Heart disease cardiac drugs

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. 

Anticoagulant drugs include heparin and warfarin (Coumadin ) —agents used to prevent deep vein thrombosis. They are also used to prevent formation of emboli due to atrial fibrillation, valvular heart disease, and other cardiac disorders. Heparin, which is not absorbed by the gastrointestinal tract, is available only by injection its effect is immediate. 

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... 

Valvular heart disease Serious regurgitant cardiac valvular disease, primarily affecting the mitral, aortic, or tricuspid valves, has been reported in otherwise healthy people who had taken certain anorectic agents in combination for weight loss. The etiology of these valvulopathies has not been established and their course in individuals after the drugs are stopped is not known. 

Injection - Heart failure secondary to chronic lung disease cardiac arrhythmias brain tumor acute alcoholism delirium tremens idiosyncrasy to the drug increased intracranial or CSF pressure head injuries acute bronchial asthma upper airway obstruction. Because of its stimulating effect on the spinal cord, morphine should not be used in convulsive states (eg, status epilepticus, tetanus, strychnine poisoning) concomitantly with MAOIs or in those who have received such agents within 14 days. 

Cardiovascular Specifically, screen and evaluate patients with coronary heart disease, serious cardiac arrhythmias or vasospastic diseases before nicotine is prescribed. There have been occasional reports of tachyarrhythmias associated with nicotine use therefore, if an increase in cardiovascular symptoms occurs, discontinue the drug. 

Dobutamine (Dobutrex). Dobutamine is used for short-term management of cardiac decompensation that sometimes occurs during exacerbations of heart disease or following cardiac surgery.28 This drug is often administered via intravenous pump infusion to allow relatively stable plasma levels. 

Hypertension is the most common cardiovascular disease. Thus, the third National Health and Nutrition Examination Survey (NHANES III), conducted from 1992 to 1994, found that 27% of the USA adult population had hypertension. The prevalence varies with age, race, education, and many other variables. Sustained arterial hypertension damages blood vessels in kidney, heart, and brain and leads to an increased incidence of renal failure, coronary disease, cardiac failure, and stroke. Effective pharmacologic lowering of blood pressure has been shown to prevent damage to blood vessels and to substantially reduce morbidity and mortality rates. Many effective drugs are available. Knowledge of their antihypertensive mechanisms and sites of action allows accurate prediction of efficacy and toxicity. As a result, rational use of these agents, alone or in combination, can lower blood pressure with minimal risk of serious toxicity in most patients. 

In most cases, the reversal of symptomatic myocardiopathy has been achieved without drug toxicity (19,43). Davis and Porter (19) and Tsironi et al. (44) confirmed clinically the laboratory data of Link et al. (45) that DFO therapy reverses cardiac arrhythmias in some patients previously unresponsive to medical treatment. This may be attributed to removal of a toxic labile iron pool. They also mentioned improvement of left ventricular ejection fraction in seven of nine patients. It is important to note that oral chelators are less effective than DFO and are unable to prevent cardiac mortality in patients with established heart disease (46). 

Because digitoxin has a very low therapeutic index, toxicity occurs rather routinely and can be fatal patients must be monitored closely. Moderate overdoses can be picked up by GI or CNS complaints however, more serious toxicity on cardiac rhythm is more difficult to distinguish from the effects of heart disease. Digitalis antibody fragments are available for serious toxicity, i.e., when cardiac arrest is imminent. The fragments bind the drug and are excreted by the kidneys. 

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