Cardiovascular Pharmacology Flashcards
(33 cards)
What 2 systems are targeted pharmacologically when treating hypertension?
1) RAAS
2) Sympathetic nervous system (NAd)
What are the main functions of AII?
1) Potent vasoconstrictor
2) Activates sympathetic nervous system (^ NAd)
3) Activates aldosterone (Na+ retention)
4) Vascular growth, hyperplasia and hypertrophy
What are the main ways that the sympathetic NS leads to increase in BP?
1) NAd is vasoconstrictor so ^ TPR
2) Positive chronotropic and inotropic effects
3) Increased renin release
What are the main ACE inhibitors and what diseases are clinically indicated, and main side effects?
__pril (Ramapril, Enalapril, Perindopril)
- HT, HF and Diabetic Nephropathy
SE: Hypotension, Hyperkalaemia, Acute renal failure and Teratogeny of pregnancy
Why do ACEi lead to increased kinin production and what are the side effects as a result?
- Converts bradykinin to inactive peptides, so inhibition causes kinin build up
Dry chronic cough, rash and anaphylactoid reaction
What are ARB’s, which receptor do they work on and what are the medication examples/
Angiotension 2 receptor blockers
- AT-1 receptor
__artan (Candesartan, Valsartan, Losartan)
What diseases are ARB indicated and what are the potential side effects?
Diseases: HT, HF and Diabetic Nephropathy
SE: Hypotension, hyperkalaemia, renal dysfunction and rash
Where do CCB’s work, examples and diseases indicated?
- L type Ca2+ channels
- ___pine (Amlodipine, Felodipine), Diltiazem and Verapamil
- Diseases: Hypertension, IHD and Arrhythmia
Where do the different types of CCB’s work?
DH: Arterial Vasodilators (Amlodipine etc.)
Verapamil: Heart as -ve chrono and ino
Diltiazem: Heart and Vasculature
What are the different side effects of CCB from different abilities?
VD: Flushing, Headache and Oedema
- ve Inotropic: Worsening Cardiac Failure
- ve Chronotropic: Bradycardia and Atrioventricular block
What are the main side effects of Verapamil?
1) Worsening Cardiac Failure (-ve inotropic)
2) Bradycardia (-ve chronotropic)
3) AV block (-ve chronotropic)
4) Constipation
What are beta blockers disease indicated and some examples?
Diseases: IHD, HF, HT and Arrhythmia
BB: Bisoprolol (B1 selective), Atenolol and Propanolol (B1/2 non selective)
What are the main side effects of beta blockers?
Fatigue, Headache, Nightmares, Bradycardia, Hypotension, Cold Peripheries, Erectile Dysfunction and Bronchospasm
Where do thiazides work and what is an example?
DCT
Bendroflumethiazide (__thiazide)
What are some examples of loop diuretics?
Furosemide, Bumetanide
What is a potassium sparing diuretic and why are they especially effective?
Spironolactone, with anti-aldosterone effects
In what diseases are diuretics indicated and what are their main side effects?
D: HF and HT
SE: Hypovolaemia, hypotension, reduced serum electrolytes, increased uric acid, ED and impaired glucose tolerance
What are the lines of treatment for hypertension?
1st Line: CCB’s
2nd: Combine ACEi/ARB with CCB’s
3rd: Combine above with thiazide diuretic
What metabolises ANP/BNP and why does this help treat heart failure?
NEP - Metabolises ANP/BNP,
Inhibitors increase levels of ANP/BNP in serum
What are the main functions of ANP/BNP?
Increased renal excretion of Na+ and water
Vasoldilation and inhibit aldosterone release
Which nitrates are pharmacologically used?
1) Isosorbide mononitrate
2) GTN spray
How do nitrates work in treating HF and what are the main potential side effecs?
Treat: Venodilators, reducing preload and BP
SE: Headache, syncope and tolerance
What classification groups anti-arrhythmic drugs?
Vaughan Williams classification
What are the VW class of drugs and examples?
1: Na+ CB w/3 sub divisions 1a: disopyramide, 1b: lidocaine and 1c: flecainide
2: BB: Propanolol, atenolol and bisoprolol
3: Prolong AP e.g. amiodarone (^ chance of SE)
4: CCB: Verapamil and Diltiazem (Not_prils)
