Cardio Pharmacology Flashcards
diuretics
- block Na+ reabsorption
- loop e.g furosemide, used for HF
- thiazide e.g bendrofluazide, used for HT
- side effects..
increased uric acid (gout)
hypokalaemia
hyperglycaemia
impotence
B Blockers
- end in ‘olol’
- act on B1/B2 adrenoreceptors (Gs)
- selective e.g atenelol
- non elective e.g propranalol
- used in HT, angina, post MI, HF (long term), V/SVT arrythmias
- side effects…
lethargy - do not use in asthma
- do not use with CCBs
Calcium Channel Antagonists
- prolong opening of L type channels, so cause delayed conduction in the heart
- e.g verapamil, diltazem (rate limiting), dihydropyridine (amlodipine)
- used in SVT arrythmias, HT, angina
- side effects…
oedema
hypotension
alpha blockers
- blocks vascular alpha 1 receptors
- e.g doxazosin
- used in HT, prostatic hypertrophy
- side effects..
postural hypotension
ACE inhibitors
'pril' - block conversion of angiotension 1 to 2 - used in HT, HF, post MI - side effects... cough renal dysfunction angioneurotic oedema hypotension
ARB
‘sartan’
- block angiotensin 1 receptors
- used in HT, HF, post MI, diabetic nephropathy
- side effects…
renal dysfunction
first dose hypotension
- DO NOT use in pregnancy of renal artery stenosis
nitrates
- relax all SM via metabolism of NO, redirect blood to ischaemia
- e.g GTN, isosorbide mononitrate
- used in angina, MI, acute HF
side effects..
headaches
tolerance (leave 8/24 free)
hypotension
collapse
K+ channel agonist
- decrease calcium sensitivity of SM, so calcium pump is activated which promotes K efflux and therefore VASODILATION
- used in angina, HT
- e.g nicorandil
- side effects…
reflex tachycardia
na/h20 retention
fibrates
- reduce liver production of VLDL and increase rate of removal of triglycerides
- e.g bezofibrate, gemfibrozil
- used in hypertriglyceridaemia
- side effects
myositis - DO NOT use with statins
statins
‘statin’
- competitive inhibitors of HMG CoA reductase, which reduces LDL in the liver
- used in high cholesterol, diabetes, angina, MI, CVA/TIA
- side effects..
myopathy
rhabdomyolysis renal failure
- DO NOT use in pregnancy
- ineffective in familial hypercholesterolemia
fibrinolytics
- dissolves formed clots
- used in STEMI, PE, CVA
- e.g streptokinase
- side effects..
haemorrhage
antiplatelets
- prevent the formation of a new thrombus
- e.g aspirin, clopidogrel, prasugrel, tricagrelor
- used in angina, CVA/TIA, acute/post MI
- side effects..
haemorrhage
peptic ulcer
asthma
warfarin
- prevents new thrombosis
- blocks clotting factors 2, 7, 9, 19
- used in DVT, PE, NSTEMI, AF
- side effects..
haemorrhage
heparin
- bind to anti thrombin III, stops it anti thrombotic properties
- reversed by protamine
rivaroxaban
- factor Xa inhibitor
dabigatron
- thrombin factor IIa inhibitor (Xa converts II -> IIa)
digoxin
- blocks AV node conduction, producing AVN delay
- used in AF, HF
- side effects…
bradycardia and heart block
nausea/vomiting
blurred yellow vision
ventricular irritability -> arrythmias
B adrenoreceptor Agonist
- act on alpha1, b1 and b2
- used in anaphylactic shock, cardiac arrest
- e.g adrenaline, dobutamine (selective for B1, used in HF)
- side effects..
arrythmias
ivabradine
- HCN channel blocker, which usually open to allow Na+ influx to start depolarisation
- used in HF and angina
aldosterone receptor antagonist
- blocks aldosterone receptor, K sparing diuretic
- e.g spironolactone
- used in moderate and severe HF
- side effects..
gynaecomastia
Non selective muscarinic ACh receptor antagonists
- increase HR
- must be used in a high dose >600mg
- e.g atropine
- used in severe bradycardia and after MI
