GROUP 3:

Leader: CATUBAY, CRISTINE JOY A.

Members: Catudio, Clarisse
Cuadra, Desiree
Castillo Joana
Caratay, Danah
Catudio, Charmaine
Cuevas, Vianeza
Duran, Joan
Ongkit, Honey Jean
Dumdumaya, Zyrene
Carpeso, Mae Kyla
Daiz, Mar Justine
Cardiente, John Anthony
DRUGS AFFECTING
CARDIOVASCULAR
SYSTEM
Drugs that affect the cardiovascular system primarily
target the heart, blood vessels, and blood pressure to
treat various conditions such as hypertension, heart
failure, arrhythmias, and ischemic heart disease. Below
are the main categories of drugs that influence the
cardiovascular system:
These medications play vital roles in managing
cardiovascular health, either by directly affecting heart
function or modifying factors like blood pressure and
cholesterol.
DRUGS AFFECTING
CARDIOVASCULAR
SYSTEM:
Atenolol
 Atenolol is a beta-blocker used in the treatment of several
cardiovascular conditions. It is a selective beta-1 adrenergic receptor
blocker, meaning it primarily affects the heart rather than the lungs or
peripheral blood vessels. This makes it useful for controlling heart rate,
reducing blood pressure, and managing heart-related symptoms.
DOSAGE:
 1. Dosage:
 The dosage of Atenolol depends on the condition being treated. Below are general guidelines:
 Hypertension (High Blood Pressure):

o Initial dose: 25-50 mg once daily.

o Maintenance dose: 50-100 mg once daily.

 Angina Pectoris (Chest Pain):

o Initial dose: 50 mg once daily.

o Maintenance dose: 50-100 mg once daily.

 Acute Myocardial Infarction (Heart Attack):
o Initial IV dose: 5 mg over 5 minutes, followed by 5 mg after 10 minutes if well-tolerated.
 Oral dose: 50 mg orally 10 minutes after the last IV dose, then 50 mg twice daily for 1-2 days,
followed by 100 mg once daily for maintenance
 Arrhythmias (Irregular Heartbeat):
o Dose varies; typically 50-100 mg per day depending on response.
 Note: Always adjust the dose according to the patient's response and medical condition.
2. Mechanism of Action:

 Atenolol works by selectively blocking beta-1 adrenergic receptors primarily in the heart. This
leads to:
 Decreased heart rate (negative chronotropy): Reduces the number of heart beats per minute.

 Decreased contractility (negative inotropy): Reduces the force with which the heart muscles
contract.
 Decreased oxygen demand: As a result of the reduced heart workload.

 Reduced renin secretion: This contributes to lowering blood pressure by reducing angiotensin
II production, which causes vasoconstriction and fluid retention.
3. Indications:

 Atenolol is prescribed for various cardiovascular conditions, including:

 Hypertension:
 Angina pectoris:
 Acute myocardial infarction:
 Arrhythmias:
4. Contraindications:

Atenolol should not be used in certain patients due to

potential harm. Contraindications include:
• Bradycardia
• Hypotension
• Severe peripheral arterial disease
• Hypersensitivity
5. Adverse Reactions

Common Adverse Reactions:

 Bradycardia
 Fatigue
 Dizziness
 Cold extremities
Amlodipine
 Amlodipine is a long-acting calcium channel blocker (CCB) used
primarily to treat hypertension and angina. It works by relaxing blood
vessels, allowing for better blood flow and reduced heart workload.
1. Dosage:
 The usual dosage of Amlodipine depends on the condition being treated:

 Hypertension (High Blood Pressure):

o Initial dose: 5 mg once daily.

o Maximum dose: 10 mg once daily.

 Chronic Stable Angina and Vasospastic Angina (Chest Pain):
 Chronic stable angina. This chest pain occurs when your heart is working hard enough to need
more oxygen, such as during moderate or vigorous exercise or mental stress.
 Coronary Artery Disease:
 Coronary artery disease (CAD) is a common type of heart disease. It affects the main blood
vessels that supply blood to the heart, called the coronary arteries. In CAD, there is reduced
blood flow to the heart muscle.
o 5-10 mg once daily, based on the clinical condition and tolerance.
 Elderly or those with hepatic impairment (Hepatic impairment refers to liver damage that
results in the liver failing to perform its functions correctly): Start at a lower dose, typically 2.5
mg once daily, with cautious titration upwards.
2. Mechanism of Action
 Amlodipine is a dihydropyridine calcium channel blocker. Its main action is to inhibit the
influx of calcium ions into vascular smooth muscle and cardiac muscle cells, resulting in:

