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Drug Profiles > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Examples: loop diuretics

A

furosemide, bumetanide

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2
Q

loop diuretics - how do they work?

A

inhibits Na, Cl, K reabsorption in ascending loop of henle

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3
Q

indications: loop diuretics

A

pulmonary oedema due to LVF. Chronic heart failure. Kidney impairment. resistant hypertension

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4
Q

Contra-indications: loop diuretics

A

electrolyte imbalance. renal dysfunction. Gestational hypertension

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5
Q

Side effects: loop diuretics

A

dehydration, hypotension, any low electrolyte state, tinnitus

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6
Q

Interactions: loop diuretics

A

NSAIDs (reduce diuretic efficiency), corticosteroids (enhance hypokalaemia), aminoglycosides (enhance ototoxicity/nephrotoxicity)

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7
Q

Examples: thiazide diuretic

A

bendroflumethiazide

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8
Q

bendroflumethiazide - how does it work?

A

inhibits NaCl transporter in distal tubule. Inhibit Na reabsorption and so also decrease H2O reabsorption

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9
Q

Indications - bendroflumethiazide

A

hypertension. oedema secondary to heart failure. prophylaxis of Ca containing renal stones.

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10
Q

Contra-indications - bendroflumethiazide

A

electrolyte imbalance. renal dysfunction. pregnancy. Addison’s disease. Gout.

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11
Q

Side effects: bendroflumethiazide

A

cardiac arrhythmias due to hypokalaemia and hyponatraemia. Male impotence. Thrombocytopenia.

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12
Q

Interactions - bendroflumethiazide

A

NSAIDs (reduce diuretic efficacy). B-blockers (potentiate hyperglycaemia). Corticosteroids (enhance hypokalaemia) ACEi, lithium, digoxin, theophylline

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13
Q

examples: potassium sparing diuretics

A

spironolactone, amiloride

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14
Q

potassium sparing diuretics: how does it work?

A

competitive antagonists that either compete with aldosterone for intracellular cytoplasmic receptor sites or directly block Na channels. Prevents Na reabsorption and K/H ion secretion

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15
Q

Indications: potassium sparing diuretics

A

hypokalaemia. oedema from hepatic cirrhosis, congestive heart failure, Conn’s syndrome

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16
Q

Contra-indications: potassium sparing diuretics

A

severe renal impairment, hyperkalaemia, volume depletion, Addison’s disease, pregnancy

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17
Q

Side effects: potassium sparing diuretics

A

GI problems, dizziness, hypotension, urinary issues, skin rash

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18
Q

Interactions: potassium-sparing diuretics

A

aldosterone antagonists, digoxin, lithium, cyclosporins, ACEi, NSAIDs

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19
Q

Examples: Beta blockers (class II anti-arrhythmic)

A

atenolol, propanolol, bisoprolol

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20
Q

Beta blockers - how does it work?

A

block epinephrine/adrenaline from binding to B-receptors. Reducing heart contraction force, conduction speed, more perfusion. Reduce renin secretion caused decreased blood pressure

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21
Q

Indications - beta blockers

A

angina, ACS, chronic heart failure, AF, supraventricular tachycardia, hypertension (2nd line), panic disorder, anxiety

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22
Q

Contra-indications: beta-blockers

A

asthma, caution in COPD, heart failure, heart block, unstable angina, sick sinus syndrome

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23
Q

Side effects: beta-blockers

A

fatigue, headache, nausea, sleep disturbance, male impotence, liver damage, can mask hypoglycaemia

