Cardiovascular Agents/Biosynthesis of Steroids/Glycosides

What are the different types of cardiovascular diseases?

Coronary artery disease - ischemic heart disease

Peripheral - in blood vessels that supply blood to the arms and legs

Cerebrovascular - supply blood to brains(includes stroke)

Renal Stenosis - narrowing of arteries that carry blood to kidneys

Aortic aneurysm: enlargement/bulge that occurs in the wall of the arta that carries blood from the heart to the body

What are the heart diseases?

Cardiomyopathy - disease cardiac muscle

Hypertensive - high blood pressure

Heart failure - inability of the heart to supply sufficient blood to the tissues

Pulmonary: failure at the right side of the heart with respiratory system involvement.

Dysrhythmias - abnormalities of heart rhythm

Congenital - malformations at birth

Rheumatic - heart muscles and valves damage due t rheumatic fever caused by streptococcus pyogenes

What are the different classes of cardiovascular agents?

Antianginals, Anti Arrhythmics, Aantihypertensives, Vasopressors, Antihyperlipidemics, Anticoagulants, Antiplatelet, Diuretics, Vasodilators

What drugs are Antianginals?

Nitrates, beta blockers, calcium channel blockers

What drugs are antiarrhythmics?

Sodium channel blockers, beta blockers. Rhythmic contraction of the heart is disturbed/altered.

How kind of drugs are antihypertensives?

Thiazide diuretics, calcium channel blockers, ace inhibitors, angiotensin 2 receptor antagonists, and beta blockers

What kind of drugs are antihyperlipidemics?

They lower serum levels of cholesterol and various lipids

What do coagulants do?

Help prevent blood clots also known as blood thinners

What kind drugs are thrombolytics?

Clot-busting drugs that break up and dissolve blod clots that get i the way of the blood flow. The major classes are tPA, SK, UK

What do vasopressors do?

make blood vessels constrict or become narrow in people with low blood pressure

What do antiplatelet agents do and what are some examples?

Stop blood cells from sticking together and forming blood clots. Aspirin, Ticlopidine, Clopidogrel, and Diyridamole

What do Diuretics do?

Increase water excretion and soidum in urine, therefore decreasing blood volume

What do Vasodilators do and what kind of drugs are they?

Open blood vessels, ACE Inhibitors, ARB’s, CCB’s

What is the mechanism of action for ACE inhibitors AND ARB’s?

ACE Inhibitors: prevent ACE from converting angiotensin 1 to angiotensin 2 which is a powerful vasoconstrictor

ARBs: Block the action of angiotensin 2 which is the hormone that constricts blood vessels and increases blood pressure

What are the 2 ways you can treat angina?

By increasing blood flow or decreasing oxygen demand

What is the enzyme used to reduce NO from organic nitrates?

Aldehyde Dehydrogensase-2

What is the mechanism of action for CCB’s?

block the passage of Ca+2 ions from outside to inside of the muscle cell
will also prevent the contraction of muscles leading to reduced work load and hence lowered oxygen requirement.

What are the 3 classes for CCB’s?

Dihydropyridines, Benzothiazepine, Arylalkylamines

What do non-dihydropyridines have inhibitory effects on?

SA and AV nodes which slow cardiac conduction and contractility

Propanolol is what kind of beta blocker?

Nonselective

What is the other word for Vitamin D3 and what is the precursor molecule?

Cholecalciferol and 7-Dehydrocholesterol

What is the other word for Vitamin D2?

Ergocalciferol

When in the body, Vitamin D has to metabolize to what?

1α, 25-dihydroxycholecalciferol in 2 steps:

IN THE LIVER - Cholecalciferal is hydroxylated to 25-hydroxycholecalciferol by enzyme 25-hydroxylase

IN THE KIDNEY - 25-hydroxycholecalciferol to 1α, 25-dihydroxycholecalciferol

What is Cardiac Glycosides mechanism of action?

Causes positive inotropic effect and REVERSIBLY inhibit the sodium potassium ATPase pump in myocardial cells

Cardiac Glycosides have 2 different moieties, what are they?

1. Aglycone(steriod portion) with a lactone ring

2. Glycone(sugar)

What is the difference between Digoxin and Digitoxin?

Digoxin is a cardiac glycoside with ONE LESS hydroxyl group then Digitoxin so just count the OH groups and you’ll know

What is Digoxin used for?

control atrial fibrillation/flutter and systolic heart failure and treatment of Paroxysmal Supraventricular Tachycardia

What is Digitoxin?

it is a lipid soluble cardiac glycoside, after hydrolysis it becomes digitoxigenin (genin means without sugar) and is used for the same reasons as Digoxin but is not that skrong