Cardiovascular Flashcards
(alpha blocker)
Selective blockers of alpha-1-adrenoreceptor found in smooth muscle, blood vessel and urinary tract. Causes vasodilation and increased bladder outflow
✖ Postural hypotension
Doxazosin
Alpha blocker
Benign prostatic elargement
Tamulosin
Benign prostatic enlargement
Adenosine
Diagnostic and therapeutic agent in supraventricular tachycardia
Agonist of adenosine receptors on heart cell surface. Reduces frequency of spontaneous depolarisation and increases refractory. Used in cardioversion
✖Hypotension
✖Coronary ischemia
✖heart failure
✖asthma
Adrenaline
Cardiac arrest
Anaphylaxis
Local vasoconstriction (i.e. control of bleeding)
Potent agonist of alpha-1, alpha-2, beta-1 and beta-2 adrenoceptors. Induces systemic vasoconstriction but vasodilation of heart (increasing blood flow in heart). Additional affects: bronchodilation and suppression of inflammatory mediator release
(Aldosterone antagonists)
Aldosterone: mineralocorticoid produced in adrenal cortex. Acts on mineralcorticoid receptors in disal tubules (ENaC), increasing reabsorption of sodium + water. Elevating blood pressure with corresponding potassium excretion. Aldosterone antagonist competitively inhibit this effect
✖severe renal impairement
✖hyperkalaemia
✖Addison’s disease
Spironolactone
(Aldosterone antagonist)
Ascites
Chronic heart failure
Primary hyperaldosteronism
Eplerenone
Aldosterone antagonist
Chronic heart failure
(Amiodarone)
Tachyarrhythmias (i.e. atrial fib, flutter, supraventricular tachy, ventricular tachy, refractory ventriculat fib
Several effects: blocks sodium, calcium, potassium channels. Antagonist to alpha and beta adrenergic receptors. Overall reduces ventricular rate, reduce spontaneous depolarisation, slow conduction velocity
(Angiotensin receptor blockers)
Generally used when ACE inhibitors are not tolerated due to cough
Similar effects to ACE inhibitors, instead block action of angiotensin II on angiotensin type 1 receptor. Reduces peripheral vascular resistance, lowers blood pressure, dilated efferent glomerular arteriole (reduces intraglomerular pressure and slows CKD)
✖Renal artery stenosis
✖Acute kidney injury
Losartan
(Angiotensin receptor blockers) Hypertension Chronic heart failure Ischaemic heart disease Diabetic nephropathy + Chronic kidney disease
Candesartan
(Angiotensin receptor blockers) Hypertension Chronic heart failure Ischaemic heart disease Diabetic nephropathy + Chronic kidney disease
Irbesartan
(Angiotensin receptor blockers) Hypertension Chronic heart failure Ischaemic heart disease Diabetic nephropathy + Chronic kidney disease
(Angiotensin coverting enzyme inhibitors)
Commonly used in heart conditions and kidney disease
Prevents conversion of angiotensin to angiotensin II. Blockage reduces afterload, dilates efferent glomerular arteriole, reduces aldosterone level (promotes sodium and water secretion)
Ramipril
(Angiotensin coverting enzyme inhibitors)
Hypertension
Chronic heart failure
Ischaemic heart disease
Diabetic nephropathy + Chronic kidney disease
Lisinopril
(Angiotensin coverting enzyme inhibitors)
Hypertension
Chronic heart failure
Ischaemic heart disease
Diabetic nephropathy + Chronic kidney disease
Perindopril
(Angiotensin coverting enzyme inhibitors)
Hypertension
Chronic heart failure
Ischaemic heart disease
Diabetic nephropathy + Chronic kidney disease
(Antimuscarinics)
Binds to muscarinic receptor as competitive inhibitor of acetylcholine. Muscarinic receptor responsible for parasympathetic effects. Antimuscarinics have oppositve effects: increasing heart rate and conduction, reduce smooth muscle tone and peristaltic condition, reduce secretion from respiratory glands
Atropine
(Antimuscarinics)
Bradycardia
(Anti-platelet drugs / ADP-receptor antagonists)
Prevent platelet aggregation by binding to adenosine diphosphate (ADP) receptors on platelet surface. Independant of COX pathway so synergistic with aspirin
✖ Active bleeding
Clopidogrel
(ADP-receptor antagonists)
Acute coronary syndrome
Prevent occlusion in coronary artery stents
Prevention of thrombolitic events
Ticagrelor
(ADP-receptor antagonists)
Acute coronary syndrome
Prevent occlusion in coronary artery stents
Prevention of thrombolitic events
Prasugrel
(ADP-receptor antagonists)
Acute coronary syndrome
Prevent occlusion in coronary artery stents
Prevention of thrombolitic events
(Aspirin)
Irreversibly inhibits cyclooxygenase (COX), reducing production of thromboxane from arachidonic acid. Reduces platelet aggregation
Acute coronary syndrome + Ischemic stroke Prevention of thrombotic events ✖ < 16 years ✖ Aspirin hypersensitivity ✖ Third trimester
(Beta blockers)
Beta-1 adrenoreceptors found in hear, beta-2 adrennoreceptors found in blood vessel smooth muscle. Beta-blockers reduce force and speed of heart condition. Reduce blood pressure by reducing renin secretion in kidney via beta-1 receptors
✖ Asthma
✖Heart block
Bisoprolol
(Beta blockers) Ischemic heart disease Chronic heart failure Atrial fibrillation Supraventricular tachycardia Hypertension
Atenolol
(Beta blockers) Ischemic heart disease Atrial fibrillation Supraventricular tachycardia Hypertension
Propanolol
(Beta blockers) Ischemic heart disease Atrial fibrillation Supraventricular tachycardia Hypertension