- Decrease the force of contraction of the heart - Decrease the HR

- Vasodilation (Coronary and peripheral), so reduces BP - Reduces myocardial oxygen consumption rate

Cardio Drugs COPY Flashcards by Ruari Pitts

Give examples of ACE Inhibitors (ACE Is)

“pril”

Ramipril, Lisinopril and Quinapril

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MoA of ACE Is

Inhibit ACE from converting angiotensin I into angiotensin II (a vasocontrictor)

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Effect of ACE Is

Vasodilate, causing a reduce in blood pressure

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Give examples of Angiotensin Receptor Blockers (ARBs)

“sartan”

Valsartan, Losartan and Eprosartan

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MoA of ARBs

They are antagonists to angiotensin II (a vasoconstrictor)

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Effect of ARBs

Vasodilate, causing a reduce in blood pressure

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Give examples of Beta 1 Blockers (BBs)

“olol”

Atenolol, Bisoprolol, Metropolol

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Give examples of Nonselective Beta Blockers (BBs)

“olol”

Propanolol

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MoA of B1Bs

They block B1 adrenoceptors

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Effect of B1Bs

Decrease the force of contraction of the heart

- Decrease the HR

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MoA of Nonselective BBs

They block both B1 and B2 adrenoceptors

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Effect of Nonselective BBs

Basically blocks sympathetic responses:

Decreases the HR (reduced SA-AV node conduction)
Decreases force of contraction of the heart
Have an antiarrhythmic effect
Reduce Renin, so decrease BP

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Give examples of Calcium Channel Blockers (CCBs)

Smooth Muscle selective: “dipines”

Amlodipine, Nifedipine and Felodipine

Cardio selective: Verapamil

Others: Diltiazem

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MoA of CCBs

Block L-type Ca2+ channels in Smooth muscle

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Effect of CBBs

Vasodilation (Coronary and peripheral), so reduces BP

- Reduces myocardial oxygen consumption rate

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Give examples of Anti-Arrhythmic drugs?

Digoxin, Adenosine, Amiodarone, Verapamil, Magnesium Sulphate

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MoA of Digoxin

Blocks Na+/K+ pump, slowing AV node conduction

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MoA of Verapamil

Blocks L-type Ca2+ channels, slowing AV node conduction

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MoA of Adenosine

Stimulates adenosine receptor that inhibits adenyl cyclase, therefore inhibiting Ca2+ influx.

It hyperpolarises the AV node, suppressing conduction.

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MoA of Amiodarone

Slows conduction of the SA and AV nodes

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Give examples of Alpha Blockers

“zosin”

Prazosin and Doxazosin

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MoA of A1 Blockers

Block A1 receptors

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Effects of A1 Blockers

Vasodilation

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Give examples of Nitrates

Short acting: Glyceryl trinitrate (GTN)

Long acting: Isosorbide mononitrate

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MoA of Nitrates

They metabolise to produce NO, increasing cGMP, activating kinase A causing relaxation. Also keeps K+ channels open.

Effect of Nitrates

Vasodilation

MoA of Ivabradine

It inhibits the funny channel and therefore inhibits the pacemaker activity of the SA node

Effect of Ivabridine

Decreases the HR

Give examples of Diuretics

Thiazide: Bendroflumethiazide Loop: Furosemide Others: Spironolactone

MoA of Spironolactone

- It is a competitive inhibitor of aldosterone | - It targets the distal nephron

MoA of Loop Diuretics

Inhibits reabsorption of NaCl in the Loop of Henle

MoA of Thiazides

Inhibit reabsorption of NaCl in the distal tubule

Give examples of Fibrinolytics

Streptokinase and tissue plasminogen activator (tPA)

MoA of Fibrinolytics

Oppose the anticoagulation cascade via activation of plasminogen

Effect of Fibrinolytics

"Clot busters" Re-open occluded arteries by dissolving clots

Give examples of Anticoagulants

"Blood thinning" "rin" Warfarin, Heparin, LMWH, "an" Rivaroxiban, Apixaban, Dabigatran

MoA of Warfarin

Prevents Vitamin K conversion

MoA of Heparin

Inactivates Xa and thrombin IIa

MoA of LMWH

Inactivates Xa

MoA of Rivaroxiban and Apixaban

Inhibits Xa

MoA of Dabigatran

Direct thrombin inhibitor

Give examples of Antiplatelets

Aspirin, "grel" Clopidogrel, Prasugrel, Ticagrelor

MoA of Aspirin

Prevents platelet aggregation via prevention of thromboxane A2 production

MoA of Clopidogrel, Prasugrel, Ticagrelor

They inhibit adenosine diphosphate receptors

Give examples of Potassium Channel Openers (PCOs)

"dil" Nicorandil and Minoxidil

MoA of PCOs

They open K+ channels, causing hyperpolarisation of L-type Ca+ channels

Effect of PCOs

They cause relaxation of arterial smooth muscle

Give examples of Statins

"statin" Simvastatin and Atorvastatin

MoA of Statins

They competitively inhibit HMG-CoA reductase, reducing cholesterol production

Effect of Statins

Reduce cholesterol, LDLs and triglycerides

Give examples of Fibrates

Bezafibrate and Gemfibrozil

MoA of Fibrates

They activate PPAR Alpha, that stimulate lipid metabolism

Effect of Fibrates

Reduce triglycerides, LDLs and HDLs

Side effect of BBs

- Bronchospasm (never give to asthmatics) - Bradycardia - Aggravates heart failure - Masks a hypo - Impotence + libido (decreased sex drive) - Cold peripheries - Dangerous in hypotension

Side effects of Digoxin

A lot of really bad shit - Disturbances of colour vision - Bradycardia - Tender breasts - Can cause heart block - Is toxic in hypokalaemia

Side effects of Nitrates

- Can develop tolerance (give 8 hour free window) | - Headaches

Side effects of Loop Diuretics

Hypo everything

Side effects of CCBs

- Ankle Oedema | - Don't give with BBs as will cause severe bradycardia (especially verapamil)

Side effects of ACE Is

Never use in pregnancy - Dry cough - Angioedema (in afro-Caribbeans) - hyperkalaemia - first dose hypertension (if on diruetics)

Side effects of ARBs

Never use in pregnancy

Side effects of Anticoagulants

Risk of haemorrhage

Side effect of PCOs

NaCl and water retention

Give an example of an Anti-Muscarinic

Non-selective: Atropine

MoA of Atropine

Inhibit the parasympathetic nervous system (M1, M2, M3) and so increased SA node conduction

Effects of Atropine

Increased HR

Side effects of Atropine

Dry mouth and pupil dilation

Give an example of a B1 receptor agonist

Dobutamine

MoA of Dobutamine

Stimulation of B1 receptor

Effects of Dobutamine

Increases AV node conduction

Side effects of Statins

Don't give in pregnant woman - Myopathy - Renal Failure

Side effects of Fibrates

Myositis

Side effects of Antiplatelets

- Haemorrhage | - Peptic ulcer

Side effects of Spironolactone

- Gynecomastia | - Hyperkalaemia