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Risk Factors of Cardiovascular Disorders - Drugs

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In the modern world, drugs are available for almost all diseases due to the impressive growth of the pharmaceutical industry over the last 100 years. However, due to extensive use of drugs, patients may suffer from minor to severe adverse drug reactions. Many drugs used for cardiovascular and non-cardiovascular conditions affect the cardiovascular system with unexpected and serious effects. Cardio-toxicity is a well-known adverse effect of several non-cardiovascular drugs. In various studies, it has been shown that as a result of the abundance of mitochondria in cardiac muscle cells and the close relationship between oxidative metabolism and myocardial function and viability, mitochondrial dysfunction should always be suspected in cardio-toxicity. Several types of cardiac complications may be linked to the use of non-cardiovascular drugs (Bajracharya et. al. 2015).

Anti-arrhythmic drugs act on various ion channels but many of them have potential risk of causing arrhythmias through multiple pathways. Many newer anti-arrhythmic drugs can cause arrhythmias. Early signs of digoxin toxicity are premature ventricular contractions, and hyperkalemia can increase the risk of arrhythmias. Diuretics cause dys-electrolytemia, which can induce arrhythmias. Adenosine suppresses most ventricular arrhythmias but is associated with sympathetic activation (Meenakshisundaram et. al. 2015).

Phosphodiesterase inhibitors are inodilators and in long-term use have the potential to cause hypotension and arrhythmias.

Drug-induced long QT syndrome is caused by many drugs and is due to slowing of repolarization and blockade of the potassium currents.

Beta blockers and calcium channel blockers induce various cardiac effects.

Statins have beneficial effects on cardiovascular mortality but may predispose to new-onset diabetes.

Lithium carbonate is used for the treatment of bipolar disorder, association with hypothyroidism, causes cardiac temponade (Yamaguchi et. al. 2013).

Chemotherapy and Anti-cancer therapy: Cytotoxics, such as anthracyclines, or other biological agents have been implicated in causing clinically significant cardiac dysfunction (Esposito et. al. 2015).

Ergot Toxicity: Ergot alkaloids (such as methysergide and ergotamine), ergot-derived dopaminergic agonists (such as pergolide and cabergoline) and drugs metabolized into norfenfluramine (such as fenfluramine, dexfenfluramine and benfluorex) cause drug-induced valvular heart disease (Andrejak and Tribouilloy 2013).

Psychotropic medications used to treat or manage psychiatric symptoms or challenging behaviors; these include antipsychotics, antidepressants, and anxiolytics, as well as mood stabilizers. Such drugs act both directly and indirectly on the cardiovascular system producing adverse effects that range from orthostatic hypotension to sudden cardiac death (Subramaniam et. al. 2015).

Cardiovascular Disorders - Index

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