Cardiac Pharmacology

Cardiac Pharmacology

1st Edition - January 28, 1981

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  • Editor: R. Douglas Wilkerson
  • eBook ISBN: 9781483276410

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Cardiac Pharmacology aims to interface basic and clinical knowledge of those interventions used or being studied for use in the treatment of heart disease. The book is divided into four major sections which address intrinsic and neural control of cardiac function, pharmacologic modification of cardiac contractility and cardiac output, the genesis and control of cardiac arrhythmias, and pharmacologic manipulation of myocardial oxygen supply and demand. The last three sections contain a chapter describing the techniques employed in the study of that particular aspect of cardiac function and its alterations by pharmacologic interventions. Cardiologists, pharmacologists, physiologists, and those interested in the area of cardiovascular medicine will find the book insightful.

Table of Contents

  • List of Contributors


    I Intrinsic and Neural Control of Cardiac Function

    1 Regulation of Myocardial Contractility

    I. Contractility Defined

    II. Neural Regulation of Cardiac Contractility

    III. Humoral Regulation of Contractility

    IV. Autoregulation


    2 The Nervous System as an Important Site of Action for Drugs Affecting Cardiovascular Function

    I. Introduction

    II. Positive Inotropic Agents

    III. Antiarrhythmic Agents

    IV. Antihypertensive Agents

    V. Antianginal Agents

    VI. The Nervous System as a Target for Developing New and Better Therapies for Cardiovascular Disease


    II Pharmacologic Modification of Cardiac Function

    3 Evaluation of Drug-Induced Alterations in Myocardial Contractility

    I. Introduction

    II. Conceptual Basis for Indices of Myocardial Contractility

    III. Indices Obtained During the Isovolumic Phase of Ventricular Systole

    IV. Indices Obtained During the Ejection Phase of Ventricular Systole

    V. The Walton-Brodie Strain Gauge Arch

    VI. Summary


    4 Cyclic Nucleotides and Cardiac Function

    I. Cyclic AMP

    II. Cyclic GMP

    III. Phosphodiesterase

    IV. Effects of Hypoxia and Ischemia on Cyclic Nucleotide Content of the Heart

    V. Cyclic Nucleotides and Coronary Vascular Function

    VI. Cyclic Nucleotides and Cardiac Metabolism


    5 Na+, K+-ATPase Activity and Cardiac Glycoside Action

    I. Introduction

    II. The Nature of the Enzyme

    III. Theories on the Mechanism of Action of Cardiac Glycosides

    IV. Digitalis Toxicity and Na+, K+-ATPase Activity

    V. Conclusions


    6 Effects of Digitalis Glycosides on Myocardial Function

    I. Introduction

    II. Inotropic Effects of Digitalis Glycosides

    III. Cardiac Electrophysiologic Effects of Digitalis

    IV. Digitalis Glycoside Toxicity

    V. New Directions in Research on Positive Inotropic Agents


    7 Clinical Pharmacology of Digitalis Glycosides

    I. Introduction

    II. Pharmacokinetics of the Digitalis Glycosides

    III. Serum Levels of Digitalis Glycosides

    IV. Drug Interactions

    V. Digitalis Intoxication


    8 Physiologic and Pharmacologic Basis for the Use of Vasodilators in Heart Failure

    I. Introduction

    II. Mechanism of Action of Vasodilators

    III. Afterload or Impedance Reduction

    IV. Venodilation

    V. Improvement in Segmental Myocardial Ischemia

    VI. Left Ventricular Compliance

    VII. Pathophysiology of Myocardial Failure

    VIII. Classification of Vasodilators

    IX. Hemodynamic Effects of Vasodilators

    X. Clinical Use of Vasodilators in Heart Failure and Myocardial Infarction

    XI. Summary


