50 Drugs Flashcards
Name some cardioselective beta-blockers and their side effects
- Bisoprolol and Atenolol. They are selective for beta 1 receptors in cardiac and renal tissue.
- Side effects are bradycardia, hypotension, BRONCHOSPASM, fatigue, cold extremities, sleep disturbance
Name some non-cardioselective beta blockers and their side effects
- Propanolol and carvediol. Used in migraine prophylaxis + others.
- Side effects are bradycardia, hypotension, fatigue, cold extremities, sleep disturbances and loss of hypoglycaemia awareness
What are the side effects of Aspirin?
Bleeding, peptic ulceration, angioedema, bronchospasm
What are the side effects of clopidogrel?
Bleeding, abdominal pain and diarrhoea
What are the side effects of tissue plasminogen activators?
Bleeding and allergic reaction/angioedema
What are the side effects of unfractionated heparin and LMWH?
Unfractionated and LMWH - Bleeding, heparin induced thrombocytopenia and osteoporosis
What are the side effects of Warfarin?
Bleeding, warfarin necrosis and osteoporosis
What are the side effects of dabigatran and factor Xa inhibitors?
Dabigitran - Bleeding or dyspepsia.
Factor Xa - bleeding and nausea
What are the side effects of ACE inhibitors?
Dry cough,
Hypotension,
Hyperkalaemia,
Renal impairment
What features of nitrates and the side effects?
Features - Converted to NO which is cardioselectivity and acts predominantly on coronary blood vessels.
Side effects - Headaches, postural hypotension and tachycardia
What is the mechanism of action of rate limiting calcium channel blockers?
Prevent entry of calcium by blocking L type calcium channels. Therefore myocardial and smooth muscle contractility is reduced, It dilates coronary blood vessels and reduced afterload and prolongs AV node conduction which slows the HR.
Examples = verapamil and diltiazem
Indications = SVT, angina and hypertension
What are the side effects of rate limiting calcium channel blockers?
Verapamil = constipation, flushing, headaches, hypotension.
Diltiazem = GI upset, bradycardia, peripheral oedema, dizziness, headaches and hypotension
Explain the mechanism of action of non-rate limiting calcium channel blockers and some examples
- Prevent cellular entry of calcium by blocking L type calcium channels, depress contractility, dilate coronary arteries and reduce afterload but these do not lower heart rate so used in hypertension and angina.
Eg, amlodipine or nifedipine
What are the side effects of non rate limiting calcium channel blockers?
- Ankle oedema, abdo pain, palpitations, flushing, headaches
What is the mechanism of action of statins and the side effects?
Inhibits HMG CoA reductase which is the rate limiting stem in the synthesis of cholesterol. This increased LDL receptor expression and increases hepatic uptake of cholesterol, lowering plasma cholesterol levels.
Side effects = Myalgia, myopathy, GI disturbances, liver abnormalities