START WITH THE NAME OF

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

 2. Conversion of prothrombin to thrombin

Ca++ and Factor V
Prothrombin Thrombin
Activated Thromboplastin

 3. Conversion of Fibrenogen to fibrin

Plasma accelerator and Ca++
Fibrenogen Fibrin
Thrombin
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 Coagulants
 1. Vitamin K
Natural: Vit. K1 (Phytonadione), K2
Synthetic: Acetomenaphthone
 2. Fibrinolytic Inhibitors
Aminocaproic acid, Tranexamic acid
 3. Plasma Fractions
Factor VIII, Factor IX
Fibrenogen
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 Anti-coagulants
 1. Oral Anti-coagulants
Warfarin Na, Dicumarol
 2. Anti-Thrombin Drugs
Heparin, Enoxaprin
 3. Fibrolytic (Thrombolytic) Drugs
Streptokinase, Urokinase
 4. Anti-Thrombotic drugs
Aspirin, Sulfinpyrazone
 5. Extra-vascular Anti-coagulants
Drugs which remove Ca++ from blood e.g.
Citrates, Oxalates, Fluorides 15
 Anti-Anemics
 A. Drugs for iron deficiency anemia
1. Oral iron preprations
Ferrous sulfate, Ferrous gluconate,Ferrous fumarate,
ferrous succinate
 2. Parenteral iron preparations
Iron dextran, Iron-sorbitol
 B. Drugs for Megaloblastic anemia
1. Vit. B12 (Cyanocobalamin)
2. Folic acid
 C. Hematopoietic Growth factors
1. Erythropoietin
2. Interleukin-3
3. Stem cell factor 16