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Pharmacology Year 1 > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is an example of a thiazide diuretic?

A

Bendrofluazide

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2
Q

What is the mechanism of a thiazide diuretic?

A

Promote sodium and water excretion from the kidneys by inhibiting reabsorption in the distal tubule

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3
Q

What are thiazide diuretics used for?

A

Hypertension

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4
Q

What are the side effects of thiazide diuretics?

A 
Hypokalaemia = Tiredness
Arrythmias
Hyperglycaemia - Diabetes 
Increase uric acid - gout 
Impotence
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5
Q

What is an example of a loop diuretic?

A

Furosemide

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6
Q

What is the mechanism of loop diuretics

A

Promote sodium and water excretion from the kidneys by inhibiting reabsorption in the thick ascending limb of the loop of Henlé

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7
Q

What are loop diuretics used for?

A

Heart failure

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8
Q

What are the side effects of loop diuretics?

A 
Hypokalaemia - Tiredness
Arrythmias
Hyperglycaemia - Diabetes
Increased uric acid - Gout 
Impotence
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9
Q

What are the major classes of diuretics?

A

Thiazides

Loop

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10
Q

What are the major classes of beta blockers?

A

Cardioselective

Non-selective

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11
Q

What is an example of a cardioselective beta blocker?

A

Atenolol

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12
Q

What is the mechanism of action of a cardioselective beta blocker?

A

Blocks only beta-1 receptors

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13
Q

What does beta-1-receptor stimulation lead to?

A 
Stimualtion of Gs 
Increased cAMP
Increased PKa
Increased CICR VIA RyR2
Increased Contractility
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14
Q

What are cardioselective beta blockers indicated for?

A

Angina
Heart Failure
Hypertension

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15
Q

What are the side effects of cardio-selective beta blockers?

A 
Tiredness
Col peripheries
Can cause HF long term
Bradycardia 
Fatigue
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16
Q

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

A

Propranolol

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17
Q

What is the mechanism of action of a non-selective beta-blocker?

A

Block beta-1 and beta-2 receptors

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18
Q

What does stimulation of beta 2 adrenoceptors cause?

A

Vasodilation of coronary arteries and increased heart rate

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19
Q

What are non-selective beta blockers indicated for?

A

Thyrotoxicosis

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20
Q

What are the side effects of non-selective beta blockers?

A 
Tiredness 
Cold peripheries
Can cause HF in the long term
Bradycardia
Fatigue
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21
Q

What are the warnings for beta-blocker use?

A

Never use in asthma as it can result in bronchospasm

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22
Q

What are the major classes of calcium channel antagonists?

A

Dihydropyridines

Rate-limiting calcium antagonists

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23
Q

What is an example of a dihydropyridine?

A

Amlodipine

24
Q

What is an example (2) of a rate-limiting calcium antagonist?

A

Verapamil

Diltiazem

25
Q

What is the mechanism of action of calcium channel blockers (CCBs)?

A

Prevent opening of L-type calcium channels in excitable tissues in response to depolarisation and hence limit intracellular calcium increase.
This reduces TPR and MABP
Coronary vasodilation is very useful for angina and HT

26
Q

To which tissues is verapamil selective?

A

Cardiac muscle cells

27
Q

To which cells is amlodopine selective?

A

Smooth muscle (not heart)

28
Q

What kind of selectivity does Diltiazem show?

A

Intermediate

29
Q

What are dihydropiridines indicated for?

A

Hypertension

Angina

30
Q

What are rate-limiting calcium antagonists indicated for?

A

Supraventricular Arrythmias (RLCA’s)

31
Q

What are the side effects of CCBs?

A 
Ankle oedema
Hypotension
Dizziness
Amlopidine better as less effects on cardiac muscle 
Rate-limiting can cause constipation
32
Q

What are the warnings with CCBs?

A

Avoid use with beta-blockers

33
Q

What are the (3) classes of Vasodilators?

A

Alpha blockers (alpha-1-adrenoceptor antagonists)
ACEO
ARB

34
Q

What are 2 examples of alpha blockers?

A

Prazosin

Doxazosin

35
Q

What is the mechanism of action of an alpha blocker?

A

Block vascular alpha-1-adrenceptors

Decrease TPR and MABP

36
Q

Why is Amlodipine effective in Angina?

A

Causes peripheral arteriolar dilation decreasing after load and myocardial oxygen requirement producing coronary vasodilation

37
Q

What is the issue with diltiazem and verapamil in long-term treatment?

A

Their negative inotropic effect is later offset by baroreceptor reflex

38
Q

Why are CCBs effective in AF?

A

Decrease ventricular rate by suppression of AV node conduction

39
Q

Which CCB would usually be used for AF?

A

Verapamil

40
Q

By which mechanisms do beta blockers decrease MABP?

A

Decreasing CO
Decreasing renin release from kidneys
CNS action that decreases sympathetic activity

41
Q

How can diuretic-induced hypokalaemia be corrected?

A

Administration of potassium-sparing diuretic or Potassium supplements

42
Q

When would thiazide and loop diuretic be combined?

A

For severe resistant oedema

43
Q

For which conditions are alpha blockers indicated?

A

Hypertension and Prostate cancer

44
Q

Which side effect do alpha blockers cause?

A

Postural hypotension

45
Q

What is an example of an ACEI?

A

Lisinopril

46
Q

What is the mechanism of action of ACEIs?

A

Blocks conversion of angiotensin I to angiotensin II

47
Q

For which conditions are ACEIs indicated for?

A

Hypertension
Cardiac Failure
Following MI

48
Q

What are the side effects of ACEIs?

A 
Dry cough (build-up of bradykinin)
Hypotension (esp. if on diuretics)
49
Q

When are ACEIs contraindicated?

A

Pregnancy (foetal toxicity)

Bilateral Renal Artery stenosis

50
Q

Why are ACEIs effective in hypertension?

A

Decrease TPR and MABP and possible suppression of proliferation of smooth muscle cells in the media of resistance vessels

51
Q

Why are ACEIs effective in cardiac failure

A

Decrease vascular resistance so increased perfusion
Increased excretion of sodium and water
Regression of LVH

52
Q

What is an example of an ARB?

A

Losartan

53
Q

What is the mechanism of action of an ARB?

A

AT1 receptor antagonist - competitively blocks the agonist action of angiotensin II at the AT1 receptor
Causes venous dilation (decreased preload) and arteriolar dilation (decreased after load and TPR) leads to decreased MABP

54
Q

For which conditions are ARBs indicated for?

A

Hypertension
Cardiac Failure
Following MI

55
Q

When would and ARB be used over an ACEI?

A

If the side effects from ACEI are intolerable

56
Q

When are ARBs contraindicated?

A

Pregnancy (foetal toxicity)

57
Q

By which mechanism do beta blockers help angina?

A

Reduce HR and force, especially during exercise or stress. Coronary vessel diameter is marginally reduced but myocardial oxygen requirement falls so there is better oxygenation of the myocardium

Pharmacology Year 1 (3 decks)

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