LECTURE #: 2.8 Medication Preparations and Supplies

• Cardiac glycosides

• Antiarrhythmic agents

• Antilipemic agents

• Antihypertensives

Affect the heart and blood vessels

• Vasodilators

• Vasoconstrictors

Affect the heart

• Anticoagulants

• Platelet inhibitors

• Thrombolytics

Affect the blood vessels (blood cells)

Cardiac glycosides

Cardiotonic: increases the force of myocardial

contraction.

Cardiac glycosides

Disease Treated: Congestive Heart Failure

Antiarrhythmic agents

Suppresses different types of arrythmias

Antiarrhythmic agents

Disease Treated: Arrythmia

Antihypertensives

Treatment and management of all degrees of

Hypertension

Antihypertensives

Disease Treated: Hypertension

Vasodilators

Dilates coronary artery for Prevention and

Treatment of Angina.

Vasodilators

Disease Treated: Angina

Vasoconstrictors

Constriction of blood vessels to elevate blood

pressure

Vasoconstrictors

Disease Treated: Shock

Antilipemic agents

Decreases Triglycerides, LDL and VLDL

Cholesterol.

Antilipemic agents

Disease Treated: Hyperlipidemia

Prevention of Coronary Heart Disease &

Myocardial Infarction

Anticoagulants

Prevent formation of clots or decrease

extension of existing clots.

Anticoagulants

Disease Treated: Thrombosis & Embolism

Platelet Inhibitors

Decrease platelet clumping.

Platelet Inhibitors

Disease Treated: Prevention of 2nd stroke, 2nd Myocardial Infraction & Peripheral Vascular Disease

Thrombolytic Agents

Potentiates the body’s process to dissolve

clots.

Thrombolytic Agents

Disease Treated: Dec. risk of mortality: Acute Myocardial Infraction & Cerebrovascular Vascular Accident

Digoxin

Cardiac glycosides examples

Procainamide, Lidocaine,

Amiodarone, Beta Blockers,

Calcium Channel Blockers

Antiarrhythmic agents examples

ACE inh., ARBs, Alpha Blockers,

Diuretics, Beta Blockers,

Calcium Channel Blockers

Antihypertensives examples

Nitrates, Beta Blockers, Calcium Channel Blockers

Vasodilators examples

Norepinephrine,

Metaraminol, Dobutamine

Vasoconstrictors examples

HMG COA reductase inh.,

Niacin, Bile Acid

sequestrants

Antilipemic agents examples

Warfarin, Heparin, Enoxaparin

Anticoagulants examples

Dipyridamole, Aspirin, Clopidogrel

Platelet Inhibitors examples

Streptokinase, Alteplase, Reteplase

Thrombolytic Agents examples

Sodium, Potassium

_____ and ______ are the ions exchanged in our cardiac muscle

Calcium

increases production of neurotransmitter

• Atrial fibrillation

• Atrial flutter

• Congestive heart failure

DIGOXIN is used to treat:

Inhibits Na+ K+ ATPase enzyme

DIGOXIN mechanism of action

• Unusual tiredness and fatigue

• Anxiety

• Hallucinations

• Poisoning and toxicity

DIGOXIN side effects

• Ace Inhibitors

• Beta blockers

Cardiac glycosides PREFERRED FIRST-LINE

TREATMENTS:

Ventricular Fibrillations

Cardiac glycosides contraindication

1A

Antiarrhythmic agents class:
prolong repolarization

1B

Antiarrhythmic agents class:

shorten repolarization

1C

Antiarrhythmic agents class:

little effect on repolarization

II

Antiarrhythmic agents class:

Beta-adrenergic blockade

III

Antiarrhythmic agents class:

potassium channel blockade

IV

Antiarrhythmic agents class:

Calcium channel blockade

• quinidine

• procainamide

• disopyramide

Antiarrhythmic agents class:

IA drugs:

• lidocaine

• mexiletine

• tocainide

• phenytoin

Antiarrhythmic agents class:

IB drugs

• flecainide

• encainide

• propafenone

Antiarrhythmic agents class:

IC drugs

• propanolol

• esmolol

Antiarrhythmic agents class:

II drugs

• sotalol

• amiodarone

Antiarrhythmic agents class:

III drugs

• verapamil

• diltiazem

Antiarrhythmic agents class:

IV drugs

• Enalapril

• Lisinopril

• Ramipril

• Captopril

Antihypertensives:

ACE inhibitors (Angiotensin converting enzyme inhibitors) Suffix: -pril

• Telmisartan

• Olmesartan

• Losartan

• Candesartan

• Valsartan

Antihypertensives:

ARBS (Angiotensin receptor blockers) Suffix: -sartan

• Amlodipine

• Felodipine

• Nimodipine

• Nifedipine

• Isradipine

• Verapamil

• Diltiazem

Antihypertensives:

Calcium channel blockers Suffix: -dipine (most of

them); some different chemical structure

• Atenolol

• Metoprolol

• Bisoprolol

• Labetolol

• Propranolol

Antihypertensives:

