1. CARDIOVASCULAR AGENTS
- some of the most widely used medications treat conditions of the cardiovascular system
- cardiovascular agents include
- antianginals
- antiarrhythmias
- antihypertensives
- vasopressors
- antihyperlipidemics
- thrombolytics
- anticoagulants

2. - used in treating
- myocardial infarction (heart attack)
- angina
- cerebral vascular accident (CVA) / stroke
- hyper / hypotension (blood pressure)
- congestive heart failure (CHF)
- arrhythmias
- high cholesterol
- blood clots
- atreiosclerosis

3. THE HEART
conduction
- the heart is a pump that uses complex chemical and electrical processes to function
- chemically charged ions stimulate heart muscle to contract and relax systematically (cardiac cycle) - pumps blood through the cardiovascular system
- the sinoatrial node (SA) generates the electrical impulse and sets the pace of the heart (stimulates the atria and ventricles)
- the atrioventricular node (AV) and Purkinje fibers (located at the base of the heart) transmit the impulse

4. the heart and circulation
- heart is divided into 4 chambers (R/L atria and R/L ventricles)
- the R atria receives deoxygenated blood from the body and pumps it to the lungs (pulmonary circulation)
- the L atria receives oxygenated blood from the lungs and pumps it to the tissues of the body (systemic circulation)
- the myocardium (heart muscle) is supplied with oxygenated blood by the coronary arteries (branch from the aorta and circle back to the heart)

5. blood clotting
- essential function of blood that prevents excessive blood loss from injuries
- clotting factors, platelets and healthy blood vessel walls are important in the formation of clots
- too much clotting can be dangerous
- if a clot (thrombus) is formed in the blood stream, it can be carried to a smaller vessel and block the flow of blood (embolism)

6. blood pressure
- outward pressure of blood against the arteries as it is pumped through the heart
- systolic pressure is the maximum pressure as the heart contracts
- diastolic pressure is the minimum pressure as the heart relaxes

7. arrhythmias
- normally, the electrical system of the heart causes it to contract (beat) in a regular and organized rhythm - can be graphed by an electrocardiogram (ECG/EKG)
- arrhythmia is an abnormal heart rhythm that can interfere with the heart’s ability to pump effectively
- tachycardia (fast)
- bradycardia (slow)
- premature or ectopic beats
- flutter and fibrillation

8. Classes of Cardiovascular Agents
antianginals
- treat cardiac related chest pain (angina) resulting from ischemic heart disease - lack of oxygen and blood flow to the heart
-nitrates, beta-blockers and calcium channel blockers (nitroglycerine / Procardia)
antiarrhythmatics
- treat irregular heart rhythms
- regulate the conduction activity of the heart by inhibiting abnormal pacemaker cells or recurring abN impulses and restoring a normal rhythm
- beta-blockers (digoxin, propranolol), drugs that block sodium, potassium ion and calcium channels

9. antihypertensives
- reduce a sustained elevation in blood pressure
- factors affecting blood pressure include stress, blood volume, arterial narrowing, age, gender and general condition of health
- furosemide (Lasix) and altace (Ramipril)
vasopressors
- increase blood pressure through fluid replacement or dopamine (Dobutamine)
antihyperlipidemics
- lower high levels of cholesterol that can lead to vessel blockage
- simvastatin and provastatin
thrombolytics (dissolve blood clots) / anticoagulants (prevent clot formation)

10. further clarification…
beta-blockers - reduce oxygen demands of the heart muscle
calcium channel blockers - relax the heart by reducing heart conduction
diuretics - decrease blood pressure by decreasing blood volume - increase the elimination of salts and water through urination
ACE inhibitors - “pril” drugs relax the blood vessels
vasodilators - relax and expand the blood vessels