Cardiovascular Drugs Notes

Learning Objectives

• Identify drug categories used to treat cardiovascular diseases.
• Identify common suffixes of generic drugs for those drug categories.
• Compare and contrast therapeutic effects of those drug categories.
• Given a generic name, identify trade names and drug categories for cardiovascular drugs.
• Given a trade name, identify drug categories and diseases/symptoms treated.
• Complete Chapter Review Exercises to demonstrate mastery.

Understanding the Heart

• Importance of the Heart: The heart is a muscular organ located in the thoracic cavity and is vital for circulating blood throughout the body.
• Conduction System: The heart's contractions are initiated and coordinated by nerve pathways within the heart, facilitating effective pumping action.
• Oxygen Supply: Oxygen and nutrients reach the heart muscle through the coronary arteries.
• Heart Disease: Leading cause of death in the U.S., influenced by factors such as sedentary lifestyle, obesity, diabetes, and smoking.

Drugs for Angina Pectoris

• Definition: Angina pectoris is chest pain due to insufficient oxygenated blood reaching the myocardium.
• Causes:
• Arterial constriction from smoking.
• Blood clots blocking arteries.
• Increased oxygen demand during exercise and stress.
• Drug Categories:
• Beta-Blockers:
  • Function: Block epinephrine, decrease heart rate, oxygen demand, and pain.
  • Common Suffix: -olol.
  • Example: Atenolol (think: beta-blocker).
  • Other uses: Atrial fibrillation, hypertension, migraines.
• Calcium Channel Blockers:
  • Function: Relax smooth muscle, dilate coronary arteries.
  • Common Suffix: -dipine.
  • Example: Diltiazem (trade name: Cardizem CD).
• Nitrates:
  • Function: Release nitric oxide, dilate coronary arteries, increase blood flow.
  • Example: Nitroglycerin: available in various forms (sublingual, intravenous).

Drugs for Myocardial Infarction

• Definition: Myocardial infarction leads to death of myocardial cells due to blocked blood flow.
• Drug Types:
• Anticoagulants: Prevent blood clotting.
• Thrombolytics: Dissolve existing clots (common in emergencies).
• Glycoprotein Inhibitors and P2Y12 Receptor Antagonists: Reduce blood clot formation post-infarction.

Drugs for Congestive Heart Failure (CHF)

• Definition: CHF occurs when the heart cannot pump adequate blood due to various conditions such as CAD or myocardial infarction.
• Types of Heart Failure:
• Right-sided CHF: Causes blood backup, leading to symptoms like distended neck veins and edema.
• Left-sided CHF: Causes pulmonary edema as blood backs up into lungs.
• Drug Categories:
• ACE Inhibitors:
  • Function: Block conversion of angiotensin, causing vasodilation.
  • Common Suffix: -pril.
• Beta-Blockers:
  • Slow heart rate and decrease oxygen demand.
  • Example: Metoprolol, shown effective in reducing hospitalization and mortality.
• Diuretics: Promote sodium and water excretion to relieve fluid retention.
• Digitalis: Enhances contractility of the heart by affecting calcium levels.

Drugs for Arrhythmias

• Definition: Cardiac arrhythmias result from electrical impulse abnormalities. Types include bradycardia, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation.
• Drug Types:
• Antiarrhythmics: Target different arrhythmias to restore normality in heart rhythm.
• Atropine: Used for bradycardia to increase heart rate by blocking acetylcholine receptors.
• Amiodarone: Treats ventricular fibrillation and is an important drug in emergency settings.

Antihypertensive Drugs

• Definition: Used to manage hypertension (HTN). Essential and secondary hypertension are the two main types.
• Drug Categories:
• ACE Inhibitors: Decrease blood pressure through vasodilation (suffix: -pril).
• Beta-Blockers: Decrease heart rate and blood pressure (suffix: -olol).
• Calcium Channel Blockers: Lower blood pressure by inhibiting calcium ion movement (suffix: -dipine).
• Diuretics: Promote fluid excretion to lower blood volume and pressure.
• Peripheral Vasodilators: Relax smooth muscle in blood vessels, reducing pressure.

Drugs for Hyperlipidemia

• Definition: High levels of cholesterol and triglycerides in the blood, leading to conditions like atherosclerosis.
• Drug Types:
• Statins: HMG-CoA reductase inhibitors that reduce cholesterol production (suffix: -statin).
• Fibric Acid Drugs: Lower triglyceride levels and raise HDL cholesterol.
• Niacin: Reduces lipoprotein levels and increases HDL cholesterol.
• PCSK9 Inhibitors: Prevent destruction of LDL receptors, thus lowering cholesterol levels.

Lifestyle Changes and Dietary Considerations

• Heart-Healthy Foods: Foods high in fiber (like oats) can help lower cholesterol levels, contributing to heart health. Supplements such as fish oil may also provide benefits in managing hyperlipidemia.
• Exercise: Regular physical activity is vital in managing cardiovascular health and preventing disease progression.