Introduction.
Signs and Symptoms.
Types of CHF.
Classification .
Drugs used in CHF.
Mechanism of action.
Structure.
Adverse Drug Reactions and
Uses.
Reference
Chemistry of Anti Anginal Drugs by Professor BeubenzProfessor Beubenz
This presentation will give you an idea about the chemistry of Anti-anginal drugs along with its classification, mechanism of action & Structural Activity Relationship.
#Professor_Beubenz
For more such videos do
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https://www.youtube.com/watch?v=-7yjQm4zzX8&t=1183s
Calcium channel blockers - Medicinal chemistry for B.Pharm.Purna Nagasree K
This ppt describes about the drugs used as calcium channel blockers, their mechanism of action, metabolism and Structure activity relationship of dihydropyridines
A condition in which the heart is unable to pump sufficient blood
to meet the metabolic demand of the body and also unable to receive it back because every time after a systole.
Chemistry of Anti Anginal Drugs by Professor BeubenzProfessor Beubenz
This presentation will give you an idea about the chemistry of Anti-anginal drugs along with its classification, mechanism of action & Structural Activity Relationship.
#Professor_Beubenz
For more such videos do
#Subscribe
#Share
#Like
to the Channel Professor Beubenz
Thank You.
https://www.youtube.com/watch?v=-7yjQm4zzX8&t=1183s
Calcium channel blockers - Medicinal chemistry for B.Pharm.Purna Nagasree K
This ppt describes about the drugs used as calcium channel blockers, their mechanism of action, metabolism and Structure activity relationship of dihydropyridines
A condition in which the heart is unable to pump sufficient blood
to meet the metabolic demand of the body and also unable to receive it back because every time after a systole.
Introduction of Steroids
Nomenclature
Sex Hormones
Biosynthesis of sex hormones
Structure, synthesis of Testosterone, Oestriol, Oestradiol, Diethyl stilbestrol, Progesterone
Reference
Introduction.
Classification .
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Mechanism of action .
Structure
Synthesis
Adverse Drug Reactions .
Uses.
Reference
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Nomenclature
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Biosynthesis of sex hormones
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Reference
Introduction.
Classification .
Drugs used in Coagulant and Anticoagulant Agents
Mechanism of action .
Structure
Synthesis
Adverse Drug Reactions .
Uses.
Reference
Med chem lecture on Anticholinergic drugs for B.Pharm level in Nepal
Content from Foye's Principle of medicinal chemistry, my own thoughts and some articles
A condition in which the heart is unable to pump sufficient blood to meet the metabolic demand of the body and also unable to receive it back because every time after a systole.
This Slideshare includes the introduction of congestive heart failure, signs and symptoms, pathogenesis, epidemiology, etiology, pathophysiology, classification of drugs which is used to manage CHF, and recent drugs used to manage CHF.
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Introduction
Limit Test for Chlorides
Limit Test for sulphates
Limit Test for Heavy metals
Limit Test for Iron
Limit Test for Arsenic
Limit Test for Lead
Reference
Learning objectives
Introduction
Complexing agents
Complexing Titration using EDTA
Need for Maintenance of pH
pH Indicators used in complexometric Titrations
Types of EDTA Titration
Factors Influencing EDTA reaction
Masking and demasking agents
Conclusion
Reference
Learning objectives
Introduction
Types of solvents
Acidimetry in non aqueous medium
Alkalimetry in non aqueous medium
Estimation of Sodium benzoate and Ephedrine HCl
Applications of non aqueous titrations in pharmacy
Conclusion
Reference
Learning objectives
Introduction
Preparation of a standard solution used for redox titration
Oxidizing and reducing agents used in volumetric analysis
N/10 potassium permanganate preparation
N/10 potassium dichromate preparation
N/10 Iodine solution preparation
Examples of redox titrations
Conclusion
References
Learning objectives
Introduction
Conditions For Volumetric Analysis
Terms In Volumetric Analysis
Primary Standard
Methods Of Expressing Concentrations In Volumetric Analysis
Types of Titration Methods
Classification Of Titrimetric Or Volumetric Methods
Conclusion
References
Introduction
error, accuracy, precision
Source of Errors
Types of Errors
Methods of minimizing errors
Test for rejection of data
Significant Level
Rounding of Figures
References
What is Pharmaceutical Chemistry
Introduction of Inorganic chemistry
What are Inorganic Compounds ??
Importance of Inorganic Pharmaceuticals Inorganic Chemistry ??
Difference between Organic Chemistry and Inorganic Chemistry
Definitions
Introduction.
Methods of Administration of Local Anaesthetics
Classification .
Drugs used in local anaesthetics.
Mechanism of action and SAR.
Structure and Synthesis.
Adverse Drug Reactions and Uses.
Reference
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Types of Diabetics Mellitus
Insulin and Insulin Preparations
Oral Hypoglycaemic Agents
Classification .
Drugs used in Anti-Diabetic agents
Mechanism of action .
