Drugs act on cardiovascular system (2).pptx

Medication administration

1. Drugs act on cardiovascular system By:-Mohammed A

2. Cardiovascular system Is a network of organs and vessels responsible for Pumping and Circulating blood throughout the body. It includes The heart, Blood vessels, and Blood itself.

3. Cont.… It delivering Oxygen Nutrients Hormones to tissues and organs Removing waste products from the body.

4. Cont.…. Drugs that act on the cardiovascular system are designed to modify the Function of the heart, Blood vessels, or Blood in order to treat various cardiovascular conditions.

5. Cont.… These drugs can have a wide range of effects, including Lowering blood pressure Regulating heart rhythm Improving blood flow Reducing the risk of blood clots.

6. Cont.… These drugs are used to manage conditions such as Hypertension (high blood pressure) Heart failure Angina (chest pain) Arrhythmias (irregular heart rhythms) Other cardiovascular disorders.

7. Classification of Drugs Act On Cardiovascular System Beta-blockers Calcium channel blockers ACE inhibitors Diuretics Antiarrhythmic drugs

8. Beta-blockers B eta refers to beta-adrenergic receptors . These receptors are proteins found on the surface of cells in various tissues, including the Heart, Blood vessels, and Lungs.

9. Cont.… When adrenaline (epinephrine) binds to these beta receptors, it triggers a series of physiological responses, such as Increasing heart rate, Constricting blood vessels, and Dilating airways.

10. Common Beta Blockers Atenolol Metoprolol Propranolol

11. Metoprolol Injection, 1 mg/ml, 05ml/ml Tablet, 50 mg, 100 mg, 200 mg Indications: Angina pectoris, Hypertension, Acute myocardial infarction

12. Mechanism of Action Metoprolol works by selectively blocking beta-1 adrenergic receptors in the heart. This action reduces the effects of adrenaline on the heart, leading to a decrease in heart rate, blood pressure, and cardiac output .

13. Side Effects Fatigue, Dizziness, Low blood pressure, Slow heart rate, and Cold hands or feet

14. Serious Side Effects Worsening heart failure Bronchospasm in patients with asthma or chronic obstructive pulmonary disease (COPD), and Low blood sugar in diabetic patients.

15. Dose and Administration Hypertension: I.V. Initial : 1.25-5 mg every 6-12 hours ; Myocardial infarction: Acute : I.V.: 5 mg every 2 minutes for 3 doses in early treatment of myocardial infarction; thereafter , give 50 mg orally every 6 hours beginning 15 minutes after last I.V. dose and continue for 48 hours ; then administer a maintenance dose of 100 mg twice daily

16. Contraindications Severe bradycardia (slow heart rate), Heart block, Cardiogenic shock, and Decompensated heart failure. Severe allergic reactions to beta blockers

17. Atenolol is a beta-blocker medication It works by blocking the effects of the hormone epinephrine, which can help reduce the workload on the heart.

18. Mechanisms of Action Blocks Beta Receptors Atenolol binds to and blocks beta-adrenergic receptors, preventing the effects of epinephrine and norepinephrine . Reduces Heart Rate By blocking beta receptors, atenolol decreases the heart's response to these hormones, resulting in a slower heart rate . Lowers Blood Pressure The reduced heart rate and decreased contractility of the heart muscle lead to lower blood pressure.

19. Cont.… Indication High blood pressure, Angina, and Certain heart rhythm disorders Side Effects Fatigue Cold Extremities Dizziness Breathing Difficulties Contraindications Bradycardia Heart Block Asthma/COPD

20. Drug Interactions Calcium channel blockers NSAIDS Diabetes medications Alcohol

21. Dosage and Administration Tablets, 50 mg, 100 mg Oral: Adult Angina pectoris: Oral: 50 mg once daily; may increase to 100 mg/day . Some patients may require 200 mg/day . Child: 0.8 to 1.5 mg/kg/day (maximum 2 mg/kg/day)

22. Propranolol is a widely-used beta-blocker medication that has been prescribed for over 50 years . It is effective in treating a variety of conditions, including high blood pressure, angina

23. Mechanism of Action Propranolol binds to and blocks beta-adrenergic receptors in the heart and other tissues . This reduces the heart's response to epinephrine, decreasing heart rate, contractility, and blood pressure. The reduced cardiac output leads to the desired therapeutic effects, such as lowering blood pressure and relieving angina symptoms.

