1)Arrhythmia- definition, types 2) Anti-Arrhythmic Drugs: [Study of the following category of medicinal compounds classification, chemical name, chemical structure (compounds with * mark) uses, stability and storage conditions, different types of formulation & their popular brand names] Quinidine Sulphate, Procainamide Hydrochloride, Verapamil, Phenytoin Sodium*, Lidocaine Hydrochloride, Lorcainide Hydrochloride, Amiodarone and Sotalol BP- Definition 3) Ranges of BP 4) Hypertension –Definition, classification 5) Anti-Hypertensive Agents: –Definition, [Study of the following category of medicinal compounds classification, chemical name, chemical structure (compounds with * mark) uses, stability and storage conditions, different types of formulation & their popular brand names] Propranolol*, Captopril*, Ramipril, Methyldopate Hydrochloride,Clonidine Hydrochloride, Hydralazine Hydrochloride, Nifedipine 6)Angina Pectoris-Definition 7) Anti-anginal Agents: Definition, Classification [Study of the following category of medicinal compounds classification, chemical name, chemical structure (compounds with* mark) uses, stability and storage conditions, different types of formulation & their popular brand names] Isosorbide Dinitrate

1. Presented by:- Shalini N. Barad
Lecturer,
Appasaheb Birnale College of Pharmacy

2.  Index
1) Arrhythmia- definition, types
2) Anti-Arrhythmic Drugs:
 [Study of the following category of medicinal compounds classification,
chemical name, chemical structure (compounds with * mark) uses, stability
and storage conditions, different types of formulation & their popular brand
names]
a) Quinidine Sulphate,
b) Procainamide Hydrochloride,
c) Verapamil,
d) Phenytoin Sodium*,
e) Lidocaine Hydrochloride,
f) Lorcainide Hydrochloride,
g) Amiodarone and
h) Sotalol

3. 3) BP- Definition
4) Ranges of BP
5) Hypertension –Definition, classification
6) Anti-Hypertensive Agents: –Definition,
[Study of the following category of medicinal compounds classification,
chemical name, chemical structure (compounds with * mark) uses,
stability and storage conditions, different types of formulation & their
popular brand names]
a) Propranolol*,
b) Captopril*,
c) Ramipril,
d) Methyldopate Hydrochloride,
e) Clonidine Hydrochloride,
f) Hydralazine Hydrochloride,
g) Nifedipine

4. 7.Angina Pectoris-Definition
8.Anti-anginal Agents: Definition, Classification
[Study of the following category of medicinal compounds
classification, chemical name, chemical structure (compounds with*
mark) uses, stability and storage conditions, different types of
formulation & their popular brand names]
a) Isosorbide Dinitrate

5.  Arrhythmia represents the irregular
heartbeat.
 During cardiac arrhythmia, the heart can
beat becomes too fast (tachycardia), too
slowly (bradycardia), or with an irregular
rhythm.

6. Normal rhythm heart beat

8. Types of Arrhythmias:

9. Anti-Arrhythmic drugs :
 Anti-Arrhythmic drugs are the medications
used for the treatment of arrhythmia.

10. CVS drugs are the agents having
action on heart muscle, blood vessels.
To improve cardiac activity & supply
sufficient qty. of blood to all parts of
body.
pharmacologically they are
categorized as-

11. C
lassification
of
Anti-
arrhythmia

12. 1. Quinidine Sulphate:
 Storage and stability:-
Darken on exposure to light, Store in WCTC amber
container.
 Uses:-
1. Treatment & prophylaxis of
a) Paroxysmal ventricular tachycardia
b) Cardiac arrhythmia
c) Extrasytolic atrial tachycardia.
2. In thyrotoxicosis.
3. Sinus rhythm
4. as alternative to Quinine in Malaria
 Brand name :- Phenipam, Natcardine

13.  Formulation: tablet, liquids, solution,
Injection, etc

14. 2. Procainamide Hydrochloride:
 Stability and Storage:It is stable in air but is
hygroscopic. Hence, it is stored in tightly-closed
containers.
 Uses:
1. For the treatment and prophylaxis of:
(a) Paroxysmal ventricular tachycardia.
(b) Cardiac arrhythmia including atrial fibrillation,
atrial flutter and prematuresystoles.
(c) Extrasystolic atrial tachycardia.

15. 2. In thyrotoxicosis in which fibrillation persists
after thyroidectomy.
3. To maintain sinus rhythm.
 Pharmaceutical Formulations:
 Procainamide Tablets LP.
 Procainamide Injection L.P.
 Brand names: Pronestyl, Procan

16. 3. Verapamil,
 Uses:
(1) Used for the prophylaxis of repetitive paroxysmal
supraventricular tachycardia,
(ii) It also used to treat hypertension,
(iii) Verapamil is used in the treatment of angina.
(iv) To control ventricular rate in patients with atrial
fibrillation or atrial flutter.
(v) It is used in the treatment of various
supraventricular tachyarrhythmias, including rapid
conversion to sinus rhythm.

