UniMark Pharmaceuticals was established in 1997 and emerging

in Pharmaceutical Market. It is dedicated to provide better quality of life to every person and cost effective treatment by focusing on the growing need of pharmaceutical market. Business Evolution: The basis of UniMark business evolution is marketing all over Pakistan With life saving drugs in Cardiovascular Market

Anti-diabetic market

Gynecology

The Human Circulatory System

M.TARIQ KHAN
(Product Manager)

Introduction
Humans and other vertebrates have a closed

circulatory system:
This means that circulating blood is pumped through

a system of vessels
This system consists of the heart (pump), series of

blood vessels and the blood that flows through them.

Parts of the Circulatory System

Divided into three major parts:

The Heart
The Blood The Blood Vessels

Functions of Circulatory System

Circulate blood throughout entire body for
Transport of oxygen to cells Transport of CO2 away from cells

Transport of nutrients (glucose) to cells

Movement of immune system components (cells,

antibodies) Transport of endocrine gland secretions

The Heart
Located near the center of your chest Hollow structure Composed almost entirely of muscle About the size of your clenched fist

The Heart: Structures

Four chambers

Two atria
Upper chambers Left and right Separated by interatrial septum

Two ventricles

Lower chambers Left and right Separated by interventricular septum

Atrioventricular septum separates the atria from the ventricles

The Heart: Structures(cont.)

27-8

Heart coverings
Pericardium

Covers the heart and large blood vessels attached to the heart

Visceral pericardium

Innermost layer Directly on the heart

Parietal pericardium

Layer on top of the visceral pericardium

The Heart: Valves

Tricuspid valve prevents blood from flowing back into the right atrium when the right ventricle contracts Bicuspid valve prevents blood from flowing back into the left atrium when the left ventricle contracts Pulmonary valve prevents blood from flowing back into the right ventricle Aortic valve prevents blood from flowing back into the left ventricle

The Heart: Blood Flow

Deoxygenat ed blood in from body
Oxygenated blood in lungs Oxygenated blood out to body

Deoxygenate d blood out to lungs Atria Contract Ventricles Contract

The Heart: Blood Flow (cont.)

Right Atrium
Tricuspid Valve

Right Ventricle

Pulmonary Valve

Body

Lungs

Aortic Semilunar Valve

Left Ventricle

Bicuspid Valve

Left Atrium

Pulmonary Semilunar Valve

The Heart: Cardiac Cycle

One heartbeat = one cardiac cycle Atria contract and relax Ventricles contract and relax Right atrium contracts Left atrium contracts Tricuspid valve opens Bicuspid valve opens Blood fills right ventricle Blood fills left ventricle
Right ventricle contracts Tricuspid valve closes Pulmonary semilunar Left ventricle contracts Bicuspid valve closes Aortic semilunar valve

valve opens Blood flows into pulmonary artery

opens Blood pushed into aorta

Cardiac Cycle
Influenced by
Exercise
Parasympathetic nerves Sympathetic nerves

Cardiac control center

Body temperature Potassium ions

Calcium ions

The Vascular System

Blood Pressure
Blood pressure is the force or pressure that the blood

exerts on the walls of the blood vessels BP = CO x TPR CO= SV x HR BP = Blood Pressure CO = Cardiac Output TPR = Total Peripheral Resistance SV = Stroke Volume HR = Heart rate

Blood Pressure

Force blood exerts on the inner walls of blood vessels Highest in arteries Lowest in veins Systolic pressure (Normal 120mmHg) Ventricles contract Blood pressure is at its greatest in the arteries

Diastolic pressure (Normal 80mmHg) Ventricles relax Blood pressure in arteries is at its lowest Reported as the systolic number over the diastolic number (120/80mmHg)

PRIMARY HYPERTENSION
It is also called Essential Hypertension About 90% persons have primary hypertension, The main reasons are believed to be involves is
Diet Age Obesity Race Heredity Stress Smoking

SECONDARY HYPERTENSION
Secondary hypertension is due to Excessive renin secretion Arteriosclerosis Endocrine Disorders

WHO B.P CLASSIFICATION

B.P classification according to the WHO is

Grade 1 (Mild Hypertension) SBP 140-159 or DBP 90-99

Grade 2 (Moderate Hypertension) SBP 160-179 or DBP 100-109

Grade 3 (Severe Hypertension) SBP 180 or DBP 110

What is the difference between the systolic pressure and diastolic pressure?
ANSWER: Systolic pressure is the result of the contraction of the ventricles increasing the pressure in the arteries. Diastolic pressure is the result of the relaxation of the ventricles lowering the pressure in the arteries.

