Cardiotonic and antiarrhythmic drugs

Name of drug Group of drug Mechanism of Pharmacological Indication Contrindication Side effects
(another name)- in action effects
latin
Digoxin (Lanoxin)– CARDIOTONIC DRUGS Increase of Ca2+ A.Cardiotonic effect Chronic heart failure Glycoside Disorders of the
Digoxinum CARDIAC ions concentration 1) Positive inotropic intoxication, heart conductivity
GLYCOSIDES inside the effect (strengthening shock, marked and rhythm:
DIGITALIS DRUGS myocardial cells and shortening of bradycardia, bradycardia, up to
→ binding of systole, increase of ventricular the heart
Ca2+ ions to cardiac output). 2) extrasystolia, stoppage,
troponine → Negative ischemic heart arrhythmia.
actomyosin chronotropic effect disease. Worsening of the
complex (prolonging of myocardial
formation → diastole, decrease of contractility.
myocardial cardiac rhythm). 3) Increase of HF
contraction Negative symptoms,
dromotropic effect retrosternal pain,
(decrease of myocardial
myocardial ischemia. Neuritis
conductivity) of the optic nerve
B.4) Positive (the change of
batmotropic effect normal vision).
(increase of
myocardial
excitability). C.
Improvement of
energy metabolism
in myocardium
(increase of ATP
content, increase of
lactic acid
utilization, decrease
of oxygen
 consumption by
myocardium C.
Diuretic effect
2. Corglycon – CARDIOTONIC DRUGS Increase of Ca2+ A.Cardiotonic effect acute heart failure Glycoside Disorders of the
Corgliconum CARDIAC ions concentration 1) Positive inotropic intoxication, heart conductivity
GLYCOSIDES inside the effect (strengthening shock, marked and rhythm:
LILY OF THE VALLEY myocardial cells and shortening of bradycardia, bradycardia, up to
→ binding of systole, increase of ventricular the heart
Ca2+ ions to cardiac output). 2) extrasystolia, stoppage,
troponine → Negative ischemic heart arrhythmia.
actomyosin chronotropic effect disease. Worsening of the
complex (prolonging of myocardial
formation → diastole, decrease of contractility.
myocardial cardiac rhythm). 3) Increase of HF
contraction Negative symptoms,
dromotropic effect retrosternal pain,
(decrease of myocardial
myocardial ischemia. Neuritis
conductivity) of the optic nerve
B.4) Positive (the change of
batmotropic effect normal vision).
(increase of
myocardial
excitability). C.
Improvement of
energy metabolism
in myocardium
(increase of ATP
content, increase of
lactic acid
utilization, decrease
of oxygen
consumption by
myocardium C.
 Diuretic effect D.
Sedative effect. E.
Anticonvulsive
effect

Digitoxin – CARDIOTONIC DRUGS Increase of Ca2+ A.Cardiotonic effect Chronic heart failure Glycoside Disorders of the
Digitoxinum CARDIAC ions concentration 1) Positive inotropic intoxication, heart conductivity
GLYCOSIDES inside the effect (strengthening shock, marked and rhythm:
DIGITALIS DRUGS myocardial cells and shortening of bradycardia, bradycardia, up to
→ binding of systole, increase of ventricular the heart
Ca2+ ions to cardiac output). 2) extrasystolia, stoppage,
troponine → Negative ischemic heart arrhythmia.
actomyosin chronotropic effect disease. Worsening of the
complex (prolonging of myocardial
formation → diastole, decrease of contractility.
myocardial cardiac rhythm). 3) Increase of HF
contraction Negative symptoms,
dromotropic effect retrosternal pain,
(decrease of myocardial
myocardial ischemia. Neuritis
conductivity) of the optic nerve
B.4) Positive (the change of
batmotropic effect normal vision).
(increase of
myocardial
excitability). C.
Improvement of
energy metabolism
in myocardium
(increase of ATP
content, increase of
lactic acid
utilization, decrease
of oxygen
 consumption by
myocardium C.