 Vasodilation (widening the blood vessel and increase the blood flow and lower blood
pressure): It primarily relaxes the smooth muscles of the peripheral arteries, leading to a
decrease in vascular resistance (afterload) and blood pressure.
 Reduction in myocardial oxygen demand: By lowering systemic vascular resistance, it reduces
the heart's workload and oxygen demand.
 Coronary artery dilation: It also increases blood flow through the coronary arteries, making it
useful in angina treatment by improving oxygen delivery to the heart muscle.
 Note: Amlodipine has minimal effects on heart rate and contractility, focusing primarily on
vasodilation.

3. Indications:
 Amlodipine is used in several cardiovascular conditions, including:
 Hypertension: Used alone or in combination with other antihypertensives to lower blood
pressure and reduce cardiovascular events (e.g., stroke, heart attack).
 Chronic stable angina: Reduces the frequency and severity of angina attacks by lowering
myocardial oxygen demand
Vasospastic angina (Prinzmetal's angina): Prevents and relieves chest pain caused
by coronary artery spasms.

Coronary artery disease (CAD): In patients without heart failure, Amlodipine is

used to manage angina and prevent cardiovascular events.
4. Contraindications:
Amlodipine should not be used in certain patients due to
potential adverse effects or worsening of medical conditions:
 Severe hypotension (low blood pressure): Amlodipine can exacerbate hypotension
due to its vasodilatory effects.

 Severe aortic stenosis: Amlodipine can lead to serious complications by lowering

blood pressure excessively in patients with this condition.

 Hypersensitivity
Use with caution in:

 Liver impairment: As Amlodipine is metabolized by the liver, dose adjustments may

be needed.

Heart failure: Although not contraindicated, it should be used cautiously, especially in

patients with severe left ventricular dysfunction

5. Adverse Reactions:
Like any medication, Amlodipine can cause side effects. These
can range from mild to serious.
Common adverse reaction:
Peripheral edema (swelling): One of the most common side effects, particularly in
the ankles and feet, due to vasodilation.
 Headache: Caused by vasodilation of blood vessels.

 Dizziness: Often related to blood pressure reduction.

 Flushing: Widening of blood vessels may cause a warm sensation or redness, especially on the
face.
 Fatigue: Possibly due to reduced blood pressure.

 Nausea: Occasionally reported with calcium channel blockers.

 Calcium channel blockers are medicines used to lower blood pressure.
 They stop calcium from entering the cells of the heart and arteries. Calcium causes the heart
and arteries to squeeze more strongly. By blocking calcium, calcium channel blockers allow
blood vessels to relax and open.

Serious Adverse Reactions:

 Severe hypotension:

 Worsening of angina

 Hepatic impairment

 Tachycardia
Gingival hyperplasia: An overgrowth of gum tissue, although uncommon, can be
seen with long-term use.
Losartan
 Losartan is an angiotensin II receptor blocker (ARB) commonly used to treat high blood
pressure, protect the kidneys in diabetic patients, and manage heart failure. It works by
blocking the effects of angiotensin II, a hormone that causes blood vessels to constrict and
raises blood pressure.

1. Dosage:
 The dosage of Losartan depends on the condition being treated and the patient's response to
the medication:
 Hypertension (High Blood Pressure):

o Initial dose: 50 mg once daily.

o Maintenance dose: 25-100 mg daily, either as a single dose or divided into two doses.

o
 Diabetic Nephropathy (Kidney Protection in Type 2 Diabetes):
o Initial dose: 50 mg once daily.

o Maximum dose: 100 mg once daily.

 Heart Failure:
o Initial dose: 12.5 mg once daily.

o Maintenance dose: 50-150 mg once daily, titrated based on the patient’s tolerance.

 Stroke Prevention in Hypertensive Patients with Left Ventricular Hypertrophy

(LVH):
o Initial dose: 50 mg once daily.

o . Dose adjustment: May be increased to 100 mg daily based on blood pressure response
 Special populations: Patients with liver impairment or elderly patients may require a lower
starting dose (e.g., 25 mg once daily).

2. Mechanism of Action:
 Losartan is an angiotensin II receptor blocker (ARB) that selectively inhibits the AT1 receptor
for angiotensin II. Angiotensin II is a potent vasoconstrictor and stimulates the release of
aldosterone, which leads to sodium and water retention.

