Cardiovascular disorders arrhythmias

The [ -adrenoreceptors antagonists (also called [)-blockers) comprise a group of chiral drugs that are mostly used in the treatment of cardiovascular disorders such as hypertension, cardiac arrhythmia, or ischemic heart disease. Teicoplanin is the chiral selector most exploited for the enantioseparation of this class of compounds, followed by vancomycin. Several P-blockers have been analyzed, particularly in the... 

Levothryoxine is contraindicated in thryotoxicosis but not in patients with a past history of myocardial infarction. Levothyroxine can cause palpitations, tachycardia, arrhythmias, restlessness, excitability and insomnia as side-effects. It should be used with caution in patients with cardiovascular disorders, including those with a past history of myocardial infarction a lower dose should be used as a starting dose. 

Cardiovascular effects Use with caution in patients with cardiovascular disorders including coronary insufficiency, ischemic heart disease, history of stroke, coronary artery disease, cardiac arrhythmias, CHF, and hypertension. 

Cardiovascular disorders Use with extreme caution in patients with cardiovascular disorders because of the possibility of conduction defects, arrhythmias, CHF, sinus tachycardia. Ml, strokes, and tachycardia. These patients require cardiac surveillance at all dose levels of the drug. In high doses, TCAs may produce arrhythmias, sinus tachycardia, conduction defects, and prolonged conduction time. Tachycardia and postural hypotension may occur more frequently with protriptyline. Hyperthyroid patients Hyperthyroid patients or those receiving thyroid medication require close supervision because of the possibility of cardiovascular toxicity, including arrhythmias. 

CCAs (channel blockers influx inhibitors) have been used primarily for the treatment of cardiovascular disorders (e.g., supraventricular arrhythmias, angina, and hypertension). Agents such as verapamil exert their effects by modulating the influx of Ca across the cell membrane, thus interfering with calcium-dependent functions. Based partly on the common effects of lithium and this class of drugs (e.g., effects on Ca "" activity), the CCAs have been studied as a potential treatment for mania. Janicak et al. (251) reported the results of a 3-week, double-blind comparison of verapamil versus placebo, which did not demonstrate a beneficial effect for verapamil (up to 480 mg/day) in 33 acutely manic hospitalized patients. 

A number of industrial chemicals have been linked to cardiotoxicity. Aldehydes and primary alcohols that can be metabolically oxidized to aldehydes have exhibited cardiodepressant effects. Acute exposure to ethanol has caused arrhythmia. Isopropyl alcohol (2-propanol), a widely used industrial chemical and personal care product, may cause cardiovascular depression and excessively rapid heartbeat. Some halogenated hydrocarbons, including chloroform, ethyl bromide, and trichlo-rofluoromethane, have been implicated in cardiovascular disorders, including arrhythmia. 

Thyroid disorders (hypothyroidism or hyperthyroidism) Cardiovascular disease (arrhythmias, congestive heart failure) Gastrointestinal disease or disorder (sprue or other malabsorption syndromes, peptic ulcer, cohtis)... 

Verapamil, proprietaiy name Calan, is a calcium channel blocker that is effective in the treatment of various cardiovascular disorders, including angina (classical and variant), arrhythmias (paroxysmal supraventricular tachycardia), atrial flutter, atrial fibrillation, hypertrophic cardiomyopathy (idiopathic hypertrophic subaortic stenosis), hypertension, congestive heart failure, and Raynaud s phenomenon, along with the preservation of ischemic myocardium and the treatment of migraine headaches. 

There are many disorders of the cardiovascular system and blood. Common cardiovascular disorders are cardiac failure, ischaemic heart disease, arrhythmias and hypertension. Although these conditions cannot be cured by drug therapy, there are many drugs available to help control them. Cardiac glycosides are useful in cardiac failure and arrhythmias because they improve myocardial contractility and slow conduction through the heart. 

Berberine has been used in the treatment of several heart diseases including hypertension and arrhythmia in folk medicine [46, 47]. Several pharmacological studies have shown the beneficial effects of berberine oti diverse cardiovascular disorders in animal and human, including prevention of ischemia-induced ventricular tachyarrhythmia, improvement of cardiac contractile function, and reductirMi of peripheral vascular resistance and blood pressure [48, 49]. Berberine has also positive inotropic, negative chronotropic, antiarrhythmic, vasodilator, and antiatherosclerosis properties [50]. 