17.  Storage : Store the medicine in a closed
container at room temperature, away from
heat, moisture, and direct light.
 Pharmaceutical Formulations :
1) Verapamil Hydrochloride prolong release
Tablets I.P
2) Verapamil Injection I.P.
3) Verapamil Tablets I.P.
 Brand name: Verelan, Covera, Calan

18. 4. Phenytoin Sodium:
• Molecular Formula: C15H12N2O2
• Structure:
 Chemical Name: 5,5-diphenylimidazolidine-
2,4-dione

19. • Uses:
1) Phenytoin is a medicine used to treat epilepsy.
2) It can also be used to treat trigeminal neuralgia.
3) For prophylactic management of Supra-
ventricular cardiac arrhythmias.
4) For prophylactic management of migraine
 Storage and stability: It is hygroscopic. Hence, it
is stored in tightly-closed containers.
 Formulations: Tablet, Capsule, Suspension,
Injection.
 Brands: Dilantin, Phenytek, and Epanutin.

20. 5. Lidocaine Hydrochloride:
 Uses:
1) It is indicated for the acute management of
ventricular arrhythmia.
2) It is also used as local anaesthetic.
 Stability and storage conditions: Lidocaine
hydrochloride is stable and is not oxidized
yair or oxygen. It is stored in tightly closed
container.

21.  Formulations:
 Lignocaine injection,
 Lignocaine eye drops
 Lignocaine gels
 Brand names:• Otek, Zingo, Xylocaine,
Lidoject

22. 6. Amiodarone
 Storage:Store protected from light, at a
temperature not exceeding 30°C.
 Uses:
i)Used in the treatment of Atrial Fibrillation.
ii)Used in the treatment of Supraventricular
Tachycardia (SVT),
iii) Used in the treatment of Recurrent
Ventricular fibrillation.
(iv) Used in the treatment of Recurrent
hemodynamically unstable Ventricular
tachycardia

23.  Pharmaceutical Formulations:
(1) Amiodarone Tablet LP.
(ii) Amiodarone Solution.
(i) Amiodarone Injection.
(iv) Amiodarone Liquid.
(v) Amiodarone IV infusion LP
 Brand Names: Nexterone and Pacerone.

24. 7. Lorcainide Hydrochloride:
 Uses:
1) It is used efficiently for the treatment of
ventricular arrhythmias.
2) It is also a local anaesthetic activity.
 Stability and storage conditions: It should
be stored in tightly closed containerdry and
dark place.
 Formulations: tablet.
 Popular brand names: Remivox. Lorivox

25. 8. Sotalol
 Uses:
1) to treat life threatening ventricular
arrhythmias.
2) to treat atrial fibrillation.
3) to treat flutter, atrial.
 Pharmaceutical Formulations :
1) Sotalol Tablet
2) Sotalol Injection, solution.
 Brand Names: Betapace, Sorine, Sotylize
and Sotagard.

26.  Stability and storage conditions: It
stored in closed temperature, away from
heat moisture.

27.  Hypertension : (HT) refers to the condition
in which the pressure in the blood vessels
is higher than normal range
 (systolic/diastolic blood pressure: 120/80
mm Hg).
 ANTIHYPERTENSIVE AGENTS
 Antihypertensive agents are the class of
drugs that are used for the treatment of
hypertension.

30.  Classification:
1) Drugs acting on Central Nervous System
(alter sympathetic activity)- eg Clonidine
( agonist)
2) Drugs affecting Nor-adrenaline pathway.
e.g. Methyldopa, and monoamino oxidase
inhibitors.
3) B-blockers e.g. Propranolol.
4) Direct Acting Vasodilators: Calcium
channel blockers e.g. Nifedipine.
5) Angiotensin converting enzyme inhibitors.
e.g. Captopril, Enalapril.

32. 1) Methyldopa :
 Storage :It is stored in tightly-closed, light-
resistant containers protected from moisture.
 Uses : It is used
(i) To control blood pressure in primary
(essential) hypertension.
(ii) To control renal hypertension.
(iii) To treat hypertension in pregnancy.
(iv) To reduce hot flushes in post menopausal
women.
(v) To treat pheochromocytoma and carcinoid
tumour.

