Related Experiment Videos
Ivabradine: from molecular basis to clinical effectiveness
1Cardiology Unit, San Camillo de Lellis Hospital, Manfredonia, Foggia, Italy. griccioni@hotmail.com
Advances in Therapy
|April 27, 2010
Summary
Ivabradine (IVA) effectively lowers heart rate (HR) by inhibiting the If current in sinoatrial node cells. This HR reduction offers benefits for patients with coronary artery disease and chronic stable angina.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Ivabradine (IVA) is a selective heart rate (HR)-lowering agent.
- It acts on sinoatrial node (SAN) cells by inhibiting the If current.
- Elevated HR is a concern in patients with coronary artery disease.
Purpose of the Study:
- To review the regulation of HR and If current by Ivabradine.
- To describe the beneficial effects of Ivabradine in coronary artery disease patients.
Main Methods:
- Review of published studies on Ivabradine's pharmacodynamics and pharmacokinetics.
- Analysis of Ivabradine's effect on HR, myocardial contractility, blood pressure, and conduction.
Main Results:
- Ivabradine dose-dependently reduces HR by slowing the diastolic depolarization slope in SAN cells.
- HR reduction occurs at rest and during exercise with minimal impact on other cardiovascular parameters.
- Ivabradine is noninferior to beta-blockers and calcium antagonists for HR reduction.
Conclusions:
- Ivabradine is a valuable therapeutic option for managing elevated HR in coronary artery disease.
- Its specific mechanism and favorable profile make it suitable for patients with chronic stable angina.
Related Concept Videos
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
01:21Pharmacodynamics: Overview and Principles
Pharmacodynamics is a scientific field that delves into drugs' intricate biochemical, cellular, and physiological effects on the human body. The study of pharmacodynamics helps us understand how drugs interact with the body and elicit various responses.
Most drugs' effects result from their interactions with drug receptors or targets within the body. These interactions trigger specific responses at the cellular or systemic level. Drug receptors can be found on the surfaces of cells or within...
Most drugs' effects result from their interactions with drug receptors or targets within the body. These interactions trigger specific responses at the cellular or systemic level. Drug receptors can be found on the surfaces of cells or within...
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
01:12Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
01:16Therapeutic Drug Monitoring: Overview and Classification
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
Cardiovascular diseases, encompassing a range of conditions, can significantly affect the heart's operations and the overall circulatory system. These conditions impair the heart's ability to pump blood, leading to a deficit in oxygen supply to crucial organs. Anomalies in the heart's electrical system, known as arrhythmias, can cause heartbeats to accelerate or slow down. Usually, heart rates increase during physical activity and decrease while resting or sleeping. However, frequent irregular...