    III Genesis and Control of Cardiac Arrhythmias

    9 Electrophysiologic Evaluation of Potential Antiarrhythmic Drugs

    I. Introduction

    II. Instrumentation

    III. Isolated Tissues

    IV. Membrane Potentials

    V. Influence of Drugs and Chemicals on Cardiac Membrane Potentials


    10 Electrophysiologic Characteristics of Cardiac Cells and the Genesis of Cardiac Arrhythmias

    I. Introduction

    II. The Resting Potential of Cardiac Cells

    III. Action Potentials in Cardiac Cells

    IV. Effects of Disease on the Electrophysiologic Characteristics of Cardiac Cells

    V. The Genesis of Cardiac Arrhythmias


    11 Antiarrhythmic Drugs

    I. Introduction

    II. Quinidine, Procainamide, and Disopyramide

    III. N-Acetylprocainamide

    IV. Lidocaine, Tocainide, and Mexiletine

    V. Phenytoin (Diphenylhydation)

    VI. Propranolol

    VII. Verapamil

    VIII. Bretylium

    IX. Aprindine

    X. Amiodarone

    XI. Conclusions


    12 The Clinical Pharmacology of Antiarrhythmic Drugs

    I. Introduction

    II. Pharmacokinetics of Antiarrhythmic Drugs

    III. Indications and End-Points for Antiarrhythmic Therapy

    IV. Role of Electrophysiologic Studies to Determine the Efficacy of Antiarrhythmic Drugs

    V. Blood Levels of Antiarrhythmic Drugs

    VI. Summary


    IV Pharmacologic Modification of Myocardial Oxygen Supply and Demand

    13 Myocardial Metabolism

    I. Introduction

    II. Control of Carbohydrate Utilization

    III. Control of Fatty Acid Metabolism

    IV. Interaction of Glucose and Fatty Acid Utilization

    V. Effects of Cardiac Work on Substrate Utilization

    VI. Effects of Hypoxia on Substrate Utilization

    VII. Effects of Catecholamines on Substrate Utilization

    VIII. Effects of Insulin on Myocardial Substrate Utilization

    IX. Summary


    14 Evaluation of Drug Effects on Coronary Blood Flow and Cardiac Oxygen Consumption

    I. Choosing the Experimental Model

    II. Methods for Measuring Coronary Flow

    III. Collateral Blood Flow Measurements

    IV. Measure of Myocardial Oxygen Consumption


    15 β-Adrenergic Antagonists in Angina and Myocardial Infarction

    I. The Basis of the Use of β-Adrenergic Antagonists in Ischemic Heart Disease

    II. Effect of β-Adrenergic Antagonists on Coronary Blood Flow

    III. Effects of β-Adrenergic Antagonists on the Blood

    IV. β-Adrenergic Antagonists in Angina Pectoris

    V. Division I: Nonselective β-Adrenergic Antagonists

    VI. Division II: Cardioselective β-Adrenergic Antagonists

    VII. Division III: Nonselective β-Adrenergic Antagonists Plus α Blockade

    VIII. Comparison of Adrenergic Blocking Drugs

    IX. β-Blocking Drugs in Combination with Other Antianginal Agents

    X. Withdrawal of β-Adrenergic Blocking Drugs in Patients with Angina Pectoris

    XI. Regulation of Dosage of β-Adrenergic Antagonists in Patients with Angina Pectoris

    XII. The Value of β- Adrenoceptor Antagonists in Angina Pectoris

    XIII. β-Adrenergic Antagonists in Myocardial Infarction

    XIV. Conclusion


    16 Modification of Myocardial Infarct Size by Drugs: Methods for Measuring Infarct Size and Approach to Patient Care

    I. The Border Zone

    II. Techniques for Measuring the Extent of Damage

    III. Factors That Determine the Outcome of Ischemic Myocardium

    IV. The Treatment of Potential Detrimental Events

    V. The Treatment of the Uncomplicated Patient

    VI. Conclusion: A Word of Caution



Product details

  • No. of pages: 464
  • Language: English
  • Copyright: © Academic Press 1981
  • Published: January 28, 1981
  • Imprint: Academic Press
  • eBook ISBN: 9781483276410

About the Editor

R. Douglas Wilkerson

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