The Heart: Cardiac Conduction System

Group of structures that send electrical impulses through the heart Sinoatrial node (SA node) Wall of right atrium Generates impulse Natural pacemaker Sends impulse to AV node Bundle of His Between ventricles Two branches Sends impulse to Purkinje

fibers

Atrioventricular node (AV

Purkinje fibers node) Lateral walls of ventricles Between atria just above ventricles Ventricles contract Atria contract Sends impulse to the bundle of His

Control of Blood Pressure

Short term control

Baroreceptors
Chemoreceptors Higher centres in the brain Long term control

RAAS system

Baroreceptors
Located in walls of aortic arch and left and right

carotid sinus Mechanical stretch receptors Neuronal circuits in brainstem compare actual value of BP provided by the baroreceptors with the set point or optimal value

Summary of the main mechanisms in blood pressure control

Baroreceptor and Chemoreceptor Reflexes

The Baroreceptor Reflex

Chemoreceptor
Nerve ending situated in the carotid and aortic bodies control of respiration Sensitive to changes in the levels of Co2 , O2 and acidity of the blood

The relationship between stimulation of chemoreceptors and arterial blood pressure

Long term Blood pressure regulation

Renin-angiotensin-aldosterone system (RAAS) Anti-diuretic harmone (ADH)

Atrial natriuretic peptide (ANP)

Harmone released by heart Sodium and water loss from the kidney

Reduces blood pressure

RAAS System

Blood supply to the heart

The heart is supplied with arterial blood by the right and left coronary arteries, which branch from the aorta immediately distal to the aortic valve The coronary arteries receive about 5% of the blood pumped from the heart, although the heart comprises a small proportion of body weight

Blood supply to the heart

Venous drainage
Most of venous blood is collected into several small veins that join to form coronary sinus, which opens into right atrium The remainder passes directly into the heart chambers through little venous channels

Heart Innervation
Heart receives visceral motor

innervation Sympathetic (speeds up) Parasympathetic (slows down)

Larry M. Frolich, Ph.D.,Human Anatomy

Electrocardiography

Alterations in Electrocardiogram

Blood

A type of connective tissue Average-sized adult Red blood cells has 4 to 6 liters of (erythrocytes) blood White blood cells (leukocytes) Amount depends on: Platelets cell Size of person fragments Amount of adipose tissue Plasma fluid part of blood Concentrations of

ions Females have less than males

Blood Components
Hematocrit The percentage of red blood cells Normal is about 45% White cells and

platelets = 1%
Plasma = 55%

Blood Components: Red Blood Cells

Erythrocytes Transport oxygen throughout the body Small biconcave-shaped cells Hemoglobin is a pigment in RBCs Oxyhemoglobin carries oxygen; bright red Deoxyhemoglobin does not carry oxygen; darker red Carries carbon dioxide, so also called carboxyhemoglobin Anemia low RBC count Erythropoietin regulates production of RBCs

Blood Components: White Blood Cells

Granulocytes Neutrophils (55%) destroy bacteria, viruses, and toxins in the bloodstream (phagocytes) Eosinophils (3%) get rid of parasitic infections such as worm infections Basophils (1%) control inflammation and allergic reactions Agranulocytes Monocytes (8%) destroy bacteria, viruses, and toxins in blood Lymphocytes (33%) provide immunity for the body

Blood Components: White Blood Cells (cont.)

WBC count normally 5000 to 10,000 cells per cubic

millimeter of blood Leukocytosis Elevated WBC count Usually due to infection Leukopenia Low WBC count Some viral infections and other conditions

Blood Components: Platelets

Fragments of cells found in the bloodstream Also called thrombocytes Important in the clotting process of blood Normal count 130,000 to 360,000 platelets per cubic millimeter of blood

Blood Components: Plasma

Liquid portion of blood

composed mostly of water Proteins Albumins Smallest plasma proteins Pull water in to help maintain blood pressure Globulins transport lipids and fat-soluble vitamins Fibrinogen needed for blood clotting

Nutrients Amino acids

Glucose
Nucleotides Lipids from the

digestive tract Gases oxygen, carbon dioxide, and nitrogen Electrolytes Waste products

Blood: Bleeding Control

Hemostasis the control of bleeding

Three processes of hemostasis Blood vessel spasm Platelet plug formation Blood coagulation

Platelet plug formation

Diseases and Disorders of the Cardiovascular System

Disease Anemia Description The blood does not have enough red blood cells or hemoglobin to carry an adequate amount of oxygen to the bodys cells A ballooned, weakened arterial wall Abnormal heart rhythms Inflammation of the heart Inflammation of the innermost lining of the heart, including valves

Aneurysm Arrhythmias Carditis Endocarditis

Diseases and Disorders of the Cardiovascular System (cont.)

