Cardio Drugs

Question 1

Furosemide
MOA
Uses

Common Names:

Answer 1

Class: Loop Diuretic 
MOA
Blocks the absorption of Na, water and Cl from filtered fluid in nephrons and ∴ increases water loss from the ascending loop of Henle massively.
Uses : Oedema, water retention
Common Names: Lasix

Question 2

What is Hydroxychlorothiazide?
Moa
Uses for?

Answer 2

Increase Na/Cl excretion in proximal part of distal convoluted tubule
Vasodilator- opens ca dependent K channels
Activation of endothelial NO Synthase
Less powerful

Oedema, Firs line BP management in CV risk patients

Question 3

Beta Blockers
Examples
MOA
Used for?

Answer 3

MOA:
Block beta receptors. Can be general or beta-1 specific → Beta-1 receptors are located in the heart and Beta-2 receptors are in the lungs, so different effects occur based on specificity.
Beta-1 blockers: reduce cardiac output and renin release from the kidney, reduce cardiac afterload, reduces energy demand
Non-specific blockers: the same but also bronchoconstrict → contraindicated by asthma.

Uses:
Angina and post MI
Hypertension
Arrhythmias

Examples
Generally end in “olol”
Non-selective: propranolol (Inderal and Deralin) and oxprenolol (Corbeton)
Beta-1 selective: metoprolol (Metohexal) and atenolol (Atehexal)
Sotolol: non selective and also has K blocking action which slows repolarisation and reduces risk of premature depolarisations- use in arrhythmias

Question 4

Ace-Inhibitors
MOA
Uses
Common names

Answer 4

Block the conversion of angiotensin I to angiotensin II by ACE as part of the RAAS, lowering arteriolar resistance and decreasing CO, vasodilation and stimulates release of ADH.
Increase Bradykinin levels

Hypertension (but not superior to diuretics) ,
congestive heart failure
First line in CCF and diabetics with proteinuria

end in “pril”
Captopril, Enalapril, Quinapril , Ramipril

Question 5

ARBS
MOA
Uses
COmmon Names

Answer 5

prevent angiotensin II from binding to its receptors, causing vasodilation
Uses
Hypertension (if people get the cough with ACEI),
congestive heart failure

“sartans”
Valsartan, Telmisartan, Losartan

Question 6

Aldosterone Antagonists
MOA
Uses
Common Names

Answer 6

antagonises aldosterone at mineralocorticoid receptors, inhibiting Na reabsorption in the Cortical collecting duct and causing a diuretic effect as water isn’t absorbed out the nephron.
K sparing diuretic

Uses:
Fluid build-up,
heart failure (more common now due to aldosterone causing cardiac fibrosis)
,liver scarring or kidney disease.

Common Names: Spironolactone, Eplerenone

Question 7

Digoxin 
Class
MOA
Uses
Common Names:

Answer 7

Class: Cardiac glycoside
MOA
Inhibits the Na/K-ATPase pump mainly in the myocardium, increasing intracellular Na and increasing contraction strength via the decreased Ca leaving the cell. Increased stroke volume but decreased HR.

EXamples
Atrial fibrillation, flutter and heart failure.
More commonly used for arrhythmias rather than CCF
Be careful with Increased K- can cause toxicity

Question 8

Ivabradine
MOA
Uses
Common Names

Answer 8

Inhibits the If (funny) current to the SA node, reducing pacemaker activity and slowing HR. Doesn’t affect contraction strength.
Uses:
Symptomatic management of chest pain and heart failure (if beta-blockers and Ca channel blockers aren’t working first)

Examples
Corlanor

Question 9

Neprolysin Inhibitor

Moa
Uses
Common Names

Answer 9

Prevent nephrolysin activity, acts as an analgesic and an antihypertensive
Uses:
Heart failure

EG
Sacubitril