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CVS block > Cardiovascular Drugs 2 > Flashcards

Cardiovascular Drugs 2 Flashcards

1
Q

What are examples of Angiotensin receptor blockers?

A

Losartan

Candersartan

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2
Q

What are the examples of aldosterone antagonists?

A

Spironolactone and Eplenerone - Used in heart failure (frequently coprescribed with ACE/ARB).

Spiro sometimes used in hypertension.

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3
Q

What do aldosterone antagonists do?

A

Enhanced diuretic effect, vasodilation

Reduces mortality in IHD and heart failure

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4
Q

What are the side effects of aldosterone antagonists?

A

Renal impairment

Hyponatraemia

Hyperkalaemia

Gynaecomastia (spiro > eplenerone)

NSAIDS should be used with extreme caution - marked hyperkalaemia seen if AKI occurs.

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5
Q

What are entresto?

A

Combination of valsartan and sacubitril

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6
Q

What are sacubitril?

A

Neprilysin inhibitor

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7
Q

What do sacubitril do?

A

Inhibits breakdown natriuretic peptides e.g ANP and BNP (and bradykinins)

Increase diuresis, natriuresis and vasodilation

Indicated in symptomatic chronic HF with reduced ejection fraction

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8
Q

Why should sacubitril not be co prescribed with ACE inhibitor?

A

Increased risk of angiodema (allow 36 hour washout period between medication)

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9
Q

What are calcium channel blockers?

A

Antihypertensive agent

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10
Q

What conditions does calcium channel blockers reduce symptoms for?

A

Angina - both dihydropyridine and non-dihydropyridine

AF/SVT - Non-dihydropyridine only

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11
Q

What do dihydropyridine(calcium channel blockers) do?

A

Block calcium entry into smooth muscle

Cause vasodilation

Less effect on myocardial pacemaking tissue

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12
Q

What are examples of dihydropyridine?

A

Amlodipine

Felodipine

Nifedipine

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13
Q

What are the side effects of dihydropyridine?

A

Postural hypotension

Peripheral oedema

Tachycardia (particularly short acting ones)

Rarely brachycardia (unless in overdose)

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14
Q

What do Non-dihydropyridine(calcium channel blockers) do?

A

Block calcium entry to smooth muscle

Block calcium entry in the myocardial pacemaking tissue
-Slow SA node function
-Slow AV conduction

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15
Q

What are examples of non-dihydropyridine?

A

Verapamil

Diltiazem

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16
Q

What are the side effects of non-dihydropyridine?

A

Bradycardia

Heart block (particularly if prescribed with beta blockers)

Postural hypotension

Peripheral oedema

17
Q

What is the primary prevention of statins?

A

Reduce cardiovascular risk if pateints 10 year risk > 20%

18
Q

What is secondary prevention of statins?

A

After cardiovascular event

19
Q

What are examples of statins?

A

Simvastatin

Rosuvastatin

Atorvastatin

20
Q

What do hydroxy-methyl-glutaryl Coenzyme A (HMGCoA) reductase inhibitor do?

A

Rate limiting step in production of cholesterol

21
Q

What are the side effects of statins?

A

Muscle aches and pain but risk of myositis is low

22
Q

Diuretics

A

Antihypertensive effects - thiazides

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)

23
Q

How do thiazide diuretics act?

A

By blocking NaCl reabsorption in distal convoluted tubule of the kidney
-Mild diuretic effect
-Vasodilatory effect

24
Q

What are examples of thiazide diuretics?

A

Indapamide

Bendroflumethiazide

25
Q

What are the common side effects of thiazide diuretics?

A

Electrolyte disturbance (Low Na and K in particular but also Hypercalcaemia)

Hyperuricaemia (causing gout and increased cardiovascular risk)

Hyperglycaemia

Dehydration

Renal impairment

Orthostatic hypotension

26
Q

How do loop diuretics act?

A

Act by blocking NaCl reabsorption in the ascending limb of the loop of Henle.
-Intense diuretic effect
-Pronounced vaso and venodilatory effect

27
Q

What are examples of Loop diuretics?

A

Furosemide

Bumetanide

28
Q

What are the common side effects of loop diuretics?

A

Electrolyte disturbance (Low K, Na and Mg and Ca)

Dehydration

Renal impairment

Orthostatic hypotension

29
Q

Antihypertensives

A

Alpha (adrenoreceptor blockers)
- Cause peripheral vasodilation
- E.g doxasocin

30
Q

Types of antianginals

A

Nitrates and Nicorandil

31
Q

Nitrates

A

Short acting e.g GTN

Long acting eg isosorbide mononitrate

Directly act to cause vasodilation via nitric oxide

Headache and postural hypotension

Nb. Need to have nitrate free period

32
Q

Nicorandil

A

Nitrate effect

K+ channel blocker

Vasodilation

Headache, postural hypotension and ulceration in GI tract.

CVS block (17 decks)

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