Disease Myocarditis Pericarditis Congestive Heart Failure Description Inflammation of the muscular layer of the heart Inflammation of the membranes that surround the heart (pericardium) Weakening of the heart over time; heart is unable to pump enough blood to meet bodys needs

Coronary Atherosclerosis; narrowing of coronary Artery Disease arteries caused by hardening of the fatty (CAD) plaque deposits within the arteries

Diseases and Disorders of the Cardiovascular System (cont.)

Disease
Hypertension

Description
High blood pressure; consistent resting blood pressure equal to or greater than 140/90 mm Hg Bone marrow produces a large number of abnormal WBCs

Leukemia

Murmurs
Myocardial Infarction

Abnormal heart sounds

Heart attack; damage to cardiac muscle due to a lack of blood supply

Diseases and Disorders of the Cardiovascular System (cont.)

Disease Sickle Cell Anemia Thalassemia Description Abnormal hemoglobin causes RBCs to change to a sickle shape; abnormal cells stick in capillaries

Inherited form of anemia; defective hemoglobin chain causes, small, pale, and short-lived RBCs Thrombophleb Blood clots and inflammation develops in a itis vein Varicose Veins Twisted, dilated veins

The doctor has told your patient she has anemia. How would you explain this to the her?
ANSWER: Anemia is a condition in which a person does not have enough red blood cells or hemoglobin in the blood to carry an adequate amount of oxygen to body cells.

CARSEL

CARSEL25 Tablets CARSEL 50 Tablets CARSEL 100 Tablets CARSEL PLUS50 Tablets CARSEL PLUS100 Tablets

PRESCRIBING INFORMATION
Carsel has the antihypertensive effect Metoprolol Tartrate is a selective beta-1adrenoreceptor

blocking agent. CARSEL PLUS has combination of Hydrochlorothiazide that has antihypertensive & diuretics action. Carsel 25,50,100 have Metoprolol Tartrate 25mg,50mg and 100 mg respectively. The 50/25 tablets contain 50mg of Metoprolol Tartrate & 25mg of Hydrochlorothiazide USP. The 100/25 tablets contain 100mg of Metoprolol Tartrate & 25mg of Hydrochlorothiazide USP.

INDICATIONS & DOSAGE

INDICATIONS DOSAGE

That is hypertension preferably 1 to 2 tablets per day in single in high risk patients with renal or divides doses disease, heart failure or diabetes mellitus
Stage III hypertension 1 to 2 tablets per day in single or divides doses

Essential hypertension WHO grade I & II

1 to 2 tablets per day in single or divides doses

PRESENTATION
Film coated tablet, blister strip 10 tablets,

available in carton pack of 30 Tablets

PRICE CARSEL 25
Retail Price = 60.00Rs Trade Price = 51.00Rs

CARSEL 50
Retail Price = 95.00Rs Trade Price = 80.75Rs CARSEL 100
Retail Price = 150.00Rs Trade Price = 127.50Rs

CARSEL PLUS
CARSEL PLUS 50 Retail Price =90.00Rs Trade Price = 76.50Rs

CARSEL PLUS 100

Retail Price = 150.00Rs Trade Price = 127.50Rs

PRICE COMPARISON
S# Brand Name Company Strength Packin g Price/ Pack Price/ Tab.

CARSEL

UniMark

25mg 50mg 100mg 100mg

30s

60.00 95.00 150.00 480.00

2.00 3.17 5.00 16.00

BETALOOC ZOK

BH

30s

MEPRESSOR

NOVARTIS

100mg 200 mg

30s 30s

187.48 323.00

6.20 10.76

MIODARONE

MIODARONE
Contain Amiodarone hydrochloride,which is a member of

a new class of antiarrhythmic drugs. The antiarrhythmic effect of Amiodarone is due to: A prolongation of the myocardial cell-action potential duration and refractory period
Noncompetitive - and -adrenergic inhibition Class III of antiarrhythmic drugs .

PRESENTATION
Presented in Alu-Alu packing of 30 Tablets

Price
Retail Price = 331.50 Trade Price = 390.00

PRICE COMPARISON
S# Brand Name Company Strength Packin g Price/ Pack Price/ Tab.