Diuretic effect
Strophanthin – CARDIOTONIC DRUGS Increase of Ca2+ A.Cardiotonic effect acute heart failure Glycoside Disorders of the
Strophanthinum CARDIAC ions concentration 1) Positive inotropic intoxication, heart conductivity
GLYCOSIDES inside the effect (strengthening shock, marked and rhythm:
STROPHANTHUS myocardial cells and shortening of bradycardia, bradycardia, up to
DRUGS → binding of systole, increase of ventricular the heart
Ca2+ ions to cardiac output). 2) extrasystolia, stoppage,
troponine → Negative ischemic heart arrhythmia.
actomyosin chronotropic effect disease. Worsening of the
complex (prolonging of myocardial
formation → diastole, decrease of contractility.
myocardial cardiac rhythm). 3) Increase of HF
contraction Negative symptoms,
dromotropic effect retrosternal pain,
(decrease of myocardial
myocardial ischemia. Neuritis
conductivity) of the optic nerve
B.4) Positive (the change of
batmotropic effect normal vision).
(increase of
myocardial
excitability). C.
Improvement of
energy metabolism
in myocardium
(increase of ATP
content, increase of
lactic acid
utilization, decrease
of oxygen
consumption by
myocardium C.
 Diuretic effect
* Dobutamine ANTIARRHYTHMIC Stimulation of 1-HEART RHYTHM bradyarrhythmias, Chronic Neurotoxicity,
– Dobutaminum; DRUGS adrenoceptors inNORMALIZATION atrioventricular cardiac, renal increase of the
Dopamine (Intropin) DRUGS FOR heart, increase of blockade and hepatic cardiac
– Dopaminum TREATMENT cAMP and insufficiency insufficiency
BRADYARRHYTHMIAS calcium content in symptoms, the
-ADRENOMIMETICS cardiomyocytes. BP decrease
Amiodarone ANTIARRHYTHMIC Decrease of HEART RHYTHM Atrial tachycardia, Chronic Neurotoxicity,
(Cordarone) – DRUGS membrane NORMALIZATIONventricular cardiac, renal increase of the
Amiodaronum DRUGS FOR permeability for tachycardia , atrial and hepatic cardiac
TREATMENT K + ions → extrasystole, insufficiency insufficiency
TACHYARRHYTHMIAS repolarization ventricular symptoms, the
AGENTS PROLONGING prolonging. extrasystole, BP decrease
REPOLARIZATION supraventricular
paroxysmal
tachycardia, ,
hypertension
Verapamil (Izoptin) ANTIARRHYTHMIC Slow-down of HEART RHYTHM Atrial tachycardia Chronic Neurotoxicity,
–Verapamilum DRUGS cardiomyocytes NORMALIZATION atrial extrasystole cardiac, renal increase of the
DRUGS FOR depolarization due supraventricular and hepatic cardiac
TREATMENT to inhibition of paroxysmal insufficiency insufficiency
TACHYARRHYTHMIAS Ca2+ ions tachycardia symptoms, the
CALCIUM transport through , hypertension , BP decrease
ANTAGONISTS. the “slow” Ca- angina pectoris
POTASSIUM DRUGS canals (15),
increase of K+
ions content in
cardiomyocytes
Diltiazem ANTIARRHYTHMIC Block of Ca2+ Antianginal, Angina pectoris, cardiogenic dysfunctions of
(Cardizem) – DRUGS = ions flow inside coronarodilating, ; resistant to shock, severe the heart rate,
Diltiazemum ANTIANGINAL the decrease of oxygen nitrovasodilators congestive HF, hypotension,
DRUGS cardiomyocytes consumption by the acute period decrease of the
CALCIUM and smooth myocardium, ; of MI, heart myocardial
ANTAGONISTS muscles cells of antiarrhythmic, blockade, contractility
 CALCIUM the coronary antihypertensive hepatic and
ANTAGONISTS, vessels. effects renal
*,benzothiazepines insufficiency
Lidocaine – ANTIARRHYTHMIC Inhibition of HEART RHYTHM ventricular Chronic increase of the
Lidocainum DRUGS Na+ , K+ , Ca2+, NORMALIZATION tachycardia, cardiac, renal cardiac
DRUGS FOR Clions transport ventricular and hepatic insufficiency
TREATMENT through extrasystole, insufficiency symptoms, the
TACHYARRHYTHMIAS membranes of BP decrease
MEMBRANE cardiomyocytes
STABILIZERS
Sotalol – Sotalolum ANTIARRHYTHMIC Block of Na+ ions HEART RHYTHM Atrial tachycardia, Chronic increase of the
DRUGS transport during NORMALIZATION ventricular cardiac, renal cardiac
DRUGS FOR depolarization in tachycardia, and hepatic insufficiency
TREATMENT sinoatrial node; atrial extrasystole, insufficiency symptoms, the
TACHYARRHYTHMIAS decrease of ventricular BP decrease
-ADRENOBLOCKERS sympathetic extrasystole,
system influence supraventricular
on heart. paroxysmal
tachycardia,

Propranolol ANTIARRHYTHMIC Block of Na+ ions HEART RHYTHM ventricular Chronic increase of the
(Anaprilin) – DRUGS transport during NORMALIZATION tachycardia, cardiac, renal cardiac
Propranololum DRUGS FOR depolarization in atrial extrasystole, and hepatic insufficiency
TREATMENT sinoatrial node; cardiac fibrillation, insufficiency symptoms, the
TACHYARRHYTHMIAS decrease of hypertension, angina BP decrease
-ADRENOBLOCKERS sympathetic pectoris
system influence
on heart.
