impact of cardiovascular drugs and its managment

seminar by suresh sir

1. Impact of Cardiovascular Drugs and its Managements Prof. Dr. A. Suresh M. Pharm., Ph. D. Principal , The Kaavery Pharmacy College, Mecheri , Salem - 636453. 9865704466 The Kaavery Pharmacy College

2. Cardiac Diseases and its Risk Factors Cardiac diseases are a leading cause of death globally . It is crucial to understand the risk factors and take preventive measures to protect your heart health. WHF , with its membership of more than 200 heart foundations , scientific societies , and patient organizations across more than 100 countries, is a committed partner to resuscitating progress on CVDs. The Kaavery Pharmacy College https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767706/#

3. Types of Cardiac Diseases 1 Coronary Artery Disease (CAD) Caused by plaque buildup in the arteries, leading to reduced blood flow to the heart. This can result in chest pain, shortness of breath, and even heart attack. 2 Heart Failure Occurs when the heart is unable to pump blood effectively, leading to fluid buildup in the lungs , legs, and abdomen. This condition can cause fatigue, shortness of breath, and swelling. 3 Arrhythmias Abnormal heart rhythm caused by problems with the electrical signals that control the heartbeat. This can cause palpitations, dizziness, and fainting. 4 Valvular Heart Disease The Kaavery Pharmacy College

4. Risk Factors for Cardiac Diseases Modifiable Risk Factors Non-Modifiable Risk Factors Gender Age Family History Ethnicity The Kaavery Pharmacy College Smoking High Cholesterol High Blood Pressure Diabetes Obesity Lack of Physical Activity Unhealthy Diet Stress

5. Smoking and Cardiac Diseases 1 Nicotine Damages the lining of blood vessels, increasing the risk of blood clots and narrowing of the arteries. 2 Carbon Monoxide Reduces the oxygen-carrying capacity of the blood, making it harder for the heart to pump blood throughout the body. 3 Other Chemicals Present in cigarette smoke can contribute to inflammation and damage to the heart muscle, increasing the risk of heart disease. The Kaavery Pharmacy College

6. High Cholesterol and Cardiac Diseases High Cholesterol Leads to plaque buildup in the arteries, narrowing them and hindering blood flow to the heart. Reduced Blood Flow Can cause chest pain, shortness of breath, and even heart attack. Damaged Heart Muscle Due to reduced blood flow, the heart muscle may become weakened and less efficient in pumping blood. The Kaavery Pharmacy College

7. High Blood Pressure and Cardiac Diseases Increased Blood Pressure Causes the heart to work harder to pump blood, which can damage the blood vessels and lead to other health issues. Strain on the Heart High blood pressure puts extra stress on the heart, increasing the risk of heart attacks and strokes. Damage to Blood Vessels Over time, high blood pressure can damage the blood vessels, making them more prone to plaque buildup and narrowing. The Kaavery Pharmacy College

8. Diabetes and Cardiac Diseases High Blood Sugar Damages blood vessels and increases the risk of plaque buildup, leading to coronary artery disease. Insulin Resistance Can increase the risk of high blood pressure and high cholesterol, further contributing to heart disease. Increased Inflammation Diabetes can trigger inflammation, which can damage the heart muscle and increase the risk of heart attacks and strokes. The Kaavery Pharmacy College

9. Cardiac Disease Causes: Cardiac disease, also known as heart disease, is a major health concern worldwide. It encompasses a wide range of conditions that affect the heart, including coronary artery disease, heart failure, and arrhythmias. The Kaavery Pharmacy College

10. Genetic Predisposition A family history of heart disease can significantly increase an individual's risk. This genetic predisposition plays a role in developing certain types of heart disease. 1 Inherited Factors Specific genes can influence cholesterol levels, blood pressure, and other factors that contribute to heart disease. 2 Family History A strong family history of heart disease, especially in close relatives, is a significant risk factor. 3 Genetic Testing Genetic testing can identify specific gene variants associated with an increased risk of heart disease. The Kaavery Pharmacy College

11. Lifestyle Choices Lifestyle factors contribute significantly to heart health. Unhealthy habits can increase the risk of heart disease. 1 Smoking Smoking damages blood vessels, leading to atherosclerosis and an increased risk of heart attack and stroke. 2 Diet A diet high in saturated and trans fats, cholesterol, and sodium can contribute to atherosclerosis and high blood pressure. 3 Physical Activity Lack of regular physical activity can increase the risk of obesity, high blood pressure, and high cholesterol, all contributing to heart disease. 4 Stress Chronic stress can increase the risk of heart disease by elevating blood pressure and heart rate.

