Cardiovascular Drugs Flashcards
For the treatment of hypertension in a black patient or any patient over 55 years, what is the first line treatment for hypertension?
Calcium channel blocker
In a patient is under 55 years old and not black, what is the first line treatment for hypertension?
ACE inhibitor
If a patient is being treated for hypertension using an ACE inhibitor, yet they suffer from a dry cough, which other treatment can they be moved to?
Angiotensin receptor blocker
(ARBs)
What is stage 2 treatment for any patient with hypertension?
Calcium channel blocker + ACE inhibitor (or ARB)
What is stage 3 treatment for any patient being treated for hypertension?
Calcium channel blocker + ACE inhibitior (or ARB) + Thiazide-like diuretic
What is stage 4 treatment, for what is now resistant hypertension?
Calcium channel blocker + ACE inhibitor (or ARB) + Thiazide-like diuretic + further diuretic or alpha blocker or beta blocker
Consider obtaining expert advice here
How do diuretics work?
They block sodium reabsorption in the kidney allowing blood pressure to be reduced as the osmotic effect is now less “into” the blood and blood volume is reduced
Thiazide diuretics are used in which condition?
Hypertension
These diuretics are the milder diuretics
Give an example of a thiazide diruretic used in hypertension
Bendrofluazide
What is the name given to the stronger variant of diuretics?
Loop diuretics
What are loop diuretics used to treat?
Heart failure
Give an example of a loop diuretic
Furosemide
What are cardio selective beta blockers?
Beta blockers that only block B1 adrenoceptors
Give an example of a selective (B1) beta blocker
Atenolol
Beta blockers should never be used to treat heart conditions when the patient has what other condition?
Asthma
Beta blockers are used to treat which 3 heart conditions?
- Angina
- Hypertension - not first line
- Heart failure
What are the two main types of calcium channel antagonists?
- Dihydropyridines
- Rate limiting calcium antagonists
Give an example of a dihydropyridine
Amlodipine
Give examples of rate limiting calcium antagonists
- Verapamil
- Diltiazem
Rate limiting calcium antagonists should not be used with which other drug class and why?
Beta blockers
Together they have a strong in fluence on the AV node and can cause heart block
What are dihydropyridines used to treat?
- Hypertension
- Angina
Rate imiting calcium antagonists are used to treat which conditions?
- Hypertension
- Angina
- Supraventricular arrythmias
How do alpha blockers work?
They can block alpha adrenoceptors allowing for vasodilation
Alpha blockers are used to treat which conditions?
- Hypertension - not first line and considered late on
- Prostatic hypertrophy
Give an example of an alpha adrenoceptor blocker
Doxazosin
How do angiotension converting enzyme inhibitors work?
They block the enzyme (ACE) that converts angiotensin I to angiotensin II
Give an example of an ACE inhibitor
Lisinopril
ACE inhibitors are used to treat which conditions?
- Hypertension
- Heart failure
- Diabetic neuropathy
Under which circumstances is ACE inhibitor use contraindicated?
- Patients with renal failure
- Pregnancy - can cause abnormalities in foetus
How do angiotension receptor blockers work?
They block angiotensin II receptor sites
Give an example of an ARB
Losartan
What are ARBs used to treat?
- Heart failure
- Hypertension
- Diabetic nephropathy
ARBs are contraindicated for which patients?
- Renal conditions - renal artery stenosis
- Prenant women - can cause damage to developing foetus
Give an example of a nitrate
- GTN - glyceryl trinitrate
- Isosorbide mononitrate
- Isosorbide dinitrate
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Nitrates are used to treat which conditions?
- Angina
- Acute heart failure
What is a common side effect of nitrates which, to avoid, affects the time they need to be taken in the day?
Tolerance
They are taken in the morning or mid-afternoon so the drug is depleted from the body system at night
Give examples of antiplatelet agents
- Aspirin
- Clopidogrel
- Ticagrelor
- Prasugrel
Antiplatelet agents are used in which conditions?
- Angina
- Acute MI
- TIA