Structure
Synthesis and SAR
Adverse Drug Reactions .
Uses.
Reference
Introduction.
Causes of Erectile dysfunction
Drugs used for Erectile dysfunction
Mechanism of action .
Structure
Adverse Drug Reactions .
Uses.
Reference
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1. 3rd UNIT
DRUGS USED IN
CONGESTIVE HEART FALIURE
Prepared by
G. Nikitha, M.Pharmacy
Assistant Professor
Department of Pharmaceutical Chemistry
Sree Dattha Institute Of Pharmacy
Hyderabad
1
Subject: Medicinal Chemistry-II
Year: B.Pharmacy 3rd Year
Semister: 1st Semister
2. Contents
Introduction.
Signs and Symptoms.
Types of CHF.
Classification .
Drugs used in CHF.
Mechanism of action.
Structure.
Adverse Drug Reactions and
Uses.
Reference
2
3. Introduction
Congestive heart failure (CHF) is defined as the inefficiency of the
heart to pump sufficient amounts of oxygenated blood to the organs
of the body to meet their normal metabolic demands.
3
4. Signs and Symptoms
Signs
Lateral displaced apex beats.
Gallop rhythm (additional heart sound)
Heart murmurs (Indicates the presence of valvular defect)
Aortic stenosis (abnormal narrowing of heart valves)
Pleural effusion (Increased volume of pleural cavity)
Pleural cyanosis (decrease absorption of oxygen due to fluid
accumulation).
4
5. Symptoms
Paroxysmal nocturnal dyspnoea (night attacks of breathlessness).
Dysponea (shortness of breath)
Orthopnoea (increased breathlessness in lying posture)
Poor circulation results in dizziness, confusion, diaphoresis
(excessive sweating)
Tachycardia (increased heart rate)
Muscle fatigue
Pulmonary oedema (accumulation of blood or fluid in lungs)
Hepatomegaly (enlarged liver)
Cardiomegaly (enlarged heart)
5
6. Types of CHF
1. Based on the amount of cardiac output:
Low output cardiac failure
High output cardiac failure
2. Based on the side of heart effected:
Left sided cardiac failure
Right sided cardiac failure
6
7. Classification
Based on inotropic effects:
1. with positive inotropic effects:
a. Cardiac Glycosides: Digitoxin, Digoxin, Ouabain
b.Phosphodiesterase Inhibtors: Inamrinone, Levoimendan,
Milrinone
c. β-adrenergic agonist: Dobutamine, Dopamine, Dopexamine
7
8. 2. without positive inotropic effects:
a. Angiotension converting enzyme (ACE)inhibitor: Captopril,
Enalapril, Ramipril, Lisinopril
b. β-adrenergic receptor antagonist: Bisoprolol, Carvedilol,
Metorolol
c. Diuretics: Acetazolamide, Bumetanide, Hydrochlorothiazine,
Metolazone, Spironolactone
d. Vasodilators: Hydralazine, Isosorbide dinitrate, sodium
nitropruside, Nesiritide
8
10. Cardiac Glycosides
Cardiac Glycosides are naturally occurring drugs with positive
inotropic action.
They are also termed cardiotonics. Cardiac glycosides are obtained
from various sources.
10
12. General Mechanism of Action
ionic movements occurring during the normal contraction of cardiac
muscle are as follows:
1. Initially calcium ions enter into the cardiac myocytes via the voltage
sensitive L-type calcium channel.
2. Such influx stimulates the release of large amounts of calcium ions
from the sarcoplasmic reticulum (SR) and mitochondria of the
myocytes. This results in contraction of cardiac muscles.
12
13. 3. The contractile process is followed by removal of calcium ions.
This is achieved by two ways reuptake of calcium ions by
sarcoplasmic reticulum and mitochondria as well as by sodium or
calcium ion exchange pump located in the cell walls of myocytes
which allows entry of 3 sodium ions for each effluxing calcium
ions.
4. sodium or calcium ion exchange pump may increase the
intracellular sodium ion channel, which each time effluxes 3 sodium
ions and influxes 2 potassium ions.
13
14. Digitalis gets reversibly bound to the sodium or potassium ATPase
pump and inhibits its activity. This results in progressive
accumulation of intracellular sodium ions and loss of potassium
ions. Due to the deposition of intercellular sodium ions, sodium or
calcium exchange pump gets activated.
14
15. Sodium or calcium exchanger extrudes sodium ions in exchange for
calcium ions. Intracellular calcium ions levels are further increased
due to increase in calcium permeability via voltage sensitive L-type
calcium channels. Increase in calcium levels by these two
mechanisms triggers the release of calcium ions from the
sarcoplasmic reticulum and mitochondria. Digitalis also inhibits the
reuptake of calcium ions by sarcoplasmic reticulum. All these
effects ultimately increases calcium levels in the cytosol which
eventually triggers contractile process in the failing heart.
