Cardiovascular Drugs

Question 1

Describe the process of atherosclerosis in blood vessels.

Answer 1

Atherosclerosis is an abnormal healing process in blood vessels where damage occurs to the vessel wall due to factors like smoking or high blood pressure. This leads to the release of platelets and inflammatory chemicals, incorporating cholesterol and forming a fibrous scar over the damaged area.

Question 2

What are the main risks associated with antiplatelet medications?

Answer 2

The main risks of antiplatelet medications include increased bleeding risk, especially when using combinations of these drugs. Effects can last up to a week after taking the medication, necessitating a cessation of at least one week before procedures. Additionally, some antiplatelets irreversibly bind to their receptors, leading to prolonged effects.

Question 3

Define the Renin-Angiotensin-Aldosterone axis.

Answer 3

The Renin-Angiotensin-Aldosterone axis is a hormonal system that regulates blood pressure and fluid balance. It involves the production of angiotensinogen by the liver, conversion to Angiotensin I by Renin, further conversion to Angiotensin II by ACE, and the action of Angiotensin II on the adrenals to release aldosterone.

Question 4

How do Beta blockers work in cardiovascular diseases?

Answer 4

Beta blockers are widely used in cardiovascular diseases to reduce mortality in ischemic heart disease and heart failure, as well as to alleviate symptoms in conditions like angina, atrial fibrillation, and supraventricular tachycardia. They act by slowing heart rate, reducing blood pressure, and protecting the heart from stress hormones.

Question 5

Describe the role of Beta 1 receptors in the heart.

Answer 5

Beta 1 receptors are predominant in the heart, SA and AV nodes, and myocardial cells. They help in slowing heart rate, increasing diastolic time, and reducing blood pressure. Additionally, they protect the heart from stress hormones but can have negative effects like bradycardia and heart block at high doses.

Question 6

What are the positive effects of Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs) in cardiovascular diseases?

Answer 6

ACE inhibitors and ARBs have positive effects in cardiovascular diseases by reducing mortality and disease progression in conditions like ischemic heart disease, cardiovascular disease, and renal disease with proteinuria. They also prevent aberrant remodeling after a heart attack and reduce symptoms in heart failure.

Question 7

How do Angiotensin Converting Enzyme (ACE) inhibitors work in the body?

Answer 7

ACE inhibitors work by inhibiting the conversion of Angiotensin I to Angiotensin II. This leads to vasodilation, reduced blood pressure, and decreased aldosterone secretion. ACE inhibitors like Ramipril, Lisinopril, and Captopril are commonly used in clinical practice.

Question 8

Define Ischaemic Heart Disease and its manifestations.

Answer 8

Ischaemic Heart Disease is a condition characterized by reduced blood supply to the heart muscle. It can manifest as angina, which causes cramping pain due to narrowed coronary arteries, or as myocardial infarction, where there is a blockage in the blood vessels leading to heart failure.

Question 9

What are the different types of strokes associated with Cerebrovascular Disease?

Answer 9

Cerebrovascular Disease can lead to transient ischemic attacks (TIAs) or thrombotic strokes. TIAs are temporary disruptions in blood flow to the brain, while thrombotic strokes occur due to the formation of a blood clot in the brain’s blood vessels.

Question 10

Describe the positive effects of ARBs like losan and candersartan.

Answer 10

Reduce blood pressure, reduce afterload on heart, prevent aberrant remodeling, and reduce proteinuria.

Question 11

What are the side effects associated with aldosterone antagonists like spironolactone and eplenerone?

Answer 11

Renal impairment, hyponatremia, hyperkalemia, and gynecomastia (more common with Spiro).

Question 12

Define Entresto and its components.

Answer 12

Entresto is a combination of Valsartan and Sacubitril. Sacubitril is a neprilysin inhibitor that inhibits the breakdown of natriuretic peptides and bradykinins.

Question 13

How do calcium channel blockers work in reducing symptoms like angina and AF/SVT?

Answer 13

They cause vasodilation and have different effects on myocardial pacemaking tissue, with non-dihydropyridine blockers being more specific for cardiac tissue.

Question 14

Describe the mechanism of action of dihydropyridine calcium channel blockers like amlodipine and nifedipine.

Answer 14

They block calcium entry into smooth muscle, leading to vasodilation with less effect on myocardial pacemaking tissue.

Question 15

What is the NNT over 5 years for Entresto compared to placebo?

Answer 15

NNT 11 over 5 years compared to placebo, roughly 20 compared to ACE inhibitors.

Question 16

Describe the side effects of Verapamil and Diltiazem.

Answer 16

Side effects include bradycardia, heart block (especially when prescribed with beta blockers), postural hypotension, and peripheral edema.

Question 17

What is the primary prevention goal of statins?

Answer 17

To reduce cardiovascular risk in patients with a 10-year risk greater than 20%.

Question 18

Define HMGCoA reductase inhibitor.

Answer 18

It is a class of drugs that inhibit the rate-limiting step in the production of cholesterol.

Question 19

How do thiazide diuretics act in the kidney?

Answer 19

They block NaCl reabsorption in the distal convoluted tubule, leading to mild diuretic and vasodilatory effects.

Question 20

Describe the mechanism of loop diuretics.

Answer 20

They block NaCl reabsorption in the ascending limb of the loop of Henle, resulting in intense diuretic effects and pronounced vasodilation.

Question 21

What are common side effects of loop diuretics?

Answer 21

Common side effects include electrolyte disturbances (low K, Na, Mg, and Ca), dehydration, renal impairment, and orthostatic hypotension.

Question 22

Do nitrates act as antianginals?

Answer 22

Yes, nitrates act as antianginals by causing vasodilation through nitric oxide release.

Question 23

How do statins help in secondary prevention after a cardiovascular event?

Answer 23

They help reduce the risk of further cardiovascular events post an initial event.

Question 24

Define NNT in the context of statins.

Answer 24

NNT stands for Number Needed to Treat and refers to the number of patients who need to be treated for a specific period to prevent one additional bad outcome.

Question 25

Define Alpha (adrenoreceptor) blockers and their function.

Answer 25

Alpha blockers cause peripheral vasodilation. An example is doxazosin.

Question 26

How does atherosclerosis play a central role in cardiovascular disease?

Answer 26

Atherosclerosis is a key factor in cardiovascular disease as it involves the buildup of plaque in the arteries, leading to reduced blood flow and potential blockages.

Question 27

What is the importance of understanding drugs for primary and secondary prevention in cardiovascular disease?

Answer 27

Understanding these drugs is crucial for managing and preventing cardiovascular issues, reducing the risk of complications and improving overall heart health.

Question 28

Do you know some drugs used for symptom control in cardiovascular conditions like angina, heart failure, and arrhythmia?

Answer 28

Yes, medications for symptom control in cardiovascular conditions include those for angina, heart failure, and arrhythmia to manage symptoms and improve quality of life.

Question 29

Describe the concept of supply and demand in economics.

Answer 29

Supply and demand is a fundamental economic principle that describes the relationship between the availability of a product or service (supply) and the desire for that product or service (demand), influencing its price in the market.

Question 30

Define inflation in the context of economics.

Answer 30

Inflation refers to the rate at which the general level of prices for goods and services is rising, leading to a decrease in the purchasing power of a currency.