33.  Pharmaceutical Formulation :
1) Methyldopa tablets I.P.
2) Methyldopa and hydrochlorthiazide
tablets I.P.
3) Methyldopa Injectable solution
 Brand Nmae: Emdopa, Meldopa, ALmet

34. 2. Clonidine Hydrochloride:
 Storage:It is stored in well-closed containers.
 Uses:
 (A) It is used:
1) To treat moderate primary hypertension.
2) To treat dysmenorrhoea.
3) For prophylaxis of migraine and cluster headache.
4) To treat postmenopausal vasomotor instability.
5) For management of opiate addiction.
 (B) It is vasodilator, decreases renin release and also
causes bradycardia.

35.  Pharmaceutical Formulations :
1) Clonidine tablets IP.
2) Clonidine injection IP.
3) Clonidine hydrochloride and chlorthalidone
tablet I.P.
 Brand Names: Hyperdine, Akramin.

36. 3. Hydralazine :
 Storage: It is stored in tightly-closed containers
protected from light, at a temperature not
exceeding 30°C.
 Uses:
 To treat moderate to severe hypertension
(usually given in combination with beta blockers
or diuretics
 For chronic control of essential hypertension.
 For acute control of hypertensive emergencies.
 (iv) To improve congestive heart failure.

37.  Pharmaceutical Formulations:
1) Hydralazine tablets.
2) (ii) Hydralazine injection IP.
 Brand Names: Hyperazine, Alazine
Mepresol.

38. 4. Nifedipine:
 Storage: Stored in tightly closed containers
protected from light.
 Uses : It is used to treat
1) (1) Hypertension: essential hypertension, renal
hypertension and hypertension in pregnancy
2) Ischaemic heart diseases like angina and
myocardial infarctions.
3) Atherosclerosis.
4) Raynaud's syndrome.
5) Exercise induced asthma.

39.  Pharmaceutical Formulations :
(i) Nifedipine capsules I.P.
(ii) Nifedipine prolong release capsules I.P.
(iii) Nifedipine prolong release tablets I.P.
(iv) Nifedipine tablets I.P.
 Brand Names: Myogard, Nicardia, Nefedin

40. 5. Captopril
 Structure:
 Chemical Name: 1-[(2S)-3-sulphanyl-2-methyl-
propanoyl] pyrrolidine-2-carboxylic acid.

41.  Storage: Store in tightly-closed containers
protected from moisture.
 Uses :
(A) It is used to treat :
(1) Mild to moderate essential hypertension.
(ii) Renal hypertension.
(iii) Refractory congestive heart failure.
(iv) Diabetic proteinuria.
(B) It also elevates mood in depressed
patient.

42.  Pharmaceutical formulation: Captopril
tablet I.P
 Brand name: Capoten

43. 6. Ramopril:
 Storage: Store at room temperature away from light
and moisture.
 Uses:
1) It is used to treat hypertension.
2) To treat heart attacks and kidney problems.
3) Ramipril is also used to improve survival after a heart
attack.
4) It may also be used in high risk patients (such as
patients with heart disease/ diabetes) to help prevent
heart attacks and strokes.
5) This is also be used to treat heart failure in patients
who have had a recent heart attack.
6) Ramipril is an ACE inhibitor and works by relaxing
blood vessels so that blood can flow more easily.

44.  Parmaceutical Formulations :
(i) Ramipril Tablets I.P.
(ii) Ramipril Capsules LP.
 Brand Names: Altace, Cardace, Ramipril,
Corpril and R.Pril.

45. Angina

48.  Angina: Angina Pectoris is a medical term for chest
discomfort or pain as a result of coronary heart disease.
 It occurs when the heart does not receive sufficient
blood, most probably due to one or more arteries of the
heart getting blocked.
 OR
 is chest pain or discomfort caused when your heart
muscle doesn't get enough oxygen-rich blood due to one
or more arteries of the heart getting blocked.
 VASODILATORS / ANTIANGINAL AGENTS
 The drugs used for the treatment of angina pectoris are
called ANTIANGINAL AGENTS

49.  Classification of ANTIANGINAL AGENTS
 Nitrates
1) Short acting: Glyceryl trinitrate,
2) Long acting: Isosorbide Dinitrate
1. Isosorbide dinitrate
 Uses:
1) It is indicated for the prevention and treatment of
angina due to coronary artery disease (CAD)
2) It is also indicated for the prevention and treatment
of congestive heart failure (CHF).
 Stability and storage conditions: It is stored in tight
closed amber colour container, protected from light.

50.  Formulations:
1) Dilute Isosorbide Dinitrate IP
2) Isosorbide Dinitrate Capsule IP
3) Isosorbide Dinitrate Tablet IP
 brand names: Anzidin, Cardicap, Olvisol,
Sorbitrate, Isordil, Ditrate