By blocking the AT1 receptor, Losartan leads to:

 Vasodilation: It relaxes blood vessels, lowering blood pressure.

 Reduced aldosterone release: This leads to decreased sodium and water retention, reducing
blood volume and blood pressure.
 Reduced cardiovascular remodeling: In conditions like heart failure or left ventricular
hypertrophy, it helps prevent heart and blood vessel damage over time.
3. Indications:
 Losartan is used in several cardiovascular and renal conditions:
 Hypertension: Losartan is used as monotherapy or in combination with other antihypertensives to
lower high blood pressure and reduce the risk of cardiovascular events like stroke and heart attack.
 Diabetic nephropathy: In patients with type 2 diabetes and hypertension, Losartan helps protect
the kidneys by reducing proteinuria (excess protein in urine) and slowing the progression of kidney
disease.
 Proteinuria is high levels of protein in your urine. Causes may include relatively harmless
conditions, including dehydration or intense exercise, or more serious, including kidney disease or
immune disorders.
 Heart failure: Losartan helps reduce heart strain and improve outcomes in patients with heart
failure who cannot tolerate ACE inhibitors.
 Stroke prevention: In hypertensive patients with left ventricular hypertrophy (LVH), Losartan
reduces the risk of stroke.
4. Contraindications:
 Losartan should not be used in certain patients due to potential risks:
 Pregnancy: Losartan is contraindicated in pregnancy, particularly in the second and third
trimesters, as it can cause harm or death to the developing fetus.
 Losartan is not recommended in pregnancy. It can reduce the level of fluid around your baby,
particularly if you take it in the second and third trimesters of pregnancy. This can result in
long-term damage to your baby's kidneys and lungs and a number of other problems.
 Hypersensitivity: Any known allergy or hypersensitivity to Losartan or other ARBs is a
contraindication.
 Severe renal impairment or bilateral renal artery stenosis: Losartan can further reduce
kidney function in patients with these conditions.
 Hyperkalemia (high potassium levels): ARBs, including Losartan, can increase potassium
levels, potentially leading to dangerous hyperkalemia.
5. Adverse Reactions:

Losartan is generally well-tolerated, but side effects can occur, ranging from mild to serious:

 Common Adverse Reactions:

 Dizziness
 Hypotension
 Hyperkalemia
 Fatigue
 Back pain or muscle cramps
Serious Adverse Reactions:
 Kidney function impairment: Losartan can worsen renal function, particularly in patients with
underlying kidney disease or bilateral renal artery stenosis.
 Angioedema: Although rare, Losartan may cause swelling of the face, lips, throat, and
extremities, similar to ACE inhibitors.
 Severe hypotension: Particularly in patients with volume depletion (e.g., those on
diuretics), which can lead to dizziness or fainting.

 Anemia

Other Considerations:
 Cough: Unlike ACE inhibitors, Losartan does not commonly cause a persistent cough, making
it an alternative for patients who cannot tolerate ACE inhibitors.

 Drug interactions: Caution should be used when Losartan is combined with other drugs
that raise potassium levels (e.g., potassium supplements or certain diuretics), as it can
increase the risk of hyperkalemia.

Clopidogrel

Clopidogrel is an antiplatelet medication that helps prevent blood clots. It is commonly used in
patients at risk for cardiovascular events.

1. Dosage:
 The dosage of clopidogrel varies based on the indication:

 For Acute Coronary Syndrome (ACS):

o Loading dose: 300 mg (if not already taking aspirin) or 600 mg (often used in certain
clinical settings).
o Maintenance dose: 75 mg once daily.
 For Prevention of Atherothrombotic Events:
o Recommended dose: 75 mg once daily, typically in combination with aspirin (dual antiplatelet
therapy).

 For Peripheral Artery Disease:

o Recommended dose: 75 mg once daily.

Note: Clopidogrel should be taken with or without food, and the loading dose is often administered at
the time of diagnosis or onset of symptoms.

2. Mechanism of Action:
 Clopidogrel works by irreversibly inhibiting the P2Y12 component of the ADP receptor on the
platelet surface:

 Inhibition of Platelet Activation: By blocking ADP from binding to its receptor, clopidogrel
prevents platelet activation and aggregation, thereby reducing the risk of thrombus formation.
3. Indications:
 Clopidogrel is indicated for several conditions, including:

 Acute Coronary Syndrome (ACS): Including unstable angina and myocardial

infarction (MI).

 Post-Myocardial Infarction: To reduce the risk of subsequent cardiovascular

events.

