Cardiovascular drugs Flashcards
anti-platelet drugs
aspirin, clopidogel, dipyridamole
beta blockers
reduced mortality in ischeamic heart disease and heart failure.
reduce symptoms in angina, Atrial fibrillation
beta blockers acting on beta 1 receptors
Predominant receptor in the heart SA, AV nodes and myocardial cells
Reduces secretion of Renin in kidneys
slows heart rate and conduction. Increases diastolic time, reduces BP
High does can lead to brachycarida and heart block
beta blockers on beta 2 receptors
act on smooth muscle in airways, peripheral vasculature. Skeletal muscle,
name 4 beta 1 receptor blockers
bisoprolol, atenolol, carvedilol, metoprolol
name a beta blocker for beta 1 and 2
propanolol
Renin angiotensin aldosterone axis
preserves circulating volume to maintain perfusion to vital organs. central hormonal axis to the development of heart failure, liver failure, kidney failure
antihypertensive
Reduces mortality and progression of disease in IHD. Prevent aberrant remodelling following MI, reduction in symptoms in heart failure
what is angiotensin II
potent vasoconstrictor, peripheral vasculature, efferent arteriole of the glomerulus
aldosterone
retention of sodium at the expense of K in the kidney
ACE inhibitor
++++ reduces blood pressure, reduce after load on heart, prevents aberrant remodelling after MI and reduces proteinuria
—— reduces perfusion pressure in glomerulus leading to renal impairment
ARBS
+++++Positive effects- Reduce blood pressure, reduce afterload on heart, prevents aberrant remodelling and reduces proteinuria
—-effects- reduces perfusion pressure in glomerulus leading to renal impairment; hyperkalaemia via effect on aldosterone levels
ARBS
+++++Positive effects- Reduce blood pressure, reduce afterload on heart, prevents aberrant remodelling and reduces proteinuria
—-effects- reduces perfusion pressure in glomerulus leading to renal impairment; hyperkalaemia via effect on aldosterone levels
entresto
combination of valsartan and sacubitil
Inhibits breakdown natriuretic peptides, increases diuresisis
statins
Primary prevention- reduce cardiovascular risk if patients 10 year risk is > 20%
simvastatin, rosuvastatin, atorvastatin
loop diuretics
act by blocking NaCl reabsorption in the ascension limb of the loop of henle
thiazide diuretics
Act by blocking NaCl reabsorption in distal convoluted tubule of the kidney
Indapamide, Bendroflumethiazide
diuretics
Antihypertensive effects- Thiazides eg. Indapamide and Bendroflumethizide
Symptomatic treatment in heart failure- generally loop diuretics eg. Furosemide and Bumetanide
Promote Sodium and Water loss in the kidney (also can lead to hypokalaemia)
Dihydropyridine
Block calcium entry into smooth muscle
Cause vasodilation
Less effect on myocardial pacemaking tissue
Eg. Amlodipine, felodipine, nifedipine
Side effects- postural hypotension, peripheral oedema, tachycardia (particularly Short acting ones), rarely bradycardia (unless in overdose)
Non-dydropyridine
Block calcium entry to smooth muscle
Blocks calcium entry in the myocardial pacemaking tissue
Slow SA node function
Slow AV conduction
Eg. Verapamil and Diltiazem
Side effects- Bradycardia, heart block (particularly if prescribed with beta blocker), postural hypotension, peripheral oedema
what are Spironolactone and eplenerone used for
heart failure
what are Spironolactone and eplenerone used for
heart failure
describe atherosclerosis
Damage to vessel wall
Smoking
Other causes low grade inflammatory damage
Wall stress (High BP)
Healing process
Activation of platelets
Inflammatory cells
Incorporation of Cholesterol
Fibrous cap
