Drugs action on Cardiovascular system

A. Antihypertensive drugs:

1. Renin-angiotensin system inhibitors:
   • Angiotensin converting enzyme (ACE) inhibitors: Captopril, enalapril, lisinopril, perindopril, ramipril, benazepril, fosinopril
   • Angiotensin receptor blockers (ARBs): Losartan, candesartan, irbesartan, valsartan, telmisartan, olmesartan, eprosartan
   • Direct renin inhibitor: Aliskiren
2. Calcium channel blockers (CCBs):
   • Benzodiazepine: Diltiazem
   • Phenylalkylamine: verapamil
   • Dihydropyridines:Nifedipine, amlodipine, cilnidipine, nicardipine, benidipine, isradipine, felodipine, lacidipine, lercanidipine
3. Diuretics:
   • Thiazides and related agents: Hydrochlorothiazide, chlorthalidone, indapamide
   • Loop diuretics: Furosemide, bumetanide, torsemide
   • Potassium-sparing diuretics: Amiloride, triamterene, spironolactone, eplerenone
4. Sympatholytic agents:
   • Centrally acting sympatholytics: Clonidine, methyldopa
   • β-Adrenergic blockers: Atenolol, metoprolol, esmolol, betaxolol, propranolol, timolol
   • β-Adrenergic blockers with α-additional blocking activity: Labetalol, carvedilol, nebivolol
   • α-Adrenergic blockers:
     • Selective: Prazosin, terazosin, doxazosin
     • Nonselective: Phenoxybenzamine, phentolamine
   • Vasodilators:
     • Arteriolar dilators: Hydralazine, minoxidil, diazoxide, fenoldopam
     • Primarily venodilator: Nitroglycerin
     • Arteriolar and venodilator: Sodium nitroprusside

B. Antiandinal drugs:

1. Nitrates:
• Short acting: Nitroglycerin (glyceryl trinitrate), isosorbide dinitrate (sublingual)
• Long acting: Isosorbide mononitrate, isosorbide dinitrate (oral), erythrityl tetranitrate, pentaerythritol tetranitrate
2. β-Adrenergic blockers: Propranolol, metoprolol, atenolol, timolol, bisoprolol
3. Calcium channel blockers: Verapamil, diltiazem, nifedipine, felodipine, amlodipine, cilnidipine, nitrendipine nimodipine, lacidipine, lercanidipine
4. Potassium channel opener: Nicorandil
5. Others: Antiplatelet agents (low-dose aspirin, clopidogrel, prasugrel), Statins, Trimetazidine, Ranolazine, Ivabradine

C. Drugs for peripheral vascular diseases:

1. Rheological agent: Pentoxiphylline
2. Phosphodiesterase-3 inhibitor: Cilostazol
3. Antiplatelet drugs: aspirin, clopidogrel, ticlopidine
4. Antioxidants: Vitamin E
5. Vasodilators:
   • Direct acting: Cyclandelate, xanthinol nicotinate
   • β-Adrenergic adonists: Isoxsuprine
   • α-adrenergic blockers: Prazosin, phenoxybenzamine
   • Calcium channel blockers: Nifedipine, felodipine
   • Prostacyclin (PGI2)

D. Drugs for congestive heart failure:

1. Diuretics:
   • Loop diuretics: Furosemide, bumetanide, torsemide
   • Thiazide diuretics: Chlorothiazide, hydrochlorothiazide, metolazone
   • Aldosterone antagonists: Spironolactone, eplerenone
2. Vasodilators:
   • Arteriolar and venodilators:
     • ACE inhibitors: Enalapril, lisinopril, ramipril, fosinopril, trandolapril
     • Angiotensin receptor blockers (ARBs): Losartan, candesartan, valsartan, telmisartan
     • Direct renin inhibitor: Aliskiren
     • Sodium nitroprusside
   • Venodilators: Nitroglycerin, isosorbide dinitrate
   • Arteriolar dilators: Hydralazine, minoxidil, nicorandil
3. β-Adrenergic blockers: Metoprolol, bisoprolol, carvedilol, nebivolol
4. inotropic drugs:
   • Sympathomimetic amines: Dopamine, dobutamine
   • Cardiac glycosides: Digoxin
   • Phosphodiesterase 3 inhibitors: Inamrinone, milrinone
5. Vasopressin-receptor antagonists: Tolvaptan, conivaptan
6. Neprilysin inhibitor: Sacubitril
7. Brain natriuretic peptide (BNP): Nesiritide
8. Calcium sensitizer: Levosimendan

E. Antiarrhythmic drugs:

1. Class I - Na Channel Blockers (Membrane Stabilizing Agents):
   • IA: Drugs that moderately depress phase 0 depolarization – quinidine, procainamide, disopyramide.
   • IB: Drugs that have minimal effect on phase 0 depolarization – lignocaine, mexiletine.
   • IC: Drugs that markedly depress phase 0 depolarization – flecainide, propafenone.
2. Class II (β-Adrenergic Blockers): Propranolol, atenolol, esmolol, metoprolol, sotalol.
3. Class III (Drugs That Prolong Duration of Action Potential): Amiodarone, dronedarone, sotalol, dofetilide, ibutilide, bretylium.
4. Class IV (Calcium Channel Blockers (CCBs)): Verapamil, diltiazem.
5. Other Antiarrhythmic Agents: Digoxin, adenosine, atropine, isoprenaline, etc.
6. Drugs for paroxysmal supraventricular trachycardia (PSVT): Adenosine, digoxin