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Drugs action on Cardiovascular system

Dugs acting 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

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