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24
Q

Interactions: beta-blockers

A

Ca channel blockers (verapamil/diltiazem), bradycardia

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25
Examples: calcium antagonists
Diltiazem, amlodipine
26
Calcium antagonists - how does it work?
reduced calcium relaxes smooth muscle --> lowers pressure. Lower cardiac conduction rate, contractility and afterload. Less oxygen demand.
27
Indications - calcium antagonists
hypertension, stable angina, cardiac arrhythmias, cerebral vasospasm
28
Contra-indications: calcium antagonists
poor LV function (heart failure), AV conduction delay (heart block), unstable angina, severe aortic stenosis
29
Side effects: calcium antagonists
ankle oedema, headaches, flushing, palpitations, constipation
30
Interactions: calcium antagonists
beta blockers, cyclosporins, digoxin, theophylline
31
Examples: ACEi
ramipril, losartan
32
ACEi - how does it work?
Reduce RAAS activity. block the conversion of angiotensin I --> angiotensin II, lowering arteriolar resistance and increasing venous capacity. Reduces aldosterone. Reduces preload.
33
Indications: ACEi
hypertension. Reduce stroke and MI risk. Chronic heart failure. Diabetic nephropathy
34
Contra-indications: ACEi
renal artery stenosis, acute kidney injury, pregnancy
35
Side effects: ACEi
persistent dry cough, hypotension, hyperkalaemia, angioedema
36
Interactions: ACEi
NSAIDs, potassium elevating drugs
37
Examples: nitrates
isosorbide mononitrate
38
Nitrates - how do they work?
stimulates guanylate cyclase which decreases intracellular Ca. Relaxation of muscle cells and dilation of blood vessels. VASODILATION of vessels by donating NO.
39
Indications - nitrates
angina. ACS. pulmonary oedema. left ventricular heart failure
40
contra-indications: nitrates
severe aortic stenosis, hypotension, electrolyte imbalance, Wolf-Parkinson-White syndrome
41
Side effects: nitrates
flushing, headaches, light-headedness
42
interactions: nitrates
phosphodiesterase inhibitors, viagra, tri-cyclic antidepressant
43
Examples: cardiac glycosides
digoxin
44
Cardiac glycosides - how does it work?
inhibits Na/K ATPase pumps, increased myocyte contraction, increased parasympathetic tone. decreased heart rate, increased contraction force
45
Indications: cardiac glycosides
congestive heart failure, AF, flutter
46
Contra-indications
electrolyte imbalance, 2nd degree heart block, ventricular arrhythmias, renal failure
47
Side effects: cardiac glycosides
bradycardia, GI effects, blurred vision
48
Interactions: cardiac glycosides
loop/thiazide diuretics, amiodarone, calcium channel blockers, NSAIDs
49
Examples: anti arrhythmic drugs (class III)
amiodarone
50
anti-arrhythmic drugs - how does it work?
bind to and block potassium channel channels that are responsible for phase 3 repolarization. prolongs action potential and refractory period.
51
Indications - anti-arrhythmic agents
dysrhythmias
52
Contra-indications- anti-arrhythmias
heart block, thyroid dysfunction
53
Side effects: anti-arrhythmic agents
hepatitis, photosensitivity, colour loss, thyroid problems
54
Interactions: anti-arrhythmias
digoxin, diltiazem, verapamil
55
What drug class is aspirin?
NSAID
56
aspirin: how does it work?
irreversibly inhibits COX. Stops formation of arachidonic acid --> thromboxane. Decreased platelet aggregation
57
Indications: aspirin
ACS, acute ischaemic stroke, AF, fever
58
Contra-indications: aspirin
children under 16 (Reye's syndrome), pregnancy, peptic ulcer disease, gout
59
Side effects: aspirin
bronchospasm, tinnitus, GI haemorrhage
60
Interactions: aspirin
anticoagulants
61
Examples: antiplatelet agent
clopidogrel, ticagrelor
62
antiplatelet - how does it work?
adenosine diphosphate receptor antagonist. Decreased platelet aggregation
63
Indications: anti-platelet
ACS, preventing coronary artery stent occlusion, CVD, AF
64
Contra-indications: anti-platelet
active bleeding, renal/hepatic impairment, haemophilia
65
Side effects: anti-platelet
bleeding, GI upset, thrombocytopenia
66
interactions: anti-platelet
cytochrome p450 inhibitors, aspirin, heparin, warfarin, NSAIDs
67
Examples: tissue plasminogen activator
heparins (enoxaparin)
68
Tissue plasminogen activator - how does it work?
inhibits thrombin and factor Xa. UFH activates anti-thrombin, inactivate Xa. LMWH directly inhibit
69
Indications: tissue plasminogen activator
VTE, DVT, PE, ACS
70
Contra-indications: tissue plasminogen activator
clotting disorders, severe hypertension, trauma/invasive surgery, renal impairment
71
Side effects: tissue plasminogen activator
bleeding, injection site reactions, heparin induced thrombocytopenia
72
Interactions: tissue plasminogen activator
antiplatelets, anticoagulants, nicotine, antihistamines
73
Examples: anticoagulants
warfarin, rivaroxaban
74
Anticoagulants - how does it work?
rivaroxaban = factor Xa inhibitor. inhibits vitamin K reductase so theres no vitamin K reactivation. Coagulation factor synthesis
75
Indications - anticoagulants
DVT, PE, preventing embolic complications in AF
76
Contra-indications - anticoagulants
pregnancy, haemorrhagic risk, liver disease
77
Side effects - anticoagulants
bleeding, alopecia
78
interactions - anticoagulants
alcohol. cytochrome p450 inhibitors (omeprazole, ciprofloxacin, erythromycin). cytochrome p450 inducers (phenytoin, carbamazepine, rifampicin)
79
Examples: statins
simvastatin
80
statins - how does it work?
inhibit HMG-CoA reductase. Clears LDLs and reduced triglyceride levels, increases HDL levels
81
Indications - statins
primary/secondary cardiovascular disease prevention, primary hyperlipidaemia
82
Contra-indications - statins
pregnancy, liver disease, renal disease
83
Side effects - statins
headache, GI issues, myopathy, rhabdomyolosis, high liver enzyme levels, hyperglycaemia
84
Interactions - statins
cytochrome p450 inhibitors (amiodipine)

Drug Profiles (3 decks)

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