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Year 1 Systems (JBR) > Cardio Drugs > Flashcards

Cardio Drugs Flashcards

1
Q

What is Ivabradine?

A

Selective blocker of HCN channels

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2
Q

What is the effect of ivabradine?

A

Reduces slope of pacemaker potentialSlow HR reduces oxygen consumption

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3
Q

What are the side effects of ivabradine?

A

Arrythmias

Hypotnesion

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4
Q

What are examples of beta-adrenoceptor agonists?

A

Dobutamine (beta-1 selective)
Adrenaline
Noradrenaline

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5
Q

What is the mechanism of a beta-adrenoceptor agonist?

A

Results in stimulation of adenylyl cyclase and production of cAMP which generates protein kinase A

Phosphorylation increases Ca-influx & CICR

Increased contractility, force and rate

Decrease cardiac efficiency

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6
Q

What are side effects of beta-adrenoceptor agonists?

A

Arrhythmias

Acute MI

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7
Q

What is an example of a non-selective beta-blocker?

A

Propranolol

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8
Q

What is an example of a selective for beta-1 beta blocker?

A

Metprolol

Atenolol

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9
Q

What is the effect of a beta blocker?

A

Decrease HR, contractility and MAP

Decrease O2 consumption

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10
Q

What are the side effects of beta-blockers?

A 
Asthma
Fatigue
Cold peripheries
Heart failure 
Bradycardia (heart block)
Hypoglycaemia
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11
Q

What is an example of a non-selective muscarinic antagonist?

A

Atropine

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12
Q

What is the effect of atropine?

A

Increase heart rate

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13
Q

What are the side effects of atropine?

A

Arrythmias
Hallucinations
Confusion

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14
Q

What type of drug is digoxin?

A

Cardiac glycoside

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15
Q

What is the mechanism of of digoxin`

A

Competes with K+ at the alpha subunit and blocks the Na/K/ATPase pump
Increase contractility by backing the sarcolemma ATPase

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16
Q

What are the indirect effects of digoxin?

A

Increased vagal activity, slows SA node discharge

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17
Q

What re the direct effects of digoxin?

A

Shortens action potential and refractory period

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18
Q

What are the overall effects of digoxin?

A

Increase force, contraction and CO

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19
Q

The effects of digoxin are dangerously enhanced with?

A

Hypokalaemia

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20
Q

What are the side effects of digoxin?

A

Heart block
Dysrhythmias
Myocarditis

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21
Q

What is Levosimendan?

A

Calcium sensitizer

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22
Q

What is the mechanism of Levosimendan?

A

Binds to troponin C in myocytes sensitising them to Ca

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23
Q

What are calcium sensitisers used for?

A

Acutely decompensated congestive heart failure

Increased contractility

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24
Q

What are the side effects of calcium sensitisers?

