Page 126 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

6- Cytoprotective agents (ex: Trimetazidine)

 This cyto-protection is obtained by providing enough energy to maintain an efficient

myocardial contraction during ischemia
 It produces a metabolic switch via inhibition of fatty acid oxidation toward
activation of glucose oxidation during ischemia

 It limits intracellular acidosis and sodium and calcium accumulation
 It preserves contractile function and limit cytolysis.
 It limits membrane damage induced by oxygen free radical.

7- Funny channel blocker (ex: Ivabradine)

 It inhibits funny channel (inhibit influx of both Na & K ion) in the SA node leading
to hyperpolarization and inhibition of Ca contraction results in decreasing
intracellular sodium and calcium overload improving oxygen supply and demand.

+
 It produces marked bradycardia so considered after βBs, Na & CCBs

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