24. Indications High blood pressure, Angina, Abnormal heart rhythms. Anxiety Migraines

25. Dosage and Administration Adult: Oral: Post-MI mortality reduction: Oral: 180-240 mg/day in 3-4 divided doses. Stable angina: Oral: 80-320 mg/day in doses divided 2-4 times/day . Initial: 80 mg once daily; maximum dose: 320 mg once daily

26. Common Side Effects Fatigue, Dizziness, Cold extremities, and Gastrointestinal disturbances.

27. Serious Adverse Effects Bronchospasm, heart block, hypoglycemia in diabetic patients.

28. Calcium Channel Blockers are a class of medications that work by blocking the entry of calcium ions into the muscle cells of the heart and blood vessels . This helps to Relax and dilate the blood vessels, Leading to improved blood flow and Reduced blood pressure.

29. Mechanism of Action Calcium channels are specialized pores in the cell membrane that allow calcium ions to flow into cells , triggering muscle contraction . Calcium channel blockers bind to and block these calcium channels , preventing calcium influx and muscle contraction. By relaxing the smooth muscle in blood vessel walls, calcium channel blockers cause vasodilation, reducing peripheral resistance and blood pressure.

30. Indication Hypertension Arrhythmias Angina

31. Side Effects Hypotension Edema Constipation

32. Some of Calcium channel blockers Treatment for hypertension Amlodipine 5mg po Bid for…. Nifedipine 20mg po Bid for ……

33. Diuretics are a class of medications that work by increasing the body's production and excretion of urine. By helping the body eliminate excess fluid, diuretics can provide relief and improve overall health . This comprehensive guide will explore the mechanism of action, types, therapeutic uses, and potential side effects and precautions associated with diuretic medications.

34. Mechanism of Action Work by interfering with the body's ability to reabsorb sodium and water in the kidneys. This leads to an increase in the amount of fluid excreted through urine, which in turn reduces overall fluid levels in the body.

35. Cont.… Different types of diuretics target specific segments of the nephron (the functional unit of the kidney). This allows for a more targeted approach to managing fluid balance and addressing various medical conditions. By increasing the excretion of sodium, diuretics indirectly promote the excretion of water, as the body attempts to maintain a balance between these two essential electrolytes.

36. Types of Diuretics Thiazide Diuretics They work by inhibiting the reabsorption of sodium and chloride in the distal convoluted tubule of the nephron. Loop Diuretics Loop diuretics, like furosemide and bumetanide, target the thick ascending limb of the nephron, blocking the reabsorption of sodium, potassium, and chloride . They are typically more potent than thiazide diuretics.

37. Cont.… Potassium-Sparing Diuretics Potassium-sparing diuretics, such as spironolactone work by inhibiting the reabsorption of sodium and the excretion of potassium in the collecting duct. This helps maintain potassium levels in the body . Osmotic diuretics ; Osmotic diuretics are substances that are filtered by the glomerulus but poorly reabsorbed by the renal tubules, leading to increased osmotic pressure in the renal tubules and increased excretion of water. Mannitol

38. Therapeutic Uses Hypertension Nephrolithiasis Edema and Fluid Retention Glaucoma

39. Side Effects Imbalances in electrolytes Like potassium, sodium, and magnesium, Which can lead to complications such as muscle cramps, fatigue, and heart rhythm disturbances. Increase the risk of developing gout By reducing the excretion of uric acid, leading to its accumulation in the body.