Ruiz et al. [101] described a facile, efficient, and eco-friendly protocol for the synthesis of a wide variety of 6-chloro-5-formyl-l,4-dihydropyridines (127) under ultrasound condition compared with the conventional thermal method (Scheme 32). It is important to mention that 1,4-dihydropyridines are very attractive targets due to tiieir wide range of biological activities. These compounds are routinely used in the treatment of a variety of cardiovascular disorders such as hypertension, cardiac arrhythmias, or angina. 

An arrhythmia may occur as a result of heart disease or from a disorder that affects cardiovascular function. Conditions such as emotional stress, hypoxia, and electrolyte imbalance also may trigger an arrhythmia An electrocardiogram (ECG) provides a record of the electrical activity of the heart. Careful interpretation of the ECG along with a thorough physical assessment is necessary to determine the cause and type of arrhythmia The goal of antiarrhythmic drug therapy is to restore normal cardiac function and to prevent life-threatening arrhythmias. 

Use with caution in oider patients with Cardiovascular disease (CVD), especially angina, arrhythmias, orCHF, Cor Pulmonale, Hepatic dysfunction. Active pepticulcer disease, GERD, /Anxiety, Seizure disorders. Migraine headaches. Hyperthyroidism... 

These drugs are best avoided in patients with cerebrovascular, cardiovascular and hepatic disorders. Some sympathomimetic effects may occur, mainly mild tremor and occasionally cardiac arrhythmias. Apparent anticholinergic effects may also occur but these are the result of sympathetic potentiation in tissues with dual cholinergic/adrenergic innervation, e.g. pupil. Sympatholytic effects can also occur, principally postural hypotension, because of synthesis of relatively inactive false transmitters, e.g. octopamine, in nerve terminals following inhibition of MAO and activation of alternative metabolic pathways. 

Adverse Effects. Quinine is associated with many adverse effects involving several primary organ systems. This drug may produce disturbances in the CNS (headache, visual disturbances, ringing in the ears), gastrointestinal system (nausea, vomiting, abdominal pain), and cardiovascular system (cardiac arrhythmias). Problems with hypersensitivity, blood disorders, liver dysfunction, and hypoglycemia may also occur in some individuals. 

Adverse Effects. The primary adverse effects associated with mycophenolate mofetil are blood disorders (anemia, leukopenia, neutropenia) and gastrointestinal problems (abdominal pain, nausea, vomiting, heartburn, diarrhea, constipation).50 Other side effects include chest pain, cough, dyspnea, muscle pain, weakness, and cardiovascular problems (hypertension, arrhythmias). 

The tricyclic antidepressants are effective in treating severe major depression. Some panic disorders also respond to TCAs. Imipr-amine has been used to control bed-wetting in children (older than 6 years) by causing contraction of the internal sphincter of the bladder. At present it is used cautiously, because of the inducement of cardiac arrhythmias and other serious cardiovascular problems. 

The reported side-effects of interferon alfa include cardiovascular problems such as arrhythmia, tachycardia and hypotension in the absence of history of such conditions, severe myelosuppression, depression and suicidal behaviour, opthalmic disorders, anorexia and flu-like symptoms and hypersensitivity reactions. Mr JJ should be advised of these and of the actions to be taken. The patient should be informed that under no circumstances should he switch treatments as different formulations may contain different dosages. Furthermore, he should be made aware of the proper disposal of used pens/syringes and to take extra care if blood enters the dispensers, as described in the product literature. Hepatitis B support groups are available. Dietary advice may be offered as cytokine-based treatments often cause reduced appetite. 

It may be possible for some individuals simply to reduce their dosage of caffeine rather than discontinue it altogether. Others may be particularly sensitive to the drug, and they may not be able to handle even reduced intake of caffeine. Patients with cardiovascular disease, especially arrhythmias, should refrain totally, as should people with prior stroke or transient ischemic attacks. Peptic ulcer patients and those with bipolar mood disorder and schizophrenia should be encouraged to avoid caffeine altogether. 

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