12. Metabolic Conditions Metabolic conditions, such as diabetes and obesity, can increase the risk of developing heart disease. Diabetes Diabetes damages blood vessels, increasing the risk of atherosclerosis and heart disease. It also increases the risk of heart attack and stroke. Obesity Obesity increases the risk of diabetes, high blood pressure, and high cholesterol, all contributing to heart disease. Metabolic Syndrome Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, including high blood pressure, high cholesterol, and insulin resistance.

13. Symptoms of Cardiac Diseases Cardiac diseases encompass a range of conditions affecting the heart's structure and function. These diseases can lead to various symptoms, ranging from mild to severe, and can significantly impact a person's quality of life. The Kaavery Pharmacy College

14. Common Symptoms of Heart Disease 1 Chest Pain Chest pain can range from sharp and stabbing to a dull ache or tightness. 2 Shortness of Breath Feeling short of breath even with minimal exertion or while resting. 3 Irregular Heartbeat Noticing palpitations, fluttering, or a racing heart. 4 Fatigue and Weakness Feeling unusually tired, weak, or lacking energy. The Kaavery Pharmacy College

15. Chest Pain and Discomfort Inflammation of the sac surrounding the heart, causing sharp, stabbing pain that worsens with deep breaths or lying down. Chest pain can also arise from digestive issues, muscle strain, or anxiety. Angina Chest pain caused by reduced blood flow to the heart muscle, often triggered by exertion or stress. Pericarditis Other Causes The Kaavery Pharmacy College

16. Irregular Heartbeat Atrial Fibrillation (AFib) Rapid and irregular heartbeat in the upper chambers of the heart. Ventricular Tachycardia Rapid heartbeat originating in the lower chambers of the heart. Bradycardia Slow heart rate below 60 beats per minute. The Kaavery Pharmacy College

17. Fatigue and Weakness Heart Failure The heart's inability to pump blood effectively, leading to fatigue and weakness. Anemia A deficiency in red blood cells, reducing the oxygen-carrying capacity of the blood. Thyroid Disorders An underactive thyroid can cause fatigue and weakness due to slow metabolism. Sleep Disorders Lack of restful sleep can also contribute to fatigue and weakness. The Kaavery Pharmacy College

18. Swelling in the Legs and Feet 1 Heart Failure The heart's inability to pump blood effectively, leading to fluid buildup in the legs and feet. 2 Venous Insufficiency Weakened veins in the legs, causing blood to pool and leading to swelling. 3 Kidney Disease Kidney disease can cause fluid retention, resulting in swelling in the legs and feet. The Kaavery Pharmacy College

19. Cardiovascular Drug Managment Cardiovascular drugs are medications used to treat heart and blood vessel diseases. The Kaavery Pharmacy College

20. Medication Classification This guide provides a comprehensive overview of common medication categories, including their mechanisms of action, examples, side effects, and important notes. Understanding these categories can empower you to make informed decisions about your health and medication management. The Kaavery Pharmacy College

21. ACE Inhibitors 1 Mechanism of Action ACE inhibitors block the action of the angiotensin-converting enzyme, which is responsible for converting angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, meaning it narrows blood vessels and increases blood pressure. 2 Examples • ** benazepril** (Lotensin) • **captopril** (Capoten) • **enalapril maleate** (Vasotec) • **lisinopril** (Prinivil, Zestril) • **quinapri**l (Accupril) • **ramipril** (Altace) 3 Side Effects and Notes A dry, non-productive cough is a common side effect of ACE inhibitors. Don't use potassium supplements or salt substitutes without first asking your healthcare provider. The Kaavery Pharmacy College

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23. ARBs (Angiotensin II Receptor Blockers) Mechanism of Action ARBs block the action of angiotensin II by preventing it from binding to its receptors in blood vessels. This results in vasodilation and a decrease in blood pressure. Examples • ** candesartan cilexetil** (Atacand) • **eprosartan mesylate** (Teveten) • **irbesartan** (Avapro) • **losartan** (Cozaar) • **telmisartan** (Micardis) • **valsartan** (Diovan) The Kaavery Pharmacy College

