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2017 PNLE REVIEW MATERIALS FOR SALE

Friday, August 14, 2015

Common Cardiac Drugs


Common Cardiac Drugs
Drugs
Main effects
Mechanism
Sites of action
abciximab
anticoagulant stops platelet activation
monoclonal antibody to fibrinogen receptors
platelets
amiloride (combination with frusemide is frumil)
potassium sparing diuretic
plasmalemma sodium & chloride channels
kidney (distal tubules)
amiodarone
class III anti-arrhythmic
prolongs action potential duration
myocardium
aspirin
anticoagulant stops platelet activation
COX inhibitor, blocks TXA2 synthesis
platelets
atropine (sometimes used to stop vagus bradycardia)
parasympatholytic, increases heart rate
blocks muscarinic AcCh receptors
pacemaker cells (sino-atrial node)
captopril
reduces arterial blood pressure
ACE inhibitor
relaxes vascular smooth muscle
clopidogrel
anticoagulant stops platelet activation
blocks ADP receptor
platelets
digitalis and ouabain
increase cardiac contractility, delay AV node triggering
block Na / K ATPase raising intracellular sodium, then calcium
all tissues, but the Na/Ca exchanger is mainly in heart
dipyridamole (often used for X-ray imaging)
coronary vasodilation
inhibition of adenosine uptake
coronary vasculature
furosemide
diuretic
plasmalemma sodium & chloride channels
kidney (loop of Henle)
isoprenaline (and other adrenaline analogues)
increase cardiac contractility
beta agonist raises cyclic AMP
many tissues
losartan
reduces arterial blood pressure
angiotensin AT1 receptor blockade
relaxes vascular smooth muscle
lovastatin
reduces blood cholesterol levels
HMG-CoA reductase inhibitor
liver
morphine
pain relief (mainly)
opiate receptors
brain
nitroglycerine (and many other organic nitrates)
reduce cardiac work load
metabolised to NO
relaxes vascular smooth muscle
propranolol
reduces cardiac contractility, class II anti-arrhythmic
beta blocker lowers cyclic AMP
many tissues
quinidine, novocaine,lidocaine and other local anaesthetics
class I anti-arrhythmics
delay recovery of sarcolemma sodium channels after AP
myocardium
spironolactone (usually added to other diuretics)
reduces diuretic potassium losses
aldosterone antagonist
kidney (distal tubules)
urokinase (streptokinase is cheaper but antigenic)
dissolves blood clots (fibrinolytic)
activates plasminogen to plasmin (protease)
blood clots
verapamil, nifedipine and other dihydropyridines
reduce cardiac work load, class IV anti-arrhythmic
block sarcolemma calcium channels
myocardium; relax vascular smooth muscle
warfarin
anticoagulant
vit. K antagonist
blocks g-carboxy glutamate synthesis
liver
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