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Drug-induced cardiovascular diseases.

S M Deglin, J M Deglin, E K Chung

    Drugs
    |July 1, 1977
    PubMed
    Summary

    Many drugs can cause serious cardiovascular toxicity, affecting both cardiac and non-cardiac conditions. Understanding these drug-induced cardiac side effects is crucial for patient safety and effective treatment.

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    Area of Science:

    • Pharmacology
    • Cardiology
    • Toxicology

    Background:

    • Drugs used for cardiovascular conditions, like digitalis glycosides and antiarrhythmic agents, are well-documented causes of cardiac toxicity, including arrhythmias.
    • Non-cardiac drugs, such as oral contraceptives and chemotherapeutic agents (doxorubicin, daunorubicin), also pose significant cardiovascular risks, though less understood.
    • Psychotherapeutic drugs, including phenothiazine antipsychotics and tricyclic antidepressants, can exhibit arrhythmogenic potential.

    Purpose of the Study:

    • To review and summarize the cardiovascular toxicity associated with a wide range of drugs.
    • To highlight the documented and potential cardiac side effects of both cardiac and non-cardiac medications.
    • To underscore the importance of recognizing drug-induced cardiovascular toxicity in clinical practice.

    Main Methods:

    • Literature review of documented cases and known mechanisms of drug-induced cardiovascular toxicity.
    • Analysis of side effect profiles for various drug classes, including cardiovascular, antiarrhythmic, beta-adrenergic blocking, sympathomimetic, oral contraceptive, anti-neoplastic, and psychotherapeutic agents.
    • Synthesis of information regarding the extent of understanding and controversies surrounding these toxicities.

    Main Results:

    • Digitalis glycosides are a primary cause of arrhythmias.
    • Antiarrhythmic agents, beta-blockers, and sympathomimetic amines can lead to arrhythmias, myocardial depression, heart failure, and ischemia.
    • Non-cardiac drugs present less understood but significant risks, including thromboembolism (oral contraceptives) and cardiomyopathy (chemotherapy drugs like doxorubicin).
    • Psychotropic medications can also induce arrhythmias.

    Conclusions:

    • A broad spectrum of drugs, beyond those directly targeting the heart, can induce serious cardiovascular toxicity.
    • Further research and clinical awareness are necessary to fully understand and manage the cardiovascular risks associated with non-cardiac and newer drug classes.
    • Recognizing and managing drug-induced cardiovascular toxicity is essential for patient safety and optimal therapeutic outcomes.

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