Medicine & USMLE


Cardiovascular Drugs (New)
  1. Ivabradine
  2. Nitroprusside
  3. DHP Calcium Channel Blockers
  4. Hydralazine
  5. Fenoldopam
  6. Nitrates
  7. Ranolazine
  8. Sacubitril


Ivabradine is a medication used to treat chest pain and heart failure. It works by blocking funny sodium channels in pacemaker cells. This prolongs the slow depolarization of the cell, causing a lengthening of phase 4 of the pacemaker action potential. Side effects of ivabradine include seeing luminous phenomena and bradycardia. Hypertension may also occur as a rare side effect.

Key Points

  • Ivabradine
    • Mechanism
      • Selective inhibition of funny sodium channels (IF)
      • Prolongs the slow depolarization phase (phase 4) of the pacemaker action potential
        • This decreases SA and AV nodal activity, leading to negative chronotropy and dromotropy without affecting inotropy
        • This works to reduce myocardial oxygen demands
    • Clinical Use
      • Treats heart failure
        • Used to treat chronic heart failure with reduced ejection fraction
      • Treats angina
        • Reduction in myocardial oxygen demand can treat angina
        • Used as second-line anti-anginal treatment, in patients who cannot take B-blockers
    • Side Effects
      • Luminous phenomena / visual brightness
        • Due to inhibition of ion channels in the retina that are similar to funny channels
      • Hypertension
      • Bradycardia