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Year 4 pharmacology and drugs > Cardiovascular drugs > Flashcards

Cardiovascular drugs Flashcards

1
Q

Give examples of organic nitrates and their methods of administration

A

GTN - sublingual, spray, IV, transdermal patch

Isosorbide mononitrate - PO

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2
Q

How do organic nitrates work

A

Relaxation of vascular smooth muscle cells

  • venorelaxation (reduces preload)
  • arteriolar dilatation (reduces afterload)
  • improves coronary blood flow via collateral vessels (increased perfusion of ischaemic zones)
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3
Q

indications of organic nitrates

A

angina

ACS

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4
Q

unwanted effects of organic nitrates

A

tolerance
postural hypotension
headaches

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5
Q

Give examples of vasodilating chemicals

A

bradykinin
ADP
5HT
nitric oxide

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6
Q

Give examples of vasoconstricting substances

A

adrenaline, angiotensin II and ADH produce endothelin which causes vasoconstriction

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7
Q

Give examples of endothelin antagonists and their indication

A

bosentan and ambrisentan

pulmonary hypertension

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8
Q

What is RAAS

A

renin angiotensin aldosterone system

- Na excretion and vascular tone

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9
Q

where are the following produced and released from:
angiotensinogen
renin
angiotensin converting enzyme (ACE)

A

angiotensinogen - liver
renin - kidneys
ACE - lungs

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10
Q

What does renin do

A

convert angiotensinogen to angiotensin 1

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11
Q

what does ACE do

A

convert Ag1 to Ag2

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12
Q

what are the actions of angiotensin 2

A 
act on AT1 receptors to cause 
vasoconstriction
ADH increase
increase thirst 
release more aldosterone (retains Na therefore water)
All of these help to increase MABP
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13
Q

how do you calculate MABP

A

MABP = CO x SVR

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14
Q

How do you calculate MAP

A

MAP = 1/3diastolic + PP

MAP = (2x diastolic) + systolic
———————————
3

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15
Q

how do ACE inhibitors work

A

they inhibit the action of ACE and prevent conversion of Ag1 to Ag2
they cause venodilatation and arteriolar dilatation
they reduce the release of aldosterone
no effect on cardiac contractility

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16
Q

Side effects of ACEI

A

dry cough (from bradykinin)
postural hypotension
RARE - angioedema

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17
Q

indications for ACEI + ARBs

A

hypertension
cardiac failure
post MI

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18
Q

How do ARBs work

A

angiotensin receptor blocker

inhibit the actions of Ag2

19
Q

what can you do if a patient develops a dry cough on ACEI

A

switch to ARB

20
Q

Contraindications for ACEI + ARBs

A

pregnancy
allergy
bilateral renal artery stenosis

21
Q

what are the functions of the following adrenoceptors when their agonist binds:
a1
B1
B2

A

a1 - vasoconstriction (vessels)
B1 - ^ HR, force, AVN conduction (heart)
B2 - bronchodilatation (lungs)

22
Q

indications of B blockers

A

heart failure
angina
hypertension (3rd/4th line)

23
Q

mechanism of B blockers

A

decrease myocardial requirement
increase time in diastole
decrease time in systole

24
Q

give examples of selective B blockers

which receptor does it block

A

atenolol
bisoprolol
metoprolol
B1

25
Q

give an example of a non-selective B blocker

which receptors does it block

A

propranolol

B 1+2

26
Q

What type of receptors do CCB block and where can these be found

A

L type Ca channels

heart and vessels

27
Q

what CCB acts on the heart and what is its effect

A

verapamil
reduces heart rate and AVN conduction
reduces cardiac contractility

28
Q

what CCB acts on smooth muscle cells in vessels and what is its effect

A

amlodipine

arteriolar dilatation reducing SVR (little/no effect on veins)

29
Q

which CCB is used in hypertension and why

A

amlodipine

less effect on the heart

30
Q

Why is amlodipine good for angina

A

causes coronary vasodilatation and reduce afterload

good as prophylaxis alongside GTN if B blockers are contraindicated

31
Q

side effects of amlodipine

A

ankle oedema
hypotension
dizziness
flushing

32
Q

which CCB has intermediate effects

A

diltiazem

33
Q

diltiazem and verapamil has positive/negative inotropic effects

A

negative inotropic effects

34
Q

which CCB is used in arrhythmias

A

verapamil

35
Q

what should you never give with verapamol

A

B blocker

Verapamil + B blocker = verapakill

36
Q

examples of K channel openers and their function

A

nicorandil
minoxidil
vascular smooth muscle cell relaxation

37
Q

how do alpha1 blockers work

A

block a1 receptors to cause vasodilatation and therefore reduced BP

38
Q

examples of alpha blockers

A

prazosin

doxazosin

39
Q

what is an additional effect of alpha blockers

A

provide relief in benign prostatic hyperplasia

40
Q

side effects of alpha blockers

A

postural hypotension

41
Q

mechanism of action of thiazide diiuretics

A

inhibit NaCl reabsorption in distal tubule by blocking Na/Cl cotransporter

42
Q

mechanism of action of loop diuretics

A

inhibit NaCl reabsorption in ascending loop of henle by blocking Na/K/2Cl cotransporter

43
Q

side effects of thiazide and loop diuretics

A

hypokalaemia

44
Q

what is isoprenaline

A

B agonist

positive inotrope

Year 4 pharmacology and drugs (18 decks)

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