MIOARONE

UniMark

200mg

30s

390.00

13.00

CARDARONE

Sanofi aventis

200mg

30s

464.14

15.4

SEDACORONE

BIO PHARMA

200 mg

50s

585.84

12.00

ANGIPRO 75
Aspirin is acetylsalicylic acid and is antithromoltic,

analgesic, antipyretic and anit-inflammatory agent. The enteric coated Angipro 75 is designed to resist disintegration in the stomach, but to dissolve in a better neutral to alkaline environment of the duodenum.

MECHANISM OF ACTION
Aspirin as anti-platelet drug blocks thromboxane A2 sysnthesis

from arachidonic acid in platelets Aspirins mode of action as an anti-inflammatory and antirheumatic agent may be due to inhibition of synthesis and release of prostaglandins.

 INDICATIONS
ANGIPRO 75 (enteric coated Aspirin) is indicated for:

Angina Pectoris Myocardial Infarction Myocardial infarction prophylaxis Transient Ischemic Attacks Prophylactic use of ANGIPRO is also recommended to avoid the chances of thrombo embolic disorders ANGIPRO 75 is also indicated in condition requiring chronic or long-term aspirin therapy for pain and inflammation, e.g. rheumatoid arthritis, Juvenile rheumatoid arthritis,

PRICE
M.R.P. Rs.. 30.00Rs TRADE PRICE25.50Rs

PRICE COMPARISON
Brand Name Company Strength Packing Price/ Pack Price/ Tab.

ANGIPRO

UniMark

75 mg

30s

30.00

1.00

LOPRINE

HIGHNOO N
SCOTMAN N PACIFIC PHARMA Atco

75mg

30s

33.00

1.10

APISCOT

75 mg

30s

30.00

1.00

DOLOPRIN

75mg

30s

30.00

1.00

ASCARD

75mg

30s

33.00

1.10

 NIGLYS SR
2.6/6.4mg
Glyceryl Trinitrate Sustained release pellets

Mode of action
Glyceryl trinitrate has dilator properties on vascular

smooth muscle in virtually all vascular beds. The beneficial effects in therapeutic doses and the effects seen with overdose are attributable to the physiologic consequences of systemic venous and arteriolar vasodilatation. The cardiac preload, systemic blood pressure and systemic vascular resistance all show a progressive decrease.

 NIGLYS, relaxes smooth muscle including vascular

smooth muscle, and reduces systolic blood pressure. It is thought that the anti-anginal effect mainly depends on reducing myocardial oxygen demand by means of peripheral vasodilatation , which causes decreased venous return permitting a reduction in left ventricular volume and energy expenditure.

Indications
1-Prophylaxis and treatment of angina 2- Left ventricular failure. 3-Control of hypertension during cardiac surgery. 4-Congestive cardiac failure unresponsive to usual therapy. 5- IHD, CHD

PRESENTATION
Niglys is available in capsules form as 2.6 mg and 6.4 mg sustained release pellets.

Packing
Niglys 2.6mg = 30s capsules Niglys 6.4mg = 30s capsules

PRICE COMPARISON
S# 1 2 3 4 5 6 7 8 9 10 11 12 Brand Name Niglys SR Niglys SR Angiocard SR Angiocard SR Nitromint Nitromint Cardnit Cardnit Sustac Sustac Nitroscot Nitroscot Company UniMark UniMark Highnoon/ /Biogenics Highnoon/ /Biogenics Medipex Medipex Atco Atco Searle Searle Scottman Scottman Strength 2.6 mg 6.4mg 2.5 mg 6.5mg 2.6 mg 6.4mg 2.6 mg 6.4mg 2.6 mg 6.4mg 2.6 mg 6.4mg Packing 30s 30s 30s 30s 60s 30s 30s 30s 30s 30s 30s 30s Price/ Pack 110.00 150.00 119.84 142.59 221.97 168.00 106.00 130.00 157.22 185.80 130.00 160.00 Price/ Tab. 3.60 5.00 3.99 4.75 3.70 5.60 3.50 4.30 5.24 6.19 4.33 5.33

(UNIPLATE)Clopidogrel

It is an oral, thienopyridineclass antiplatelet agent used to inhibit blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease.

Mode of action
Clopidogrel is a prodrug, the action of which may be

related to an ADP receptor on platelet cell membranes. The drug specifically and irreversibly inhibits the P2Y12 subtype of ADP receptor, which is important in activation of platelets and eventual cross-linking by the protein fibrin.[1] Platelet inhibition can be demonstrated two hours after a single dose of oral clopidogrel, but the onset of action is slow, so that a loading-dose of 300 mg is usually administered.

PRICE(1X10S)
M.R.P.130.00Rs TRADE PRICE110.00Rs

Brand Name

Company

Strength

Packing

Price/ Pack

Price/ Tab.

