Cardiac drugs: Difference between revisions

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The [[heart]] is very useful, and [[cardiology|cardiologists]] attempt to keep it that way. The drugs they use are below:
The [[heart]] is very useful, and [[cardiology|cardiologists]] attempt to keep it that way. The drugs they use are below:


==ACE inhibitors==
===ACE inhibitors===
====How they work====
ACE inhibitors inhibit the action of the ACE enzyme, reducing blood pressure. Common ones are '''ramipril''' and '''perindopril'''. They are used tp treat [[hypertension]]<ref>"Effects of ACE Inhibitors, Calcium Antagonists, and Other Blood Pressure lowering Drugs " by RB Thakkar and S Oparil - Current Hypertension Reports. Volume 3, Number 3, 227-228, DOI: 10.1007/s11906-001-0043-5</ref>. See the [[ACE inhibitors|ACE inhibitor page]] for more.
They inhibit the action of [[angiotensin converting enzyme]] (ACE). This prevents the [[renin-angiotensin]] loop from working, thus preventing peripheral constriction of blood vessels, and effectively lower [[blood pressure]].
====What are they used for====
They are commonly used to treat [[hypertension]] and [[heart failure]]. They are the [[Essential_hypertension#Management|first line treatment for white people under the age of 55]] with high blood pressure.  


====Common types and dose====
===Angiotension II receptor agonists===
*'''Ramipril''' 2.5–5mg OD (max 10mg)
Also known as ARBs, they work in a very similar way to ACE inhibitors, but are don't cause a dry cough. In time, they may replace ACE inhibitors as the first line treatment. More on them [[ACE inhibitors|here]].
*'''Perindopril''' 2-4mg OD


====Side effects====
===Antiarrhythmics===
They can have a negative effect on [[renal]] function, and should '''never be used on a patient with bilateral [[renal artery stenosis]]'''. They also shouldn't be used with potassium sparing [[diuretics]] as this can cause [[hyperkalaemia]].
 
Their key side effect is a '''characteristic dry tickling cough''', that won't go away. If patients get this, and can't cope with it, you need to take them off the drug, probably best to try them on a angiotensin-II receptor antagonist...
 
==Angiotension II receptor agonists==
Also known as ARBs (angiotensin II receptor blockers), they work in a very similar way to ACE inhibitors, but are don't cause the dry cough. In time, they way replace ACE inhibitors as the first line treatment.
====Common types and doses====
*'''Losartan''' 50mg OD, upto 100mg in hypertension.
*'''Candestartan''' 32mg OD.
 
==Antiarrhythmics==
There are a variety of [[antiarrhythmic drugs]] (possibly the hardest word to spell in the whole world).
There are a variety of [[antiarrhythmic drugs]] (possibly the hardest word to spell in the whole world).


The most well known are beta blockers and calcium channel blockers, however there are many more types. Visit the [[antiarrhythmics|page on antiarrythmics]] to find out more about them.
The most well known are [[amlodipine]], [[atropine]] and [[adenosine]], however there are many more types. Visit the [[antiarrhythmics|page on antiarrythmics]] to find out more about them.


===Beta blockers===
===Beta blockers===
[[Beta blockers]] make the heart pump slower and less hard. Common ones are '''propanolol''', '''bisoprolol''' and '''atenolol'''. They are mainly used to [[primary prevention of ischaemic heart disease|prevention of MIs]] and deal with [[tachyarrhythmias]]. See the [[beta blockers|beta blockers page]] for more.


===Calcium channel blockers===
===Calcium channel blockers===
[[Calcium channel blockers]] have a wider range of effects. Some, like '''verapamil''', make the heart pump slower and less hard. Others, like '''nifidipine''' mostly just dilate blood vessels in the heart and body, meaning they are used to treat [[angina]]. Find out more on the [[calcium channel blockers|calcium channel blockers page]].


==Diuretics==
===Diuretics===
[[Diuretics]] are used to control [[hypertension]], by reducing the amount of fluid in the body. They are so sexy that they have their [[diuretics|own page]]. Check it out!
[[Diuretics]] are used to control [[hypertension]], by reducing the amount of fluid in the body. They are so sexy that they have their [[diuretics|own page]]. Check it out!
===Nitrates===
These are used to treat [[angina]]. There are two main types, '''glyceryl trinitrate''' - well known in the GTN spray - and '''isosorbide dinitrate''', used sublingually and for prophylaxis. More on the [[nitrates]] page.
{{reflist}}

Latest revision as of 12:03, 14 April 2011

This dog is suffering from a persistent dry cough due his antihypertensive medication - rampril. It's probably time he was switched to an ARB instead.

The heart is very useful, and cardiologists attempt to keep it that way. The drugs they use are below:

ACE inhibitors

ACE inhibitors inhibit the action of the ACE enzyme, reducing blood pressure. Common ones are ramipril and perindopril. They are used tp treat hypertension[1]. See the ACE inhibitor page for more.

Angiotension II receptor agonists

Also known as ARBs, they work in a very similar way to ACE inhibitors, but are don't cause a dry cough. In time, they may replace ACE inhibitors as the first line treatment. More on them here.

Antiarrhythmics

There are a variety of antiarrhythmic drugs (possibly the hardest word to spell in the whole world).

The most well known are amlodipine, atropine and adenosine, however there are many more types. Visit the page on antiarrythmics to find out more about them.

Beta blockers

Beta blockers make the heart pump slower and less hard. Common ones are propanolol, bisoprolol and atenolol. They are mainly used to prevention of MIs and deal with tachyarrhythmias. See the beta blockers page for more.

Calcium channel blockers

Calcium channel blockers have a wider range of effects. Some, like verapamil, make the heart pump slower and less hard. Others, like nifidipine mostly just dilate blood vessels in the heart and body, meaning they are used to treat angina. Find out more on the calcium channel blockers page.

Diuretics

Diuretics are used to control hypertension, by reducing the amount of fluid in the body. They are so sexy that they have their own page. Check it out!

Nitrates

These are used to treat angina. There are two main types, glyceryl trinitrate - well known in the GTN spray - and isosorbide dinitrate, used sublingually and for prophylaxis. More on the nitrates page.

References

  1. ↑ "Effects of ACE Inhibitors, Calcium Antagonists, and Other Blood Pressure lowering Drugs " by RB Thakkar and S Oparil - Current Hypertension Reports. Volume 3, Number 3, 227-228, DOI: 10.1007/s11906-001-0043-5
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