressure, chest pain (angina) caused by reduced blood supply to the heart
muscle and some arrhythmias (abnormal heart rhythms).
 What the Medication Does
 Interrupts the movement of calcium into the cells of the heart and blood vessels.
 May decrease the heart's pumping strength and relax blood vessels.
 Commonly prescribed include:
 Amlodipine (Norvasc)
 Diltiazem (Cardizem, Tiazac)
 Felodipine (Plendil)
 Nifedipine (Adalat, Procardia)
 Nimodipine (Nimotop)

12. Digitalis Preparations
 Reason for Medication
 Used to relieve heart failure symptoms, especially when the patient isn't responding to other standard
treatments including ACE inhibitors, ARBs and diuretics.
 Also slows certain types of irregular heartbeat (arrhythmias), particularly atrial fibrillation.
 What the Medication Does
 Increases the force of the heart's contractions.
 Can be beneficial in treating heart failure and irregular heartbeats.
 Commonly prescribed include:
 Digoxin (Lanoxin)

13. Vasodilators
 Reason for Medication
 Used to ease chest pain (angina)
 What the Medication Does
 Relaxes blood vessels and decreases blood pressure.
 A category of vasodilators called nitrates increases the supply of blood and oxygen to the heart
while reducing its workload which can ease chest pain (angina).
 Nitroglycerin is available as a pill to be swallowed or absorbed under the tongue (sublingual), a
spray, and as a topical application (cream).
 Commonly prescribed include:
 Isosorbide dinitrate (Isordil)
 Isosorbide mononitrate (Imdur)
 Hydralazine (Apresoline)
 Nitroglycerin (Nitro Bid, Nitro Stat)
 Minoxidil

14. Diuretics
 Also known as Water Pills.
 Reason for Medication
 Used to help lower blood pressure.
 Used to help reduce swelling (edema) from excess buildup of fluid in the body.
 What the Medication Does
 Causes the body to rid itself of excess fluids and sodium through urination.
 Helps to reduce the heart's workload.
 Also decreases the buildup of fluid in the lungs and other parts of the body, such as the ankles and
legs.
 Different diuretics remove fluid at varied rates and through different methods.
 Commonly prescribed include:
 Acetazolamide (Diamox)
 Amiloride (Midamor)
 Bumetanide (Bumex)

15. Cholesterol-Lowering Medications
 Statins: Atorvastatin (Lipitor), Fluvastatin (Lescol), Lovastatin (Mevacor), Pitavastatin (Livalo),
Pravastatin (Pravachol), Rosuvastatin (Crestor), Simvastatin (Zocor)
 Nicotinic acids: Niacin
 Cholesterol absorption inhibitor: Ezetimibe (Zetia)
 Combination statin and cholesterol absorption inhibitors: Ezetimibe/Simvastatin (Vytorin)
 Reason for Medication
 Used to lower LDL ("bad") cholesterol
 What the Medication Does
 Various medications can lower blood cholesterol levels, but drugs other than statins are usually only
used for patients in whom statins are not effective or who have serious side effects from statin
therapy.
 They work in the body in different ways. Some affect the liver, some work in the intestines and some
interrupt the formation of cholesterol from circulating in the blood

16. Advantages
 After acute myocardial infarction, β-adrenergic blockers reduce mortality regardless of patient age.
 Statins and antiplatelet drugs have proven beneficial in both primary and, especially, secondary
prevention of coronary events in older adults.
 In elders with chronic heart failure, loop diuretics must be used cautiously, owing to their higher
potential for adverse effects
 Angiotensin-converting-enzyme inhibitors and β-blockers reduce symptoms and prolong survival.
 The high risk of stroke in elderly patients with atrial fibrillation is markedly reduced with warfarin

17. Common Side Effects
 ACE inhibitors includes adverse effects like dizziness, low blood pressure, changes in kidney
function, dry cough, increased potassium levels and swelling in your lips or throat.
 Aldosteron antagonists can cause changes in kidney function, increased potassium levels, and
swelling or tenderness in breasts (men and women).
 Use of diuretics may cause side effects like increased urination, dizziness, low blood pressure,
dehydration, changes in kidney function, ringing or buzzing in ears, skin rash or hives, increased
blood sugar levels and gout.
 Antiarrythemic agents may cause nausea, poor appetite, digestive problems, yellow tinge or
halos in your vision (sign of toxicity) and abnormal heart rhythm (dizziness/palpitations).
 Vasodilators has side effects like low blood pressure, dizziness, headache and nausea.