Potassium aspartate ANTIARRHYTHMIC increase of K+ HEART RHYTHM cardiac glycosides Chronic increase of the
and magnesium DRUGS ions NORMALIZATION intoxication, cardiac, renal cardiac
aspartate (Panangin, DRUGS FOR content in angina pectoris, and hepatic insufficiency
Asparcam) – TREATMENT cardiomyocytes bradyarrhythmias, insufficiency symptoms, the
Panangin, Asparcam TACHYARRHYTHMIAS atrioventricular BP decrease
CALCIUM blockade
 ANTAGONISTS.
POTASSIUM DRUGS

Antianginal antiatherosclerotic and drugs

Nitroglycerine ANTIANGINAL DRUGS Release of Antianginal, All kinds of angina the close-angle pulsatory,
(Sustac) - NITROVASODILATORS nitrogen oxide (II) coronarodilating, pectoris glaucoma, bursting
Nitroglycerinum → effects; decrease of (treatment and epilepsy, headache;
restoration of oxygen consumption prophylaxis), cerebral forms orthostatic
endothelial by myocardium, Myocardial of hypotension and
relaxing increase of infarction, pulmonary hypertension reflex
factor level. myocardium supply edema and cerebral tachycardia; the
with oxygen, bleedings. feeling of fever,
preferable decrease facial skin
of venous pressure, reddening.
* Isosorbide ANTIANGINAL DRUGS Release of Antianginal, All kinds of angina the close-angle pulsatory,
dinitrate (Isordil; NITROVASODILATORS nitrogen oxide (II) coronarodilating, pectoris glaucoma, bursting
Iso-Mik) - → effects; decrease of (treatment and epilepsy, headache;
Isosorbidi dinitras; restoration of oxygen consumption prophylaxis), cerebral forms orthostatic
Isosorbide endothelial by myocardium, Myocardial of hypotension and
mononitate (Imdur) - relaxing increase of infarction, pulmonary hypertension reflex
Isosorbidi factor level. myocardium supply edema and cerebral tachycardia; the
mononitras with oxygen, bleedings. feeling of fever,
preferable decrease facial skin
of venous pressure, reddening.
Molsidomine – ANTIANGINAL DRUGS Releases nitric Smooth muscle Myocardial the close-angle pulsatory,
Molsidominum NITROVASODILATORS oxide in relaxation, infarction, pulmonary glaucoma, bursting
smooth muscle, especially in vessels edema epilepsy, headache;
which • other cerebral forms orthostatic
activates guanylyl smooth muscle is of hypotension and
cyclase relaxed hypertension reflex
and increases but not as markedly and cerebral tachycardia; the
cGMP • vasodilation bleedings. feeling of fever,
decreases facial skin
 venous return and reddening.
heart size
• may increase
coronary flow
in some areas and in
variant
angina
Menthol (Validol) – ANTIANGINAL DRUGS dilates coronary coronarodilating Removal and lacrimation and
Mentholum; Medicines increasing the vessels by effect. prevention of attacks dizziness.
Validolum oxygen delivery to the reflex and of stable and unstable
myocardium increase the angina pectoris,
(coronarolytics) oxygen supply to acute myocardial
the myocardium infarction (MI),
by irritating the recovering therapy
mouth after MI. The
mucous complex
membrane therapy of acute and
receptors. chronic HF.

