Which are the popular Medicines prescribed for Heart Disorders?

A person having heart disorder is more likely to take medication for the rest of life. Medicines in Heart disorders can be of many types. These can be monotherapy or a combination of different drugs.

Commonly prescribed Medicines for Heart Disorders are diuretics, vasodilators, calcium channel blockers, beta-blockers, ACE inhibitors.

The following list provides you a quick look at medications prescribed for heart disorders. Brand names, company, and pack details are shown in parentheses.

Acenocoumarol: It is a vitamin K antagonist and inhibits the reduction of vitamin K by acting on vitamin K epoxide reductase.

This in turn prevents gamma-carboxylation of the glutamic acid residues in the vitamin K-dependent clotting factors such as factor II, VII, IX, and X and anticoagulant protein C and S. As a result of this, thrombin formation is inhibited and clotting cannot occur.

Amlodipine: It acts directly on the vascular smooth muscle and decreases the peripheral vascular resistance by inhibiting the influx of calcium ions into the vascular smooth muscle and cardiac muscle. This, in turn, causes a decrease in blood pressure.

Atenolol: It is a beta-blocker and antagonizes the sympathetic innervation.

This, in turn, increases the release of norepinephrine from the peripheral nervous system and prevents the increase in the heart rate, electrical conductivity, and contractility in the heart.

Ticagrelor : The drug and its major metabolite reversibly binds to the allosteric site of the P2Y₁₂ subtype adenosine diphosphate receptor and prevents signal transduction and platelet activation.

Cilnidipine: It acts on and inhibits the L-type and N-type calcium channels of blood vessels.

This in turn inhibits the influx of calcium and contraction of blood vessels that finally reduce the blood pressure. It also inhibits the emission of norepinephrine at the sympathetic nerve and aids in the reduction of stress blood pressure.

Telmisartan: It is an angiotensin (AT) receptor blocker and prevents the binding of angiotensin-II with the AT receptors located in the vascular smooth muscles, adrenal gland, and other tissues.

This in turn blocks the vasoconstrictor and aldosterone-secreting effects produced by angiotensin-II.

Clopidogrel: It is a prodrug and gets metabolized by carboxylesterase-1 to form the active form that irreversibly binds to the P2Y₁₂ Adenosine diphosphate receptors on the platelets.

This in turn inhibits the binding of adenosine diphosphate to the receptors and thereby blocks the ADP-mediated activation of glycoprotein GP IIb/IIIa complex. All these ultimately prevent the aggregation of platelets.

Bisoprolol: It selectively and competitively blocks the stimulation of β₁ adrenoreceptors by the adrenaline that in turn reduces the contractility and heart rate of the heart muscle and pacemaker cells.

As a result of this, the cardiac output and blood pressure also decrease. It also reduces the secretion of renin by the kidneys.

Torsemide: It is a loop diuretic and acts on the thick ascending loop of Henle. It inhibits the Na⁺/K⁺/Cl^– cotransporter by binding to the chloride ion binding site of this pump.

It also reduces the expression of aldosterone synthase, thromboxane A₂ and transforming growth factor beta-1. These changes along with a reduction in aldosterone receptor binding are due to the inhibition of the downstream cascade following angiotensin-II activation.

Acetylsalicylic acid: It irreversibly inhibits cyclooxygenase-1 (COX-1) enzyme in the platelets and megakaryocytes.

This in turn prevents the formation of thromboxane A₂ that is essential for the platelet aggregation and clot formation. Thereby it acts as an antiplatelet agent.

Atorvastatin: It is a lipid-lowering drug that competitively inhibits HMG-CoA reductase (3-hydroxy-2-methylglutaryl Coenzyme A) enzyme and prevents the conversion of HMGCoA to mevalonate.

It also enhances the uptake of low-density lipoproteins (LDL) in the liver by upregulating the LDL receptors. It also elicits its action by reducing the very low-density lipoproteins- cholesterol, serum triglycerides, and intermediate-density lipoproteins.

Trimetazidine: It inhibits β-oxidation of free fatty acids and increases the metabolic rate of glucose as well as pyruvate dehydrogenase activity.

This corrects the imbalance between glucose oxidation and glycolysis. It also directly inhibits cardiac fibrosis.

Ivabradine: It lowers heart rate by selectively inhibiting the channel responsible for the cardiac pacemaker current.

It also prolongs diastolic depolarization and reduces myocardial oxygen demand by disrupting the flow of this current.

Losartan: Losartan and its 5-carboxylic acid metabolite selectively inhibit angiotensin-II receptor type-1 (AT₁) and reduces the end-organ responses to angiotensin-II.

It antagonizes the release of aldosterone, reduces total peripheral resistance and cardiac venous return. These changes facilitate its use as an antihypertensive agent.

Hydrochlorthiazide : It is a thiazide diuretic that acts on the distal convoluted tubule by inhibiting the reabsorption by the sodium-chloride symporter.

This in turn reduces the difference in concentration gradient between the epithelial cells and the distal convoluted tubule and thereby prevents reabsorption of water.

Metoprolol: It is a selective beta-1 blocker that specifically inhibits the beta receptors present in the cardiac cells. This causes negative chronotropic and ionotropic effects that in turn reduces cardiac output and heart rate. It also reduces cardiac excitability and myocardial oxygen demand.