Beta blockers Suffix: -olol

• Hydrochlorthiazide

• Chlorthiazide

• Chlorthalidone

• Spironolactone

• Furosemide

Antihypertensives:

Diuretics

• Hydralazine

• Minoxidil

• Sodium Nitroprusside

• Diazoxide

Antihypertensives:

Direct Vasodilators

• Terazosin

• Doxazosin

• Prazosin

Antihypertensives:

Alpha blockers Suffix: -zosin

• Clonidine

• Methyldopa

Antihypertensives:

Central Alpha 2 Agonists

Septic Shock, neurogenic shock

Vasoconstrictors:

Phenylephrine common uses

all types of shock

Vasoconstrictors:

Norepinephrine common uses

Anaphylaxis, ACLS, septic shock

Vasoconstrictors:

Epinephrine common uses

Renal Insufficiency, septic shock, cardiogenic shock

Vasoconstrictors:

Dopamine common uses

Cardiogenic shock (CS)

Vasoconstrictors:

Dobutamine common uses

bradycardia due to heart block,

effects HR

Vasoconstrictors:

Isoproterenol common uses

Cardiogenic shock-in those who don't respond to dobutamine

Vasoconstrictors:

Milrinone common uses

Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Rosuvastatin, Simvastatin

Antihyperlipidemic Agents:

HMG COA REDUCTASE INHIBITORS (-vastatin)

Fenofibrate, Gemfibrozil, Clofibrate

Antihyperlipidemic Agents:

FIBRATES (-fibr-):

NIACIN

Antihyperlipidemic Agents:

Nicotinic acid

Colesevelam, Colestipol

Antihyperlipidemic Agents:

BILE ACID SEQUESTRANTS (-oles-)

Ezetimibe

Antihyperlipidemic Agents:

CHOLESTEROL ABSORPTION INHIBITORS:

Familial lipoprotein lipase deficiency, Genetic, Very Rare, Chylomicron

Antihyperlipidemic Agents Type I DISORDER, CAUSE, OCCURANCE, ELEVATED PLASMA LIPOPROTEIN

Familial hypercholesterolemia, Genetic, Less

Common, LDL

Antihyperlipidemic Agents Type IIa DISORDER, CAUSE, OCCURANCE, ELEVATED PLASMA LIPOPROTEIN

Polygenic hypercholesterolemia, Multifactorial, Most

Common, LDL

Antihyperlipidemic Agents Type IIb DISORDER, CAUSE, OCCURANCE, ELEVATED PLASMA LIPOPROTEIN

Familial dysbetalipoprotenemia, Genetic, Rare, IDL Chyamicrons remnants

Antihyperlipidemic Agents Type III DISORDER, CAUSE, OCCURANCE, ELEVATED PLASMA LIPOPROTEIN

Hypertriglyceridemia, Multifactorial Genetic, Common, VLDL

Antihyperlipidemic Agents Type IV DISORDER, CAUSE, OCCURANCE, ELEVATED PLASMA LIPOPROTEIN

Familial combined hyperlipidemia, Genetic, Less

common. VLDL, LDL

Antihyperlipidemic Agents Type V DISORDER, CAUSE, OCCURANCE, ELEVATED PLASMA LIPOPROTEIN

Anticoagulants

Anticoagulants, Platelet Inhibitors, and Thrombolytic Three major classifications of drugs:

o Suppress the coagulation cascade

o Heparin, warfarin

Antiplatelets

nticoagulants, Platelet Inhibitors, and Thrombolytic Three major classifications of drugs:

o Inhibit platelet aggregation

o Aspirin, clopidogrel

Thrombolytics

Anticoagulants, Platelet Inhibitors, and Thrombolytic Three major classifications of drugs:

o Promote lysis of fibrin strands, causing

dissolution of thrombi

o tissue plasminogen activator ie t-PA

(alteplase)

Heparin, Inactivation of clotting Factors, Prevent venous Thrombosis

Classification of drugs used in Thromboembolism:

Anticoagulant Parenteral prototype, action & effect

Warfarin, Decrease synthesis of Clotting factors, Prevent venous Thrombosis

Classification of drugs used in Thromboembolism:

Anticoagulant Oral prototype, action & effect

Aspirin, Decrease platelet aggregation, Prevent

arterial Thrombosis

Classification of drugs used in Thromboembolism:

Antiplatelet drugs prototype, action & effect

Streptokinase, Fibinolysis, Breakdown of thrombi

Classification of drugs used in Thromboembolism:

Thrombolytic drugs prototype, action & effect

COX inhibitors, Decreased thromboxane A2

Platelet Inhibitors: Mechanism and result of ASA, NSAIDs

ADP receptor blockers, Decreased

activation of platelets and eventual crosslinking by the protein fibrin

Platelet Inhibitors: Mechanism and result of Thienopyridines (Clopidogrel, Prasugrel, Ticlopidine)

Glycoprotein IIb/IIIа inhibition, Platelet aggregation inhibiton

Platelet Inhibitors: Mechanism and result of Abciximab, Eptifibatide,Tirofiban

Acetyl salicylic acid

Chemical name of ASA-