24. Antiarrhythmics 1 Class I: Sodium Channel Blockers These drugs block sodium channels, which slows the rate of depolarization during phase 0 of the cardiac action potential. This reduces the conduction velocity of the heart . Q UINIDINE, LIDOCAINE, PROPAFENONE 2 Class II: Beta Blockers Beta blockers block the effects of adrenaline and noradrenaline on the heart, slowing the heart rate and reducing the force of contractions. 3 Class III: Potassium Channel Blockers These drugs prolong the action potential duration, which can help to control irregular heartbeats . AMIODARONE 4 Class IV: Calcium Channel Blockers Calcium channel blockers block the flow of calcium into heart muscle cells, which slows the heart rate and reduces the force of contractions. The Kaavery Pharmacy College

25. Beta Blockers Mechanism of Action Inhibit the angiotensin-converting enzyme, reducing the production of angiotensin II, a substance that narrows blood vessels. This leads to vasodilation and lower blood pressure. Examples • ** acebutolol HCl** (Sectral) • **atenolol** (Tenormin) • **betaxolol** (Kerlone) • **bisoprolol** (Zebeta) • **carvedilol** (Coreg) • **labetalol HCl** (Normodyne, Trandate) • **metoprolol succinate** (Toprol XL) • **metoprolol tartrate** (Lopressor) • **nadolol** (Corgard) • **nebivolol** (Bystolic) • **pindolol** (Visken) • **propranolol HCl** (Inderal) • **sotalol** (Betapace) • **timolol maleate** (Blocadren) Side Effects In some people, beta blockers can cause drowsiness. Call your healthcare provider right away if you have any of these side effects: chest pain, fainting or severe dizziness, slow, fast, or irregular heartbeat, swelling of your feet or ankles, unusual bleeding or bruising, unusual weight gain, wheezing or trouble breathing. The Kaavery Pharmacy College

26. Anticoagulants and Platelet Inhibitors MEDICATION CATEGORIES EXAMPLES Mechanism of Action SIDE EFFECTS AND NOTES Anticoagulants • **dalteparin sodium** (Fragmin) • **enoxaparin** (Lovenox) • **fondaparinux** (Arixtra) • **heparin sodium** • **warfarin** (Coumadin) Anticoagulants, commonly known as blood thinners, work by interfering with the blood clotting process. Here's a detailed look at their mechanisms: **Warfarin**: Inhibits the synthesis of vitamin K-dependent clotting factors (II, VII, IX, and X) in the liver. This reduces the blood's ability to form clots • **Warfarin**: May increase the risk of bleeding. It's important to monitor your INR (international normalized ratio) regularly to ensure the medication is working effectively and safely. Platelet inhibitors • **aspirin** • **cilostazol** (Pletal) • **clopidogril bisulfate** (Plavix) • **dipyramidamole** (Persantine) • **prasugrel** (Effient) • **ticlopidine** (Ticlid) Platelet inhibitors work by preventing platelets from clumping together, which is a key step in the blood clotting process. This helps to reduce the risk of blood clots forming in the arteries. • **Aspirin**: May cause stomach upset or bleeding. • **Clopidogrel**: May increase the risk of bleeding. It's important to talk to your doctor about any potential risks before starting this medication. The Kaavery Pharmacy College

27. Diuretics Mechanism of Action Increase the excretion of sodium and water from the body, reducing blood volume and, consequently, blood pressure. Examples • ** amiloride** (Midamor) • ** bumetanide ** ( Bumex) • ** chlorothiazide** (Diuril) • **ethacrynic acid** (Edecrin) • **furosemide** (Lasix) • **hydrochlorothiazide** (Esidrix, HydroDIURIL, Microzide, Oretic) • **indapamide** (Lozol) • **metolazone** (Mykrox, Zaroxolyn) • **triamterene** (Dyrenium) Side Effects Diuretics can cause extreme weight loss, light headedness, or increased blood pressure. The Kaavery Pharmacy College

28. Aldosterone Receptor Antagonists 1 Mechanism of Action Aldosterone receptor antagonists block the action of aldosterone, a hormone that promotes sodium retention and potassium excretion. This helps to lower blood pressure and reduce fluid retention. 2 Examples • **eplerenone** (Inspra) • **spironolactone** (Aldactone) 3 Side Effects Aldosterone receptor antagonists can cause hyperkalemia (high potassium levels in the blood), which can be dangerous. It's important to monitor your potassium levels regularly if you're taking these medications. The Kaavery Pharmacy College

