This Presentation provides a general introduction to Cardiac Pharmacology, list of various Cardiac disorders and Drugs used to treat Cardiac disorders. An assignment for the subject, Advanced Pharmacology - I, 1st year M.Pharm, 1st semester.

1. ADVANCED
PHARMACOLOGY-I
“Cardiovascular
Pharmacology”
General Introduction
By,
Chetan A., M.Pharm 1st Year (Pharmacology)
K.K. College of Pharmacy
Chennai, Tamilnadu

2. Learning Objective
• Cardiovascular system
• Common terms in CVS
• Cardiovascular Pharmacology
• List of cardiac disorders
• List of Drugs to treat Cardiac disorders
• Recent Discovery
• Facts
• Reference

3. Cardiovascular System
The essential components of CVS are,
• Arteries (Leaving Heart with O2 blood)
• Capillaries (Arteries merge into Capillaries merge into Veinules)
• Veins (Returns to heart with O2-less blood)
• Portal Veins (blood from GIT, pancreas, gallbladder, Spleen to Liver)
• Heart (Pumping Machine)
• Coronary Arteries (O2 blood to Heart)
• Lungs (O2 supplier and CO2 remover)
• Systemic Circulation (Blood flow from heart to body to heart)
• Brian (Occasionally working machine)
• Kidney (Human Drainage System)
• Lympatic System (Part of Circulatory system and immune system)

4. Figure 1

5. Common Terms in CVS
• Cardiovascular (Circulatory) system – heart and blood vessels
• Arteries – transport blood to tissues
• Capillaries – sites of exchange, fluid O2, CO2, nutrients etc.
• Venules – collect blood from capillaries
• Veins – transport blood back to heart Blood moves within vessels –
higher pressure to lower pressure
• Resistance to flow depends on vessel diameter, length and viscosity
of blood

6. Cardiovascular Pharmacology
• Cardiovascular Pharmacology deals with the study of the effects of drugs upon the heart or
circulatory system.
• It mainly contributes to the safety profile of potential new drugs and provides
pharmacological data that can be used for optimization of further compounds and the
ultimate selection of compounds suitable for clinical development.
• The cardiac drugs affect the function of the heart in three main ways.
• They can affect the force of contraction of the heart muscle (inotropic effects), they
can affect the frequency of the heart beat or heart rate (chronotropic effects) or they
can affect the regularity of the heart beat (rhythmic effects).
• Drugs can also affect blood vessels by altering the state of compression of the smooth muscle
in the vessel wall, altering its diameter and accordingly directing the volume of blood stream.
Such medications are classified as vasoconstrictors or vasodilators depending on the smooth
muscle lining contraction and relaxation respectively.

7. Cardiovascular Pharmacology
These are some of the Cardiac Disorders:
• Angina
• Arrhythmias
• Edema
• Heart Failure
• Systemic Hypertension
• Pulmonary Hypertension
• Hypotension
• Myocardial Infarction
• Hyperlipidemia

8. Cardiac Disorders
• Angina:
A type of chest pain caused by reduced blood flow to the heart. Angina is
a symptom of coronary artery disease.It feels like squeezing, pressure,
heaviness, tightness or pain in the chest. It can be sudden or recur over time.
Depending on severity, it can be treated by lifestyle changes, medication,
angioplasty or surgery.
• Arrhythmia:
Improper beating of the heart, whether irregular, too fast or too slow.
Cardiac arrhythmia occurs when electrical impulses in the heart don't work
properly. There may be no symptoms. Alternatively, symptoms may include a
fluttering in the chest, chest pain, fainting or dizziness. If required, treatment
includes anti-arrhythmic drugs, medical procedures, implantable devices and
surgery.

9. Cardiac Disorders
• Edema:
Edema"is the medical term for swelling. Body parts swell from injury or
inflammation. It can affect a small area or the entire body. Medications, pregnancy,
infections, and many other medical problems can cause edema. Edema happens when
your small blood vessels leak fluid into nearby tissues.
• Cardiac Failure:
A chronic condition in which the heart doesn't pump blood as well as it should.
Heart failure can occur if the heart cannot pump (systolic) or fill (diastolic) adequately.
Symptoms include shortness of breath, fatigue, swollen legs and rapid heartbeat.
Treatments can include eating less salt, limiting fluid intake and taking prescription
medication. In some cases a defibrillator or pacemaker may be implanted.

10. Cardiac Disorders
• Systemic Hypertension :
Systemic Hypertension is high blood pressure in the systemic arteries - the
vessels that carry blood from the heart to the body's tissues (other than the lungs). High
systemic (or body) blood pressure is usually caused by the constriction of the small
arteries (arterioles).
• Pulmonary Hypertension :
Pulmonary hypertension (PH or PHTN) is a condition of increased blood
pressure within the arteries of the lungs. Symptoms include shortness of breath,
syncope, tiredness, chest pain, swelling of the legs, and a fast heartbeat. The condition
may make it difficult to exercise.

11. Cardiac Disorders
• Hypotension :
Hypotension is the medical term for low blood pressure (less than 90/60). A
blood pressure reading appears as two numbers. The first and higher of the two is a
measure of systolic pressure, or the pressure in the arteries when the heart beats and fills
them with blood
• Myocardial infarction :
A myocardial infarction (MI), also known as a heart attack, occurs when blood
flow decreases or stops to a part of the heart, causing damage to the heart muscle. The
most common symptom is chest pain or discomfort which may travel into the shoulder,
arm, back, neck or jaw.

