cardiovascular drugs

positive inotropes, negative inotropes, vasodilators, antiarrhythmics, negative chronotropes, diuretics

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Last updated: April 18, 2023

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First submitted	April 18, 2023
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What are the positive inotropes?	What are the common uses?		What kind of agonists/antagonists are they?
Digoxin	to improve myocardial contractility	to prevent arrhythmias	Na+ - K+ - ATPase channel antagonist
Dobutamine	used to improve myocardial contraction force to improve cardiac output		β1 agonist

What are the vasodilators?	What are examples of each?		What is the mechanism of action for each?	What will the use of vasodilators do?		What are the clinical indications for vasodilators?
Angiotensin Converting Enzyme (ACE) inhibitors	Perindopril (and other -prils)		inhibits the Angiotensin Converting Enzyme, therefore inhibiting the production of Angiotensin II	decrease afterload	improve peripheral perfusion	heart failure	hypertension
Angiotensin II receptor inhibitors	Irbesartan (and other -sartans)		acts as an antagonist at the Angiotensin II receptor, therefore inhibiting the production of ADH and Aldosterone
Beta blockers	Propranolol	Atenolol	β1 antagonism leading to decreased heart rate and negative inotropy, leading to decrease blood pressure
Calcium channel blockers	Amlodipine		blocks the influx of calcium into cardiac and vascular smooth muscle cells, therefore decreasing myocardial contractility and causing vasodilation
Nitrates	Nitroglycerin	Nitroprusside	used as a prodrug that converts to nitric oxide, leading to vasodilation & reduced preload
α1 antagonists	Prazosin		α1 selective antagonist, leading to vasodilation

What are the antiarrhythmics?	What is an example of each?		What type of blocker is each?
Class I	Lignocaine		sodium channel blockers
Class II	Atenolol	Propranolol	blockade of sympathetic autonomic effects
Class III	Sotalol	Amiodarone	potassium channel blockers
Class IV	Diltiazem		calcium channel blockers
Digoxin			Na+ - K+ - ATPase channel blocker

What are the negative inotropes?	What are the negative chronotropes?	What are examples of these?
calcium channel blockers		Amlodipine	Diltiazem
Class II antiarrhythmics		Propranolol	Atenolol
-	Digoxin	-

What are the diuretics?	What are examples of these?	What are they used for?		What is the mechanism of action of each?
loop diuretics (renal diuretic)	Frusemide	fluid accumulation in the lungs, abdomen, or pleural space after heart failure		Na+-K+-2Cl- pump antagonist, therefore creating an enormous natriuresis (sodium in urine) and subsequent diuresis
potassium sparing diuretics (renal diuretic)	Spironolactone	used on occasion in preference to frusemide if concerned about potassium levels		aldosterone antagonist (aldosterone drives the Na+-K+- ATPase pump)
osmotic diuretics	Mannitol	cerebral oedema (after head trauma)	glaucoma	increases plasma osmolality so moves fluid from tissues to plasma through osmosis

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