UNIPLATE
LOWPLAT

UniMark
PHARM EVO CCL

75 mg
75 mg

10s
10s

130.00.00
140.00

13.00
14.00

NO-CLOT

75mg

10s

140.00

14.00

CLOTNILL

BH

75 mg

10s

130.00

13.00

OGREL PIDOGREL PLAVIX

BOSCH HIGH NOON S.AVENTIS

75 mg 75 mg 75mg

10s 10s 28s

120.00 100.00 3360.00

12.00 10.00 120.00

KOLMARK 10/20 (Tablets)

Generic name: Atorvaststin Calcium

Mode of action
KOLMARK is a selective, competitive inhibitor of

HMG-CoA reductase, the rate-limiting enzyme that converts 3-hydroxy-3- methylglutaryl-coenzyme A to mevalonate, a precursor of sterols, including cholesterol. KOLMARK lowers plasma cholesterol and lipoprotein levels by inhibiting HMG-CoA reductase and cholesterol synthesis in the liver and by increasing the number of hepatic LDL receptors on the cell surface to enhance uptake and catabolism of LDL; KOLMARK also reduces LDL production and the number of LDL particles

INDICATIONS
Prevention of Cardiovascular Disease in adult patients without clinically evident coronary heart

disease, but with multiple risk factors for coronary heart disease such as age, smoking, hypertension low HDL-C, or a family history of early coronary heart disease, kolmark is indicated to: Reduce the risk of myocardial infarction Reduce the risk of stroke Reduce the risk for revascularization procedures and angina n patients with type 2 diabetes, and without clinically evident coronary heart disease, but with multiple risk factors for coronary heart disease such as retinopathy, albuminuria, smoking, or hypertension, KOLMARK is indicated to: Reduce the risk of myocardial infarction Reduce the risk of stroke

patients with clinically evident coronary heart disease, KOLMARK is indicated to: Reduce the risk of non-fatal myocardial infarction Reduce the risk of fatal and non-fatal stroke Reduce the risk for revascularization procedures Reduce the risk of hospitalization for CHF Reduce the risk of angina Hyperlipidemia a. LDL-C remains 190 mg/dL or b. LDL-C remains 160 mg/dL

PRICE(1X10S)
KOLMARK 10
M.R.P.125.00Rs TRADE PRICE..106.25Rs

KOLMARK 20
M.R.P.180.00 Rs
TRADE PRICE..153.00 Rs

PRICE COMPARISON
Brand Name Company Strength Packing Price/ Pack Price/ Tab.

KOLMARK
FOPSEC

UniMark
MERCK

10 mg 20mg
10mg 20mg 10mg 20mg 10mg 20mg

10s
10s

125.00 180.00
130.00 22.00 130.00 230.00 150.00 250.00

12.50 18.00
13.00 22.00 13.00 23.00 15.00 25.00

LIPIREX

HIGHNOON

10s

LIPIGET

GETZ

10s

MONOSOR 20/40
(Isosorbide-5-mononitrate) Tablets

MODE OF ACTION
It is of Synthetic origin and belongs to Nitrates. It

belongs to EDRF (NO) agonist pharmacological group on the basis of mechanism of action and also classified in Antianginal Agents and V isosorbide-5-mononitrate is organic nitrate esters commonly used in the treatment of angina pectoris, myocardial infarction, congestive heart failure. Organic nitrate esters have a direct relaxant effect on vascular smooth muscles, and the dilation of coronary vessels improves oxygen supply to the myocardium. The dilation of peripheral veins, and in higher doses peripheral arteries, reduces preload and after-load, and thereby lowers myocardial oxygen consumption.

INDICATIONS
Isosorbide 5-Mononitrate is

primarily indicated in conditions like Congestive heart failure, Prevention and treatment of scurvy, Prophylaxis of angina.

PRICE
MONOSOR 20(2x10s)
M.R.P..77.00Rs Trade Price65.45 Rs

MONOSOR 40 (2x10s)
M.R.P123.00Rs Trade Price104.55 Rs

PRICE COMPARISON
Brand Name Company Strength Packing Price/ Pack Price/ Tab.

MONOSOR

UniMark

20mg 40mg

20s

77.00 123.00

3.85 6.15

MONIS

MAPPLE

20mg 40mg
20mg 40mg 20mg 40mg

20s

77.00 123.00
191.90 308.28 72.30 111.24

3.85 6.15
3.85 6.17 3.62 5.60

ELANTON

ATCO

50s

MONOTRATE

PFIZER

20s