 Post-Stroke: In patients with a history of ischemic stroke or transient ischemic attack

(TIA).

 Peripheral Artery Disease: To reduce the risk of cardiovascular events.

4. Contraindications:
Clopidogrel should be avoided in certain situations due to potential risks:

 Active Bleeding: Such as peptic ulcer or intracranial hemorrhage.

 Hypersensitivity: Known allergy to clopidogrel or any of its components.
 Severe Liver Disease: Impaired function can increase the risk of adverse effects.
 Concurrent Use of Certain Medications: Such as proton pump inhibitors
(PPIs) like omeprazole, which can reduce clopidogrel's effectiveness.
5. Adverse Reactions:
Clopidogrel is generally well-tolerated, but side effects can occur. Common and serious reactions
include:

Common Adverse Reactions:

 Bleeding: Increased risk of bleeding, including minor bruising.

 Gastrointestinal Issues: Such as abdominal pain, diarrhea, and dyspepsia.
 Headache: Commonly reported.
Serious Adverse Reactions:

 Severe Bleeding: Including gastrointestinal bleeding or intracranial hemorrhage.

 Thrombocytopenia: Low platelet count, which may lead to increased bleeding risk.
 Allergic Reactions: Such as rash, itching, or, rarely, anaphylaxis.
• Stevens-Johnson Syndrome: A rare but serious skin reaction
Atorvastatin

Atorvastatin is a statin medication used to lower cholesterol levels and reduce the risk of
cardiovascular disease. It inhibits the enzyme HMG-CoA reductase, which plays a central role in
the cholesterol synthesis pathway.

1. Dosage:
 The dosage of atorvastatin varies based on the indication:
 For Hyperlipidemia (High Cholesterol):

o Initial dose: 10 to 20 mg once daily.

o Maintenance dose: 10 to 80 mg once daily, adjusted based on cholesterol levels and

patient response.
 For Prevention of Cardiovascular Disease:

o Recommended dose: 20 to 40 mg once daily, based on individual risk factors.

Note: Atorvastatin can be taken at any time of the day, with or without food.

2. Mechanism of Action:
Atorvastatin works by inhibiting HMG-CoA reductase, an enzyme involved in cholesterol
synthesis in the liver:
• Reduction of LDL Cholesterol: By blocking this enzyme, atorvastatin decreases the production
of cholesterol, leading to increased uptake of LDL cholesterol from the bloodstream by the
liver, ultimately lowering LDL levels.
 Increase in HDL Cholesterol: Atorvastatin may also modestly increase high-density lipoprotein
(HDL) cholesterol levels.
 Stabilization of Atherosclerotic Plaques: It helps reduce inflammation and stabilize plaques in
3. Indications:
 Atorvastatin is indicated for several conditions, including:

 Primary Hyperlipidemia: To lower total cholesterol, LDL cholesterol, and triglycerides.

 Mixed Dyslipidemia: To improve lipid profiles.
 Prevention of Cardiovascular Events: In patients with risk factors such as
diabetes or a history of cardiovascular disease.

 Familial Hypercholesterolemia: In certain pediatric patients (ages 10-17) for

managing cholesterol levels.
4. Contraindications:
 Atorvastatin should be avoided in certain situations due to potential risks:

 Active Liver Disease: Including unexplained persistent elevations in liver enzymes.

 Pregnancy and Breastfeeding: Statins are contraindicated due to potential harm to
the fetus or nursing infant.

 Hypersensitivity: Known allergy to atorvastatin or any of its components.

 Concomitant Use of Certain Medications: Such as strong CYP3A4 inhibitors
(e.g., ketoconazole, certain HIV protease inhibitors) that may increase the risk of atorvastatin
toxicity.
5. Adverse Reactions:
Atorvastatin is generally well-tolerated, but side effects can occur. Common and serious reactions
include:

Common Adverse Reactions:

 Muscle Pain (Myalgia): Muscle aches or weakness are common, but typically mild.
 Gastrointestinal Issues: Such as nausea, diarrhea, and constipation.
 Headache: Commonly reported.
Serious Adverse Reactions:

 Rhabdomyolysis: A rare but serious condition involving severe muscle breakdown,

which can lead to kidney damage.

 Liver Enzyme Elevations: Significant increases in liver enzymes may indicate liver
injury.

 Allergic Reactions: Such as rash or itching.

 Memory Loss or Confusion: Rare reports suggest cognitive effects, which
usually resolve upon discontinuation.