40. Diuretic Resistance Renal Dysfunction Impaired kidney function can reduce the effectiveness of diuretics, as the kidneys play a crucial role in the mechanism of action of these medications. High Sodium Intake Consuming a diet high in sodium can counteract the fluid-reducing effects of diuretics, as the body attempts to maintain a balance between sodium and water.

41. Thiazide Diuretics Thiazide diuretics are a class of medications commonly used to treat high blood pressure and edema (fluid retention ). They work by increasing the excretion of sodium and water in the kidneys, leading to a decrease in blood volume and a reduction in blood pressure

42. Hydrochlorothiazide (HCTZ) Tablet, 25mg Indication : Hypertension; Congestive heart failure and Contraindications : Hypersensitivity Anuria; Pregnancy

43. Cont.… Drug-interactions : furosemide, digoxin, NSAIDs . Dosage and administration: Children : 6 months: 2mg/kg/day in divided doses . Adult : Edema: 25-100mg/day in 1-2 doses; maximum: 200mg/day . Hypertension: 12.5-50mg/day: Elderly : 12.5-25mg once

44. Loop Diuretics Commonly used to treat conditions such as Heart failure, Liver disease, and Kidney disease, High blood pressure, where there is a need to reduce fluid retention.

45. Furosemide Elixir , 10 mg/ml Injection , 10 mg/ml in 2 ml ampoule Tablet , 40 mg, 80mg Indications : Edema of cardiac, Hepatic or renal origin, Oliguria due to renal failure;

46. Cont.…. Drug interactions: cephalosporin, NSAIDs, thiazide diuretics. Contraindications: patients with Precomatose states associated with liver cirrhosis, renal failure with anuria. Side effects: Hypokalemia,

47. Cont.… Dose and Administration: Edema: Oral: Adult : initially 40 mg daily on rising, maintenance, 20 mg daily or 40 mg on alternate days, may be increased to 80 mg daily in resistant oedema ; Child: 1 to 3 mg/Kg body weight daily (maximum 40 mg daily ). Acute Pulmonary edema: Slow IV injection: Adult : 20 to 50 mg, if necessary increase by 20 mg steps every 2 hours; Child : 0.5 to1.5 mg/kg body weight daily (maximum 20 mg daily ).

48. Cont.…. Hypertension : Oral : initially 40mg two times a day; the dosage being adjusted according to patient’s need. IV : hypertensive crisis in patients with normal renal function, IV 40 to 80mg. Hypertensive crisis accompanied by pulmonary edema or acute renal failure IV 100-200 mg .

49. Potassium-Sparing Diuretics are a class of medications that are used to help the body get rid of excess salt and water while retaining potassium. They work by interfering with the sodium-potassium exchange in the kidneys, which helps to increase the excretion of sodium and water while preventing the loss of potassium . This is in contrast to other diuretics, such as loop diuretics and thiazide diuretics, which can lead to potassium loss. are often used in combination with other diuretics to help maintain potassium levels in the body .

50. spironolactone Tablet , 25 mg, 100 mg Syrup, 5mg, 10mg, 25mg, 50mg,100mg/5ml Indications : Edema, ascites, Congestive heart failure Cautions: Renal and hepatic function impairment, Diabetes mellitus, Pregnancy

51. Cont.… Drug interactions: Angiotensin - converting enzyme (ACE) inhibitors, diuretics, digoxin, NSAIDs, warfarin. Contraindications: hyperkalemia, hypernatremia, pregnancy and breast-feeding.

52. Cont.… Side effects: Impotence, Gynaecomastia, Menstrual irregularities; Dose and Administration: Oral: Oedema: adult: 100 - 200 mg daily, increased if necessary to 400 mg daily in resistant oedema, usual Maintenance dose 75 - 200 mg daily.

53. Cont.… Child : initially 3 mg/kg body weight daily in divided doses . Adult: diagnosis , 400 mg daily for 3 - 4 weeks; preoperative management, 100 - 400 mg daily; if not suitable for surgery, lowest effective dose for long term maintenance .

