Cardiovascular drugs Flashcards
How does aspirin work?
Blocks cyclo-oxygenase, preventing production of thromboxane A2, thereby inhibiting platelet aggregation..
How does aspirin work?
Blocks cyclo-oxygenase, preventing production of thromboxane A2, thereby inhibiting platelet aggregation..
How does clopidogrel work?
Antagonizes the ADP receptor on platelets, preventing platelet aggregation
When are aspirin and clopidogrel used?
Acute coronary syndrome (treatment and prevention)
How do B-blockers work?
Block B-adrenoceptors:
B1- blocking causes a negative inotropic and chronotropic effect
B2- peripheral vasoconstriction and bronchoconstriction
Describe the selectivity of propanolol and bisoprolol.
Propanolol- non selective
Bisoprolol- B1 selective
When should beta-blockers be used with caution?
Peripheral vascular disease, heart failure
What are the indications for beta blockers?
Angina, hypertension, anti-dysrhythmic, post MI, heart failure (start low go slow)
What are the indications for beta blockers?
Angina, hypertension, anti-dysrhythmic, post MI, heart failure (start low go slow)
How do a) thiazide and b) loop diuretics work?
a) block the Na/Cl co-transporter b) block the triple co-transporter
What side-effect do thiazide and loop diuretics share?
Hypokalaemia
Gout is a side-effect of which diuretic?
Thiazides
What is the mechanism of action of nitrates in ischaemic heart disease?
Reduces preload and oxygen requirements of the myocardium
What is the mechanism of action of nitrates in ischaemic heart disease?
Reduces preload and oxygen requirements of the myocardium
How do calcium blockers work?
Inhibit the entry of calcium via voltage-sensitive L-type channels
Give examples of dihydropyridine calcium blockers, and explain their mechanism of action/indications.
Amlodopine, nifedipine. Mainly peripheral vasodilators- used in angina and hypertension
What are verapamil and diltiazem used to treat and why?
Hypertension, angina and dysrhythmias. Slow down transmission at SA and AV nodes
Which drug should verapamil never be used with?
Beta-blocker- risks severe bradycardia and left ventricular failure
How does digoxin work?
Blocks the Na/K pump, thereby slowing the pulse
What is digoxin used for? (2)
Rate control in fast AF
Option in heart failure
Which abnormality of electrolyte balance enhances the toxicity of digoxin?
Hypokalaemia
How do statins work?
Block HMG-COA reductase, hence blocking synthesis of cholesterol in the liver
Which class of drug is amiodarone?
Class III antiarrythmic
Monitoring of patients taking amiodarone:
a) prior to starting treatment
b) every 6/12
a) TFT, LFT, U&Es, CXR
b) TFT, LFT
Adverse effects of amiodarone? (5)
Many; important ones:
Thyroid dysfunction Pulmonary fibrosis/pneumonitis Liver fibrosis/hepatitis Neuropathy Thrombophlebitis
Which antihypertensives can cause hyperkalaemia? (4)
Spironolactone, potassium-sparing (co-amiloride), ACE inhibitors/ARBs
Which calcium channel blocker is most likely to precipitate acute pulmonary oedema in a patient with heart failure, and why?
Verapamil
Is the most negatively inotropic of the calcium blockers