29. Selection combination of drugs Managing hypertension effectively requires a multi-faceted approach, often involving a combination of medications. The selection of drugs and their combinations is crucial for achieving optimal blood pressure control while minimizing potential side effects. This presentation will delve into the recommended steps for initiating and adjusting antihypertensive therapy, highlighting key drug combinations and potential interactions to avoid. The Kaavery Pharmacy College

30. Initiating Antihypertensive Therapy 1 Step 1: Initiate Therapy The initial step in treating hypertension involves starting with a single drug. The JNC 8 Guidelines recommend either an ACE inhibitor or an ARB , or a thiazide diuretic . These medications are known for their effectiveness and safety in lowering blood pressure. 2 Step 2: Adjust Therapy If the target blood pressure is not achieved with the initial medication, a second drug is added. This typically involves combining an ACE inhibitor or ARB with a calcium channel blocker (CCB) or a diuretic . This combination provides a synergistic effect, enhancing blood pressure control. 3 Step 3: Further Adjustment If the target blood pressure remains unattainable even with two medications, a third drug is added. This usually involves combining an ACE inhibitor or ARB with a CCB and a diuretic. This triple combination therapy is often effective in achieving optimal blood pressure control. 4 Step 4: Advanced Therapy For individuals who do not achieve target blood pressure even when taking optimal doses of three drugs, an aldosterone antagonist is added to the regimen. This medication helps to further reduce blood pressure by blocking the effects of aldosterone, a hormone that contributes to hypertension. The Kaavery Pharmacy College

31. Antihypertensive Combinations to Avoid 1 Alpha or Beta Adrenergic Blockers with Clonidine Combining alpha or beta adrenergic blockers with clonidine can lead to antagonism of clonidine's action, potentially reducing its effectiveness in lowering blood pressure. 2 ACE Inhibitors + ARBs Combining ACE inhibitors and ARBs is generally not recommended as it can increase the risk of side effects without providing significant additional benefit in blood pressure control. 3 Verapamil or Diltiazem with Beta Blockers Combining verapamil or diltiazem with beta blockers can increase the risk of bradycardia (slow heart rate) and atrioventricular (AV) block, potentially leading to heart rhythm disturbances. 4 Methyldopa and Clonidine Methyldopa and clonidine belong to the same category of medications and combining them may not provide any additional benefit while increasing the risk of side effects. The Kaavery Pharmacy College

32. Understanding Drug Interactions Combination Potential Interaction Risk Beta Blockers + Diuretics Increased risk of developing hypokalemia (low potassium levels) Increased risk of arrhythmias (irregular heartbeat) ACE Inhibitors + Potassium-Sparing Diuretics Increased risk of hyperkalemia (high potassium levels) Increased risk of cardiac problems Calcium Channel Blockers + Grapefruit Juice Increased levels of calcium channel blockers in the blood Increased risk of side effects The Kaavery Pharmacy College

33. Personalized Approach to Hypertension Management Individualized Assessment Each patient's hypertension management plan should be tailored to their specific needs, considering factors such as age, medical history, and other medications they may be taking. Regular Monitoring Regular monitoring of blood pressure and other vital signs is essential to ensure that the treatment plan is effective and to identify any potential side effects. Lifestyle Modifications Lifestyle modifications, such as adopting a healthy diet, engaging in regular physical activity, and managing stress, can play a significant role in managing hypertension. Open Communication Open communication between the patient and their healthcare provider is crucial for effective hypertension management. Patients should feel comfortable discussing any concerns or questions they may have. The Kaavery Pharmacy College

34. Lifestyle Modifications and Cardiac Disease Lifestyle modifications play a crucial role in managing and preventing cardiac diseases. These changes can significantly impact heart health, reducing the risk of developing or worsening existing conditions. The Kaavery Pharmacy College

35. Diet and Nutrition Balanced Diet A balanced diet rich in fruits, vegetables, and whole grains can reduce cholesterol levels and lower blood pressure. Limit Processed Foods Processed foods, high in saturated fats, sugar, and sodium, can contribute to heart disease. Sodium Reduction A diet low in sodium helps maintain healthy blood pressure and reduces strain on the heart. Regular Meals Eating regular meals at consistent intervals helps regulate blood sugar levels and prevents sudden spikes that can impact heart health. The Kaavery Pharmacy College

36. Physical Activity 1 Regular Exercise Engage in at least 30 minutes of moderate-intensity aerobic activity most days of the week. 2 Strength Training Strength training helps build muscle mass, which can improve metabolism and reduce cardiovascular risk. 3 Active Lifestyle Incorporate physical activity into daily routines by taking the stairs, walking or cycling instead of driving short distances. The Kaavery Pharmacy College

