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