12. Cardiac Disorders
• Hyperlipidemia :
Hyperlipidemia means your blood has too many lipids (or fats), such as
cholesterol and triglycerides. One type of hyperlipidemia , hypercholesterolemia, means
there's too much LDL (bad) cholesterol in your blood. This condition increases fatty
deposits in arteries and the risk of blockages.

13. Cardiovascular Pharmacology
The following are the drugs used to treat heart disorders
• Antianginal
• Antiarrhythmic
• Antihypertensive
• Cardioinhibitory
• Cardiostimulatory
• Diuretic
• Pressor
• Anticoagulants
• Fibrinolytics
• Thrombolytic (Anti-platelet)
• Vasoconstrictor
• Vasodilator
• Antiischemics
• Antihyperlipidemics
• Drugs for Heart failure
• Hematinics
• Coagulants

14. Classes of Drugs
• Antianginal - An antianginal is a drug used in the treatment of angina pectoris, a
symptom of ischaemic heart disease. Eg, Verapamil, Amlodipine
• Antiarrhythmic - Antiarrhythmic agents, also known as cardiac dysrhythmia
medications, are a group of pharmaceuticals that are used to suppress abnormal
rhythms of the heart, such as atrial fibrillation, atrial flutter, ventricular tachycardia,
and ventricular fibrillation. Eg, Quinidine, Procainamide
• Antihypertensive - Antihypertensives are a class of drugs that are used to treat
hypertension. Antihypertensive therapy seeks to prevent the complications of high
blood pressure, such as stroke and myocardial infarction. Eg, Valsartan, Captopril
• Diuretic - A diuretic is any substance that promotes diuresis, the increased
production of urine. This includes forced diuresis. There are several categories of
diuretics. All diuretics increase the excretion of water from bodies, although each
class does so in a distinct way. Eg, Furosemide, Hydrochlorthiazide

15. Classes of Drugs
• Anticoagulants - Anticoagulants are medicines that help prevent blood clots. They're
given to people at a high risk of getting clots, to reduce their chances of developing
serious conditions such as strokes and heart attacks. A blood clot is a seal created by
the blood to stop bleeding from wounds. Eg, Heparin, Warfarin
• Fibrinolytics - Fibrinolytics are the drugs that prevents blood clots from growing and
becoming problematic. The process is called as Fibrinolysis. Eg, Eminase, Streptase.
• Thrombolytic (Anti-platelet) - Thrombolytics are the drugs that are used to
breakdown of blood clots formed in blood vessels, using medication. It is used in ST
elevation myocardial infarction, stroke, and in cases of severe venous
thromboembolism. Eg, Urokinase, Alteplase
• Vasoconstrictor - Vasoconstrictors are the drugs that constricts the blood vessels and
thereby control tissue perfusion. They are added to LA to oppose the vasodilatory
action of local anesthetic agent. Eg, Amphetamines, Antihistamines

16. Classes of Drugs
• Vasodilator - Vasodilators are medications that open (dilate) blood vessels. They
affect the muscles in the walls of your arteries and veins, preventing the muscles
from tightening and the walls from narrowing. As a result, blood flows more easily
through your vessels. Eg, Nitroprusside, Nitroglycerin
• Antiischemics - These are the drugs that are used to treat ischemia (reduced blood
flow to tissues). Eg, Beta blockers, Calcium channel blockers
• Antihyperlipidemics - Hypolipidemic agents, cholesterol-lowering drugs or
antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the
treatment of high levels of fats, such as cholesterol, in the blood. Eg,
• Hematinics - A hematinic is a nutrient required for the formation of blood cells in the
process of hematopoiesis. The main hematinics are iron, B12, and folate. Deficiency
in hematinics can lead to anaemia.

17. Classes of Drugs
• Coagulants - These are the drugs cause the blood to changes from a
liquid to a gel, forming a blood clot. It potentially results in hemostasis,
the cessation of blood loss from a damaged vessel, followed by repair.
Eg, Vitamin K

18. Recent Discovery
• Novel Antiplatelet Agents in CardiovascularDisease - Maximilian Tscharre et,al. (2020)
Antiplatelet therapy reduces atherothrombotic risk and has therefore become a cornerstone in the
treatment of cardiovasculardisease. Aspirin, adenosine diphosphate P2Y12receptor antagonists,
glycoprotein IIb/IIIa inhibitors, and the thrombin receptorblocker vorapaxar are effective antiplatelet
agents but significantly increase the risk of bleeding. Moreover, atherothromboticevents still impair the
prognosis of many patients with cardiovascular disease despite established antiplatelet therapy. Over
thelast years, advances in the understanding of thrombus formation and hemostasis led to the discovery of
various new receptors and signaling pathways of platelet activation. As a consequence, many new
antiplatelet agents with high antithrombotic efficacy and supposedly only moderate effects on regular
hemostasis have been developed and yielded promising results in preclinical and earlyclinical studies.
Although their long journey from animal studies to randomized clinical trials and finally administration in
dailyclinical routine has just begun, some of the new agents may in the future become meaningful
additions to the pharmacologicalarmamentarium in cardiovascular disease.

19. Facts
• A heart will beat about 115,000 times each day.
• Heart pumps about 7,571 litres (approx.) of blood every day.
• The heart can continue beating even when it’s disconnected from the body.
• A man’s heart, on average, is 57 gram (approx.) heavier than a woman’s heart.
• Heart cells stop dividing, which means heart cancer is extremely rare.
• The first open-heart surgery occurred in 1893.

20. Reference
• Google Search
• Slideshare
• Wikipedia
• Journal of Cardiovascular Pharmacology and Therapeutics

21. Quote
• ~ “ Do not Dwell in the past, do not dream of the future,
concentrate the mind on the present moment”

22. Thank You