37. Stress Management Identify Stressors Understanding the sources of stress in your life is the first step towards managing them. Relaxation Techniques Practices like yoga, meditation, or deep breathing exercises can effectively reduce stress levels. Support Systems Building a strong support network of friends, family, or a therapist can provide emotional support and coping strategies. The Kaavery Pharmacy College

38. Cardiovascular Conditions During Pregnancy Pregnancy is a time of significant physiological changes, including those affecting the cardiovascular system. Understanding the unique challenges posed by cardiovascular conditions during pregnancy is crucial for ensuring the well-being of both mother and baby. The Kaavery Pharmacy College

39. Physiological Changes in the Cardiovascular System During Pregnancy 1 Increased Blood Volume Pregnancy results in a significant increase in blood volume, putting extra strain on the heart. 2 Heart Rate Changes The heart rate increases during pregnancy to accommodate the increased blood volume. 3 Cardiac Output Increase The amount of blood pumped by the heart per minute, known as cardiac output, rises during pregnancy. 4 Blood Pressure Adjustments The body adjusts blood pressure to maintain proper blood flow to the placenta and the baby. The Kaavery Pharmacy College

40. Diagnosis and Monitoring of Cardiovascular Conditions Medical History A thorough medical history is essential to identify any preexisting cardiovascular conditions. Physical Examination A physical examination, including listening to the heart and measuring blood pressure, helps assess cardiovascular health. Diagnostic Tests Electrocardiograms (EKGs), echocardiograms, and other tests can help diagnose and monitor cardiovascular conditions. The Kaavery Pharmacy College

41. Risks and Complications of Cardiovascular Conditions in Pregnancy Premature Birth Cardiovascular conditions can increase the risk of preterm labor and delivery. Low Birth Weight Babies born to mothers with cardiovascular conditions may have a lower birth weight. Heart Failure Pregnancy can worsen existing heart failure, leading to complications for both mother and baby. Stroke Cardiovascular conditions can increase the risk of stroke during pregnancy. The Kaavery Pharmacy College

42. Management and Treatment Options Medications Some cardiovascular conditions may require medication to manage blood pressure, heart rate, or other symptoms. Lifestyle Modifications Healthy lifestyle choices, such as diet and exercise, can help manage cardiovascular health during pregnancy. Monitoring Regular monitoring by healthcare providers is crucial to ensure early detection and management of any complications. The Kaavery Pharmacy College

43. Heart Health: Do's & Don'ts Living with cardiac disease requires careful attention to lifestyle choices. Following a heart-healthy lifestyle is crucial for managing the condition and improving overall well-being. This presentation will provide you with practical Do's and Don'ts to help you navigate your journey to a healthier heart. The Kaavery Pharmacy College

44. Do's: Diet and Nutrition 1 Eat Plenty of Fruits and Vegetables Fruits and vegetables are packed with essential vitamins, minerals, and antioxidants that can help lower blood pressure and cholesterol levels. 2 Choose Whole Grains Over Refined Grains Whole grains, such as brown rice, quinoa, and oats, are high in fiber, which helps regulate blood sugar levels and can lower cholesterol. 3 Lean Protein Sources Lean protein sources, such as fish, poultry, beans, and lentils, are good for your heart and provide essential nutrients. 4 Limit Saturated and Trans Fats Saturated and trans fats, found in red meat, butter, and processed foods, can raise LDL cholesterol levels, increasing your risk of heart disease. The Kaavery Pharmacy College

45. Do's: Exercise and Physical Activity 1 Start Slowly Begin with short, moderate-intensity exercises like brisk walking or swimming. 2 Gradually Increase Intensity As your fitness level improves, gradually increase the duration and intensity of your workouts. 3 Consistency is Key Aim for at least 30 minutes of moderate-intensity exercise most days of the week. The Kaavery Pharmacy College

46. Don'ts: Smoking and Alcohol Consumption Smoking Smoking damages your blood vessels, increasing the risk of heart attacks, strokes, and other cardiovascular diseases. Alcohol Consumption Excessive alcohol consumption raises blood pressure and can lead to heart rhythm problems and other heart health issues. The Kaavery Pharmacy College

47. Thank You Thank you for your time and attention. We value your interest and appreciate the opportunity to connect with you. The Kaavery Pharmacy College