15
17. Properties:
Digoxin appears as clear to white crystals or white crystalline
powder, Odorless, Bitter taste, Practically insoluble in water, Very
soluble in ethanol, Freely soluble in pyridine; soluble in mixture
of chloroform and alcohol, More soluble in hot 80% alcohol
than gitoxin, Slightly soluble in dilute alcohol, chloroform.
Practically insoluble in ether, acetone, ethyl acetate, chloroform
17
18. Pharmacokinetics:
Oral, Intravenous, Intramuscular route of administration, about 13%
of a digoxin dose is found to be metabolized in healthy subjects.
Several urinary metabolites of digoxin exist,
including dihydrodigoxin and digoxigenin bisdigitoxoside.
Their glucuronidated and sulfated conjugates are thought to be
produced through the process of hydrolysis, oxidation, and
additionally, conjugation.
The cytochrome P-450 system does not play a major role in digoxin
metabolism, nor does this drug induce or inhibit the enzymes in this
system, excreted by kidneys in larger amounts i.e nearly 70% in an
unchanged form.
18
19. Adverse Drug Reactions:
Dizziness, Depression, Confusion, Anxiety
Nausea, Vomiting, Diarrhea
Head ache
Rashes, weakness
Irregular Heart rate
Blurred vision
Therapeutic Uses:
Used in the treatment of heart failure, used to relieve symptoms of
heart failure when the patient does not responding to ACE inhibitor
and diuretics.
It reduces the heart rate and increase the cardiac output.
19
21. Properties:
White or pale buff microcrystalline powder, Odorless, Bitter taste,
slightly soluble in water, very soluble in ethanol, soluble in ethyl
ether, chloroform, methanol, pyridine
Pharmacokinetics:
Oral route of administration, absorption of digitoxin is decreased
by the presence of food in stomach.
21
22. Adverse Drug Reactions:
Dizziness, Anxiety
Nausea, Vomiting
Diarrhea
Head ache
Rashes, weakness
Irregular Heart rate
Visual problems
Low platelet count
Therapeutic Uses:
Used in the treatment of heart failure
Used to treat certain types of irregular heart beat can decrease the
risk for blood clots that may reduce the risk for heart attacks
22
24. General Mechanism of Action
Vasodilators work on different substances in the body to help widen
(dilate) blood vessels. It is easier for the heart to pump blood if the
blood vessels are widened.
Vasodilators can improve heart failure symptoms by:
Dilating coronary arteries. This can help more blood reach your
heart muscle.
Dilating leg veins. This can lower the amount of blood returning to
the heart and limit the buildup of fluid in your lungs.
Dilating systemic arteries. Systemic arteries are blood vessels that
carry blood to the rest of the body (excluding the heart and lungs).
By dilating these arteries, vasodilators may relieve some of the
work your heart needs to do.
Dilating pulmonary arteries. Dilating the arteries of the lungs
(pulmonary arteries) also reduces the amount of work your heart
needs to do.
24
26. Properties:
White- to off-white lyophilized powder, Bitter taste, Practically
insoluble in water, Very soluble in ethanol
Pharmacokinetics:
Intravenous route of administration, Nesiritide undergoes
proteolytic cleavage of the peptide by endopeptidases, such as
neutral endopeptidase, which are present on the vascular lumenal
surface. Human BNP is cleared from the circulation via the
following three independent mechanisms, in order of decreasing
importance:
1) binding to cell surface clearance receptors with subsequent cellular
internalization and lysosomal proteolysis;
2) proteolytic cleavage of the peptide by endopeptidases, such as
neutral endopeptidase, which are present on the vascular lumenal
surface; and 3) renal filtration
26
27. Adverse Drug Reactions:
Head ache, Nausea, Vomiting
Rashes, Itching
Hypotension, Sweating
Anemia, Confusion
Cough
Increase creatinine
Injection side reactions
Therapeutic Uses:
It will relax and dilutes blood pressure, lowering blood pressure
improve the breathing in people with CHF.
27
29. Pharmacokinetics:
Intravenous route of administration, metabolized in liver,
eliminated through urine
Adverse Drug Reactions:
Nausea
Head ache
Hypotension
Therapeutic Uses:
Used in the treatment of heart failure
Used to improve cardiac output
29
31. Pharmacokinetics:
Oral route of administration, metabolized in liver, eliminated
through urine .
Adverse Drug Reactions:
Dizziness
Allergic reaction
Swelling
Therapeutic Uses:
It is used treat high blood pressure, It acts as a vasodilator and was
designed as a therapy for patients with acute heart failure.
31
32. Reference books
Text book of Medicinal chemistry volume-1-3rd edition by
V.Alagarasamy.
Text book of Medicinal chemistry volume-2-3rd edition by
V.Alagarasamy.
Medicinal chemistry by Rama Rao Nadendla.
Medicinal and Pharmaceutical Chemistry by Harkishan Singh, V.K
Kapoor.
Wilson and Gisvolid’s Textbook of Organic Medicinal and
Pharmaceutical chemistry-12th edition by John M. Beale, John. H.
Block.
32