54. Osmotic diuretics Osmotic diuretics are substances that are filtered by the glomerulus but poorly reabsorbed by the renal tubules, leading to increased osmotic pressure in the renal tubules and increased excretion of water.

55. Mannitol Injection , 20%, 25% Indications : reduction of increased intraocular pressure. Cautions: extravasation causes inflammation and thrombophlebitis . Dose and Administration : Adult: IV: 1.5-2 g/kg administered as a 20 % or 25% solution over a period of 30-60 minutes.

56. ACE inhibitors are a class of medications commonly used to treat conditions such as high blood pressure, heart failure, and kidney disease . They work by blocking the action of the angiotensin-converting enzyme, which is responsible for converting angiotensin I into angiotensin II. Angiotensin II is a potent vasoconstrictor that can increase blood pressure by narrowing blood vessels and promoting the retention of salt and water.

57. Side Effects Cough : Hyperkalemia : Hypotension: Kidney dysfunction: Angioedema:

58. Contraindications Pregnancy History of angioedema. Renal artery stenosis Hyperkalemia

59. Captopril Tablet, 12.5 mg, 25 mg, 50 mg, 100 mg Indications: Congestive heart failure, Hypertension, Myocardial infarction; Diabetic nephropathy. Cautions: Impaired renal function Coronary or cerebrovascular disease, Severe salt/volume depletion.

60. Cont.… Drug interactions : (ACE inhibitors are ‘potassium-sparing’ agents); aspirin, indomethacin and probably other NSAIDs, antacids, Digoxin Contraindications : hypersensitivity to ACE inhibitors

61. Enalapril Tablet , 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg. Indications : hypertension ; heart failure; asymptomatic left ventricular dysfunction.

62. Cont.… Dose and Administration: Adult : Oral : Congestive heart failure: Oral : Initial : 2.5 mg once or twice daily (usual range: 5-40 mg/day in 2 divided doses )

63. Antiarrhythmic drugs are a class of medications used to treat abnormal heart rhythms, also known as arrhythmias. These drugs work by restoring the heart's normal rhythm and preventing the occurrence of future arrhythmias. There are several different classes of antiarrhythmic drugs, each with its own mechanism of action and specific effects on the heart.

64. Class I antiarrhythmic drugs Class I antiarrhythmic drugs work by blocking sodium channels in the heart, which helps to slow down the conduction of electrical impulses and stabilize the heart rhythm. Examples of Class I antiarrhythmic drugs include lidocaine

65. Class II antiarrhythmic drugs are beta-blockers that work by blocking the effects of adrenaline on the heart, which helps to slow down the heart rate and reduce the force of contractions . Examples of Class II antiarrhythmic drugs include propranolol and metoprolol.

66. Class III antiarrhythmic drugs Class III antiarrhythmic drugs work by blocking potassium channels in the heart, which helps to prolong the duration of the action potential and stabilize the heart rhythm . Examples of Class III antiarrhythmic drugs include amiodarone

67. Class IV antiarrhythmic drugs are calcium channel blockers that work by blocking calcium channels in the heart, which helps to slow down the conduction of electrical impulses and stabilize the heart rhythm . Examples of Class IV antiarrhythmic drugs include Nifedipine

68. Nifedipine Capsule , 5 mg, 10 mg, 20 mg 30mg (s/r) Tablet , 10 mg, 20 mg,30mg, 40mg, 60mg, 90mg(m/r) Indications : hypertension and angina pectoris , Raynaud’s phenomenon.

69. Cont.… Cautions: Aortic stenosis or Hypertrophic obstructive cardiomyopathy; Angina Drug interactions: Other antihypertensive, Beta blockers Digoxin, (cimetidine, erythromycin, fluoxetine, ketoconazole)

70. Cont.…. Contraindications: Hypotension, Unstable angina or Acute myocardial infarction Side effects: Peripheral edema Dizziness Tachycardia, Constipation Dose and Administration: Oral: Adult : 10 to 20mg three times daily up to 180mg/day or 30 to 90mg sustained release once per day . Child : dosage has not been established