A

Headaches
Arrhythmias
Hypokalaemia

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25
Class I AADs act on?
Voltage activated Na+ channels
26
Example of Class I AAD?
Flecainide
27
What is the effect of Flecainide?
Reduce Na channel current
28
What are the side effects of flecainide?
Negative inotropic effects
29
What is Flecainide used for?
Rhythm control
30
What is an example of a Class II AAD?
Propanolol (beta-adrenoceptor)
31
What is propranolol used for?
Rate control
32
What is an example of a Class III AAD?
Amiodarone | Sotalol
33
What do Class III AADs act on?
Activated K channels
34
What is the effect of Class III AADs?
Action potential prolongation
35
What are Class III AADs used for?
Rhythm control
36
What is an example of a Class IV AAD?
Verapamil
37
Verapamil is an example of a?
Ca channel antagonist
38
Class IV AADs are used to control`
rate
39
What are examples of nitrates?
Isosobride mononitrate | GTN spray
40
What is the mechanism of nitrates?
Mimic effect of endothelium Produce nitric oxide which is formedthorugh influx of calcium, activation of eNOS and L-arginine NO caused efflux of calcium producing hyper polarisation and relaxation cGMP is also produced which regulates protein kinase G activity causing relaxation Endothelin is also produced
41
What is the effect of nitrates?
Venorelaxation (decreased preload and after load, CO maintained as HR increase) Arteriolar dilation, increased coronary blood flow
42
What are side effects of nitrates?
Headache Hypotension Tolerance is common
43
What are examples of ACEI?
Lisinopril
44
What is the mechanism of ACEI?
Block conversion of angiotensin I - II | Aldosterone and ADH not stimulation
45
What is the effect of an ACEI?
Vasodilation and arterial dilation
46
What are side effects of ACEI?
Dry cough Renal dysfunction (bas with renal artery stenosis / god for diabetic nephropathy) Angioneurotic oedema Fetal abnormalities
47
What is an example of an ARB?
Losartan
48
What are side effects of ARBs`
Renal dysfunction Oedema Contraindicated in pregnancy
49
What are examples of calcium antagonists?
Amlodipine Verapamil Diltiazem
50
What is the mechanism of calcium antagonsits?
Decrease conduction at SA and AV node | Decrease heart rate
51
What are side effects of calcium antagonists?
Ankle oedema | Bradycardia
52
What are examples of alpha Blockers?
Doxazosin
53
What is the mechanism of alpha blockers`
Block alpha-adrenoceptors to cause vasodilation
54
What are side effects of alpha blockers?
Postural hypotension
55
What are examples of potassium channel openers?
Minoxidil | Nicorandil
56
What is the mechanism of K-channel openers?
Causes hyperpolarisation whcih striches of calcium channels Mediated by ATP Relaxation of vascular smooth muscle
57
What are side effects of K-channel blockers?
Tachycardia | Salt and water retention
58
What is the mechanism of a thiazide diuretic?
Inhibit NaCl reabsorption in distal tubules by blocking NaCl co-transporter Increase excretion of Na, Cl, water -- decrease blood volume
59
What is the mechanism of a loop diuretic?
inhibit NaCl reabsorption in the thick ascending limb of the loop of Henle Increase excretion of Na, Cl, water -- decrease blood volume
60
What are side effects of diuretics?
``` Hypokalaemia Arrythmias Fatigue Hyperglycaemia Increase uric acid = gout (arthritis due to uric acid deposits) ```
61
What are examples of statins?
Sim/Atorvastatin
62
What is the mechanism of statins?
Block HMG CoA reductase which inhibits the formation of cholesterol Decrease LDL and total cholesterol Stabilise atherosclerotic plaque and decrease thrombosis
63
What are side effects of statins?
Myalgia, myopathy, myositis (rarely rhabdomyolosis)
64
What are examples of fibres?
Bezafibrate | Gemfibrozil
65
What is the mechanism of fibres?
Agonsit of nuclear receptors which enhances transcription of lipoprotein lipase (LPL) which hydrolyses triglycerides to fatty acids and glycerol
66
What are side effects of fibres?
Myositis
67
What are examples of bile acid binding resins?
Colestyramine, colestipol, colsevelam
68
What is the effect of bile acid binding resins?
Inhibit cholesterol absorption
69
What is the mechanism of bile acid resins?
Causes the excretion of bile salts resulting in more cholesterol to be converted to bile salts Bile resins bind bile in th intestine so it is not absorbed in the duodenum Liver uses metabolised cholesterol to compensate for loss
70
What are the side effects of bile acid resins?
GI tract irritation
71
What is the mechanism of ezetimibe?
Decrease in LDL
72
What are side effects of Ezetimibe?
Diarrhoea Abdominal pain Headache Contraindicated in breast feeding
73
What is the mechanism of warfarin?
Blocks clotting factors 2, 7, 9, and 10 (serine proteases - glycoprotein precursors of active thrombin factors) G-carboxylase enzyme is stimulated by vitamin K and modifies the serine proteases Anticoagulants act as vitamin K antagonists which prevents production of mature coagulation factors
74
What are side effects of warfarin?
Haemorrhage anywhere | Reversed by vitamin K
75
What is the mechanism of heparin?
Binds to antithrombin II, increasing its affinity for serine proteases to greatly increase their rate of activation
76
What is the mechanism of LMWH (enoxaparin and date-aron)?
Inhibit factor Xa (activates thrombin IIa - fibrin - blood clot)
77
Dabigatran and etexilate directly inhibit?
Thrombin
78
Ravaroxaban directly inhibits?
Factor Xa
79
What are side effects of anticoagulants (heparin, LMWH, Dbigatran, rivaroxaban)?
haemorrhage Osteoporosis hypoaldosteronism Hypersensitivity reactions
80
What is the mechanism of aspirin?
Blocks COX inhibiting formation of TXA2 which causes cross linking of platelets
81
What is the mechanism of clopidgrel?
Blocks ADP from binding to P2Y12 receptor and formation of fibrin
82
What are the side effects of anti platelets (aspirin/clopidogrel)?
Haemorrhage anywhere Peptic ulcer Aspirin sensitivity --> asthma
83
What are examples of fibrinolytic drugs?
Streptokinase Tissue plasminogen activator Alteplase, duteplase
84
The fibrinolytic cascade opposes the?
Coagulation cascade
85
Fibrinolytic drugs activate formation of plasmid from plasminogen which ...
lyses fibrin into fibrin fragments causing lysis of the clot
86
What are side effects of fibrinolytic drugs?
Haemorrhage risk (controlled by tranexamic acid which inhibits plasminogen activation)

Year 1 Systems (JBR) (21 decks)

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