Ranolazine (Ranexa) ANTIANGINAL DRUGS Inhibits late Reduces cardiac Prophylaxis of angina nausea,
– Ranolazinum sodium current oxygen constipation,
in heart • also demand • fatty acid dizziness
may modify oxidation
fatty acid modification
oxidation at could improve
much higher efficiency of
doses cardiac oxygen
utilization
Ivabradine – ANTIANGINAL DRUGS reduction of heart Reduces cardiac Prophylaxis of angina nausea,
Ivabradinum Inhibitor of sinoatrial rate reduces oxygen constipation,
pacemaker; oxygen demand demand • fatty acid dizziness
oxidation
modification
could improve
 efficiency of
cardiac oxygen
utilization
Atorvastatin – DRUGS FOR Inhibition of Hypolipidemic Atherosclerosis, Pregnancy, Headache,
Atorvastatinum ATHEROSCLEROSIS cholesterol effect; decrease of hyperlipidemia lactation, child giddiness,
TREATMENT synthesis in the cholesterol, age, muscular atrophy
DRUGS AFFECTING liver. triglycerols, low myopathies; and pain,
LIPID METABOLISM density lipoproteins liver, kidneys nephropathy,
(HYPOLIPIDEMIC concentrations; and blood anaemia,
DRUGS) increase of high diseases hepatitis,
density thrombocytopenia
lipoproteins
concentrations in
blood.
Lovastatin – DRUGS FOR Inhibition of Hypolipidemic Atherosclerosis, Pregnancy, Headache,
Lovastatinum ATHEROSCLEROSIS cholesterol effect; decrease of hyperlipidemia lactation, child giddiness,
TREATMENT synthesis in the cholesterol, age, muscular atrophy
DRUGS AFFECTING liver. triglycerols, low myopathies; and pain,
LIPID METABOLISM density lipoproteins liver, kidneys nephropathy,
(HYPOLIPIDEMIC concentrations; and blood anaemia,
DRUGS) increase of high diseases hepatitis,
density thrombocytopenia
lipoproteins
concentrations in
blood.
Simvastatin – DRUGS FOR Inhibition of Hypolipidemic Atherosclerosis, Pregnancy, Headache,
Simvastatinum ATHEROSCLEROSIS cholesterol effect; decrease of hyperlipidemia lactation, child giddiness,
TREATMENT synthesis in the cholesterol, age, muscular atrophy
DRUGS AFFECTING liver. triglycerols, low myopathies; and pain,
LIPID METABOLISM density lipoproteins liver, kidneys nephropathy,
(HYPOLIPIDEMIC concentrations; and blood anaemia,
DRUGS) increase of high diseases hepatitis,
density thrombocytopenia
lipoproteins
 concentrations in
blood.
Fenofibrate – DRUGS FOR Activation of the Hypolipidemic Hypertriglyceridemia Pregnancy, Myopathy,
Fenofibratum ATHEROSCLEROSIS lipoprotein lipase effect; decrease of , lactation, child hepatic
TREATMENT in liver. the cholesterol, low HDL age, dysfunction
DRUGS AFFECTING triglycerols, low myopathies;
LIPID METABOLISM density lipoproteins liver, kidneys
(HYPOLIPIDEMIC concentrations; and blood
DRUGS) increase of high diseases
FIBRIC ACID density
DERIVATIVES lipoproteins
(FIBRATES) concentrations in
blood.
Clofibrate – DRUGS FOR Activation of the Hypolipidemic Hypertriglyceridemia Pregnancy, Myopathy,
Clofibratum ATHEROSCLEROSIS lipoprotein lipase effect; decrease of , lactation, child hepatic
TREATMENT in liver. the cholesterol, low HDL age, dysfunction
DRUGS AFFECTING triglycerols, low myopathies;
LIPID METABOLISM density lipoproteins liver, kidneys
(HYPOLIPIDEMIC concentrations; and blood
DRUGS) increase of high diseases
FIBRIC ACID density
DERIVATIVES lipoproteins
(FIBRATES) concentrations in
blood.
Ezetimibe – DRUGS FOR Blocks sterol Inhibits reabsorption Elevated LDL, Pregnancy, Low incidence
Ezetimibum ATHEROSCLEROSIS transporter of phytosterolemia lactation, child of hepatic
TREATMENT NPC1L1 in cholesterol excreted age, dysfunction,
DRUGS AFFECTING intestine brush in bile myopathies; myositis
LIPID METABOLISM border • decreases LDL and liver, kidneys
(HYPOLIPIDEMIC phytosterols and blood
DRUGS) diseases
STEROL ABSORPTION
INHIBITOR
Antihypertensive and hypertensive drugs
Magnesium sulfate - ANTIHYPERTENSIVE relax the smooth Spasmolytic effect Spasms of the smooth Hypotension, Headache and
Magnesii sulfas DRUGS muscles (myotropic muscles of the marked cardiac, hypotension up to
Peripheral vasodilating of the peripheral spasmolytics) internal organs hepatic collapse; HF
medicines vessels, that it is and renal
Spasmolytics connected to their insufficiency
direct myotropic
action on the
vascular wall.
