Drugs used to treat cardiovascular disorders

Groups of drugs are described together with their relevant therapeutic indications because often the same drugs are used for different conditions. 

Cardiac glycosides are used to treat cardiac failure and atrial flutter and atrial fibrillation. 

The effect of increased intracellular calcium ion levels is a more controlled forceful contraction of the myocardium. This is known as a positive inotropic effect. 

In addition, through an effect in the central nervous system cardiac glycosides cause an increase in parasympathetic activity and therefore slow conduction through the AV node, hence their usefulness in atrial flutter and atrial fibrillation. 

However, cardiac glycosides have a very low therapeutic ratio and can be very toxic. Slowing of AV conduction can lead to AV block and arrhythmias. These signs could be confused with clinical deterioration. 

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Table 4.4 Summary of drugs used to treat cardiovascular disorders...

As with cardiac and blood disorders, respiratory disease is relatively common in many older patients. However, there are common respiratory disorders that affect younger people as well. Although there are probably not as many diseases of the respiratory system as there are of the cardiovascular system, there are still a number of important groups of drugs that are used to treat respiratory disorders and their use can be life saving. 

These drugs are contraindicated in patients with thrombophlebitis, thromboembolic phenomena, and cardiovascular and cerebrovascular disorders or a past history of these conditions. They should not be used to treat vaginal bleeding when the cause is unknown. They should be avoided in patients with known or suspected tumors of the breast or other estrogen-dependent neoplasms. Since these preparations have caused aggravation of preexisting disorders, they should be avoided or used with caution in patients with liver disease, asthma, eczema, migraine, diabetes, hypertension, optic neuritis, retrobulbar neuritis, or convulsive disorders. 

The drugs described in this chapter are used to treat a variety of disorders, ranging from severe cardiovascular and respiratory problems to symptoms of the common cold. Because these drugs are widely used in cardiovascular disease and other disorders, many patients seen in physical therapy and occupational... 

Within the last few years, the role of wake-promoting medication has received renewed and increasing attention with development of modafinil. Although the mechanism through which modafinil works remains to be determined, the low abuse potential (51) and absence of cardiovascular effects (52,53), combined with its clear wake-promoting properties, increase the potential uses for this drug. Studies have shown consistent increases in alertness for narcolepsy (54), in sleep apnea patients (treated with CPAP) with residual sleepiness (55), for shift work sleep disorder (56), and for sleep deprivation (57). 

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