Drug abuse in cardiovascular diseases

Abstract

A large amount of substances and their association can lead to worsening of latent or active cardiovascular diseases and, sometimes, to ex-novo cardiovascular diseases. Negative cardiovascular effects are mainly due to pharmacokinetics of substances, in particular if drugs are administered in combination, or if intake, distribution, and elimination processes are altered; moreover, negative effects can be due to pharmacodynamics of drugs as in the presence of an interaction between an otherwise non-toxic substance and a morphofunctional altered cardiac substrate. In the first part of this chapter, we systematically describe cardiovascular effects of illicit drugs, as listed by the World Anti-Doping Agency and including different classes of substances, namely, anabolic androgenic steroids, hormones and related substances, β2-agonists, diuretics, stimulants, narcotics, cannabinoids, glucocorticosteroids, alcohol, and β-blockers. The second part is dedicated to cardiovascular effects that can occur during the use and abuse of most common prescription drugs as antipsychotic, antibiotics, anti-viral, antihistaminic, and antineoplastic drugs.