Bendazol (Dibazol) ANTIHYPERTENSIVE Smooth muscles Decrease of BP, Hypertension, Hypotension, Headache and
– Dibazolum DRUGS relaxation due to spasmolytic , hypertensive crisis, marked cardiac, hypotension up to
Peripheral vasodilating phosphodiesterase sedative, moderate hypertension hepatic collapse; HF
medicines inhibition and immuno-stimulative combined with and renal
Spasmolytics cAMP effects. angina insufficiency
accumulation pectoris
Enalapril – ANTIHYPERTENSIVE Inhibition of ACE Decrease of BP Extremely severe Hypotension, Headache and
Enalaprilum DRUGS hypertension, chronic marked cardiac, hypotension up to
ACE INHIBITORS renal failure; hepatic collapse; HF
hypertensive crisis, and renal
acute heart failure insufficiency
Lisinopril – ANTIHYPERTENSIVE Inhibition of ACE Decrease of BP Extremely severe Hypotension, Headache and
Lisinoprilum DRUGS hypertension, chronic marked cardiac, hypotension up to
ACE INHIBITORS renal failure; hepatic collapse; HF
hypertensive crisis and renal
insufficiency
Captopril (Capoten) ANTIHYPERTENSIVE Inhibition of ACE Decrease of BP Extremely severe Hypotension, Headache and
– Captoprilum DRUGS hypertension marked cardiac, hypotension up to
ACE INHIBITORS hepatic collapse; HF
and renal
insufficiency
* Losartan ANTIHYPERTENSIVE block of Decrease of BP Extremely severe Hypotension, Headache and
(Cazaar, Lozap) – DRUGS angiotensin hypertension marked cardiac, hypotension up to
Losartanum; ANGIOTENSIN receptors hepatic collapse; HF
Valsartan – RECEPTORS and renal
Valsartanum insufficiency
Nifedipine – ANTIHYPERTENSIVE Block vascular Reduce vascular Hypertension, angina Hypotension, Headache and
Nifedipinum DRUGS calcium resistance marked cardiac, hypotension up to
Amlodipine – CALCIUM channels > hepatic collapse; HF
Amlodipinum ANTAGONISTS, cardiac calcium and renal
channels insufficiency
* Bisoprolol – ANTIHYPERTENSIVE Block β1 Prevent sympathetic Hypertension • heart Hypotension, Headache and
Bisoprololum; DRUGS receptors; cardiac failure marked cardiac, hypotension up to
* Metoprolol – b-ADRENOBLOCKERS carvedilol stimulation • reduce • coronary disease hepatic collapse; HF
Metoprololum; also blocks α renin and renal
Carvedilol – receptors; secretion insufficiency
Carvedilolum nebivolol also
releases nitric
oxide
* Doxazosin – ANTIHYPERTENSIVE Selectively block Prevent sympathetic Hypertension • Hypotension, Orthostatic
Doxazosinum; DRUGS α1 vasoconstriction • benign marked cardiac, hypotension
* Prazosin – α1-ADRENOBLOCKERS adrenoceptors reduce prostatic hyperplasia hepatic
Prazosinum prostatic smooth and renal
muscle tone insufficiency
Moxonidine – ANTIHYPERTENSIVE Imidazolin Decrease of BP, essential arterial
Moxonidinum DRUGS receptors sedative hypertension
IMIDAZOLIN stimulation,
RECEPTORS inhibition of
AGONISTS vasomotor center
activity, decrease
of central
sympathetic
pressor influence
on vessels
Clonidine ANTIHYPERTENSIVE Activate α2 Reduce central Hypertension • sedation
(Clophelin) – DRUGS adrenoceptors sympathetic clonidine • methyldopa
Clonidinum SYMPATHOPLEGICS, outflow • reduce also used in hemolytic anemia
Methyldopa – CENTRALLY ACTING norepinephrine withdrawal
Methyldopum release from from abused drugs
noradrenergic
 nerve endings
Reserpine – ANTIHYPERTENSIVE Blocks vesicular Reduces all Hypertension but psychiatric
Reserpinum DRUGS amine sympathetic effects, rarely depression,
SYMPATHETIC NERVE transporter in especially used gastrointestinal
TERMINAL BLOCKERS noradrenergic cardiovascular, and disturbances
nerves and reduce blood
depletes pressure
transmitter stores