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Cardiovascular > Cardiovascular Drugs > Flashcards

Cardiovascular Drugs Flashcards

1
Q

what are the 6 main classes of drugs used in hypertension?

A
  • calcium antagonist
  • ACE inhibitors
  • Angiotensin Receptor Blockers
  • Alpha Blockers
  • Mineralocorticoid antagonists
  • Diuretics
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2
Q

examples of cardioselective beta blockers 2

A

Atenolol and bisoprolol

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3
Q

examples of nonselective beta blockers 2

A

propanolol and carvedilol (block b1 and b2 receptors)

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4
Q

side effects of beta blockers? 4

A
  • B2 blockers can worsen asthma
  • tiredness
  • cold peripheries
  • can worsen heart failure
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5
Q

what are the two types of calcium antagonists and give examples for each. What are calcium antagonists used in?

A

dihydropyridnes (amlodipine) and rate limiting calcium antagonists (verapamil and piltiazem). Used in hyertension and angina

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6
Q

what should you avoid using rate limiting calcium antagonists with?

A

beta blockers

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7
Q

what is the mechanism of ACE inhibitors?

A

Block angiotensin 1 becoming angiotensin 2 therefor there is no vasoconstriction

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8
Q

what are ACE inhibitors and angiotensin receptor blockers good and bad for?

A

good for kidneys in diabetic nephropathy

bad for kidneys in renal artery stenosis

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9
Q

when should ACE inhibitors and angiotensin receptor blockers not be used?

A

pregnancy induced hypotension

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10
Q

name an example of angiotensin receptor blockers

A

losartan

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11
Q

what is the mechanism of alpha blockers in hypertension?

A

block a adrenoreceptors to cause vasolation

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12
Q

example of an alpha blockers? and a side effect?

A

Doxazosin. Postural hypotension

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13
Q

mechanism of mineralocoricosteroid antagonist

A

block aldosterone receptors

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14
Q

examples of mineralocorticoid antagonists?

A

spironolactone and eplerenone

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15
Q

side effects of mineralocorticoid antagonists?

A

gynaecomastia, hyperkalaemia and renal impairment

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16
Q

what are the two types of diuretics?

A

loop diuretics (strong) and thiazide diuretics (mild)

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17
Q

example and use of loop diuretics?

A

furosemide (heart failure)

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18
Q

example and use of thiazide diuretics?

A

bendrofluazide

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19
Q

side effects of diuretics?5

A
  • hypokalemia (low k resulting in tiredness)
  • arrhythmias
  • hyperglycaemia (diabetes)
  • increase in uric acid (gout)
  • impotence
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20
Q

3 types of anticholestrol drugs? which one is the strongest?

A

Statins, fibres and PCSK9 Inhibitors (strong)

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21
Q

Action and example of a statin?

A

Simvastatin. Blocks HMG CoA Reductase so cholesterol is not produced (reduction of LDL)

22
Q

action and example of a Fibrate?

A

Bezafibrate. They reduce the livers production of VLDL (triglyceride carrying particle) and speed up the removal of triglycerides in the blood.

23
Q

antithrombotic drugs are split into what two categories?

A

anticoagulants and antiplatalet drugs

24
Q

example of anticoagulant drugs? 7

A
  • heparin
  • fondaparinux
  • warfarin (weekly bloods)
  • rivaroxoban
  • edoxaban
  • dabigatran
  • fibrinolytics (another class)
25
Q

what do fibrinolytics do? example 2

A

dissolve clots and prevent them from growing. Streptokinase and tPA

26
Q

when are fibrinolytics used?

A

STEMI , serious risk of haemorrhage

27
Q

examples antiplatalets drugs? 4

A
  • aspirin
  • clopidogrel
  • prasugrel
  • ticagrelor
28
Q

which anticoagulant are given orally?

A

warfarin, rivaroxoban, dabigatran, edoxaban

29
Q

what is the holy trinity of heart failure?

A

ACE inhibitors, ARBs and betablockers

30
Q

example of HF drugs? 6 Hypertension plus two others

A

-ACE inhibitors
-ARBs
-betablockers
-Mineralocorticoid Antagonists
- Calcium antagonists
-Alpha blockers
PLUS
-digoxin
-Neprilysin Inhibitors

31
Q

what are the two effects of digoxin?

A
  1. Blocks AV conduction (delay) good for AF

2. Increases ventricular irritability which produces ventricular arrhythmias (always BAD)

32
Q

what can digoxin cause if used excessively?

A

bradycardia

33
Q

what do neprilysin inhibitors do?

A

they are endopeptidases. Inhibition of neprilysin increases the bioavailability of natriuretic peptides resulting in vasodilatory effects. They are superior to ACE Inhibitors and ARBs

34
Q

name of a neprilysin inhibitor? 1

A

Salcubitril valsartan

35
Q

two examples of PCSK9 Inhibitors

A

alirocumab and evolocumab

36
Q

action of PCSK9 Inhibitors?

A

they inhibit the binding of PCSK9 to LDL receptors which increases the number of LDL receptors available to clear LDL. Increases rate of LDL recycling

37
Q

what are the three types of anti-anginal drugs?

A

vasodilators, slow heart rate and metabolic modulator

38
Q

what are the three types of vasodilators used in anti-anginal drugs?

A

nitrates, nicorandil and calcium antagonists (dihydropyridnes)

39
Q

action and example 1 of nitrates?

A

ventilators. Open up mostly veins but also arteries. Example - isosorbide monoritrate

40
Q

what is different about the dosage of nitrates?

A

patient must have 8 hours nitrate free because a tolerance can be built up

41
Q

what is nicorandil and why is not preferred?

A

K ATP channel activator that can cause really bad mouth/GI ulcers

42
Q

what is a drug other than beta blockers that can slow down heart rate? what is its action?

A

Ivabradine. If channel modulator in the sinus node. It slows down the heart rate in sinus rhythm and won’t work in A fib

43
Q

what is the metabolic modulator used in ant-anginal treatment?

A

ranolazine

44
Q

what is the action of ranolazine?

A

it a late sodium channel modulator which decreases the calcium load on heart. It stops the heart from working so hard

45
Q

what drugs can control atrial fibrillation? 4

A
  • betablockers
  • digoxin
  • rate limiting calcium antagonists
  • amiodarone
46
Q

ACTION OF ANTICOAGULENTS what is the action of warfarin?

A

it blocks a modification of factors II, VII, IX and X which are essential for their function

47
Q

ACTION OF ANTICOAGULENTS what is the action of rivaroxiban?

A

it directly inhibits factor Xa

48
Q

ACTION OF ANTICOAGULENTS what is the action of heparin, LMWH and fendaparinux?

A

it inactivates factor Xa via antithrombin III

49
Q

ACTION OF ANTICOAGULENTS what is the action of dabigatran?

A

it directly inhibits factor IIa

50
Q

ACTION OF ANTICOAGULENTS what is the action of heparin?

A

it inactivates factor IIa via antithrombin III

Cardiovascular (4 decks)

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