Pharmacology Cardiac Drugs for UPSC CMS: Mechanisms, Doses and Side Effects

Anti-Anginal Drugs#

• Nitrates: NO -> cGMP -> vasodilation. Side effects: headache, hypotension, tolerance.
• Beta-blockers: Reduce HR and contractility. Propranolol, Metoprolol, Atenolol.
• Calcium channel blockers: Verapamil (cardio-selective), Diltiazem, Amlodipine.

Anti-Arrhythmic (Vaughan-Williams)#

Class I (Na+ channel): IA (quinidine - prolonged APD), IB (lignocaine - shortened APD), IC (flecainide - no APD change).
Class II (Beta-blockers): Propranolol, Esmolol.
Class III (K+ channel): Amiodarone (most effective, multi-channel), Sotalol.
Class IV (Ca2+ channel): Verapamil, Diltiazem.

Heart Failure Drugs#

ACE-I, ARNI, Beta-blockers, MRAs, SGLT2i, Diuretics.