Prazosin: It inhibits post-synaptic α₁adrenoreceptor and prevents the vasoconstricting effect of catecholamines on the peripheral blood vessels.

This in turn leads to peripheral vessel dilation and reduces the blood pressure.

Nebivolol: It inhibits the beta-1 adrenoreceptors present in the heart and decreases cardiac contractility, heart rate, cardiac output, and ultimately blood pressure.

It also potentiates the effects of nitric oxide to exert a vasodilatory effect on the vascular smooth muscle.

Nicorandil: It activates ATP-dependent potassium channels and causes hyperpolarization that in turn limits the duration of action potential and prevents intracellular calcium overload.

It also reduces calcium influx and mobilization in smooth muscle cells and produces vasodilation. The nitrate moiety of nicorandil also dilates the vascular smooth muscles by the stimulation of guanylyl cyclase and by increasing intracellular cGMP levels.

Nitroglycerin: It forms a free radical nitric oxide that activates guanylate cyclase and results in an increase of guanosine – 3’,5’- monophosphate (cyclic GMP) in smooth muscles and other tissues.

These changes lead to the dephosphorylation of myosin light chains that are essential for maintaining the contractile state of the muscle and ultimately result in vasodilation.

Rosuvastatin: It is a lipid-lowering agent that inhibits HMGCoA reductase and prevents the conversion of HMGCoA to mevalonate.

Sacubitril: It is a prodrug that gets converted to sacubitrilat by the action of esterases.

The active metabolite inhibits neprilysin, an enzyme that is responsible for the degradation of atrial and brain natriuretic peptide and other peptides like bradykinin. Inhibition of this enzyme in turn exerts a vasodilatory and antihypertensive effect.

Valsartan: It is angiotensin – II receptor blocker that selectively binds to the AT₁receptor and prevents the binding of angiotensin-II with this receptor to exert its hypertensive effects.

As a result of this, it reduces blood pressure, lowers aldosterone levels, reduces cardiac activity, and increases the excretion of sodium.

Heart Disorders Medicines

Enlisted herewith are the details of popularly used Medicines for Heart Disorders; brands, pack details.

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Brand Name	Compositino	Company
ACITROM	ACENOCOUMAROL	ABBOTT
AMLOKIND-AT	AMLODIPINE BESILATE + ATENOLOL	MANKIND
AXCER	TICAGRELOR	SUN
BRILINTA	TICAGRELOR	ASTRAZENECA
CILACAR	CILNIDIPINE	UNIQUE PHARM
CILACAR-T	CILNIDIPINE + TELMISARTAN	UNIQUE PHARM
CLOPILET	CLOPIDOGREL	SUN
CONCOR	BISOPROLOL	MERCK SPECIALITIES
DYTOR	TORASEMIDE	CIPLA
ECOSPRIN GOLD	ACETYLSALICYLIC ACID + ATORVASTATIN + CLOPIDOGREL	U S V
ECOSPRIN-AV	ACETYLSALICYLIC ACID + ATORVASTATIN	U S V
FLAVEDON	TRIMETAZIDINE	SERDIA
IVABRAD	IVABRADINE	LUPIN LIMITED
LOSAR	LOSARTAN	TORRENT PHARMA
LOSAR-H	HYDROCHLOROTHIAZIDE + LOSARTAN	TORRENT PHARMA
METOSARTAN	METOPROLOL TARTRATE + TELMISARTAN	SUN
MINIPRESS-XL	PRAZOSIN HYDROCHLORIDE	PFIZER
NEBICARD	NEBIVOLOL HYDROCHLORIDE	TORRENT PHARMA
NIKORAN	NICORANDIL	TORRENT PHARMA
NITROCONTIN	NITROGLYCERIN	MODI MUNDIPHARMA
PILEX	BAUHINIA + BERBERIS ARISTATA EXTRACT + CASSIA FISTULA EXTRACT + COMMIPHORA MOLMOL POWDER + MELIA AZEDARACH + MESUA FERREA + PHYLLANTHUS EMBLICA EXTRACT + TAR EXTRACT + TERMINALIA BELLIRICA + TERMINALIA CHEBULA EXTRACT	HIMALAYA DRUG
PRAZOPRESS	PRAZOSIN	SUN
ROSUVAS	ROSUVASTATIN	SUN
ROZAVEL	ROSUVASTATIN CALCIUM SALT	SUN
STAMLO	AMLODIPINE BESILATE	DR REDDYS LABS
STAMLO BETA	AMLODIPINE BESILATE + ATENOLOL	DR REDDYS LABS
TELMA	TELMISARTAN	GLENMARK PHARMA
TELMA-AM	AMLODIPINE BESILATE + TELMISARTAN	GLENMARK PHARMA
TELMA-H	HYDROCHLOROTHIAZIDE + TELMISARTAN	GLENMARK PHARMA
TELMIKIND-AM	AMLODIPINE BESILATE + TELMISARTAN	MANKIND
TELMIKIND-H	HYDROCHLOROTHIAZIDE + TELMISARTAN	MANKIND
VYMADA	SACUBITRIL + VALSARTAN	NOVARTIS