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2a Cardio > Cardiovascular Pharmacology > Flashcards

Cardiovascular Pharmacology Flashcards

1
Q

What 2 systems are targeted pharmacologically when treating hypertension?

A

1) RAAS

2) Sympathetic nervous system (NAd)

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2
Q

What are the main functions of AII?

A

1) Potent vasoconstrictor
2) Activates sympathetic nervous system (^ NAd)
3) Activates aldosterone (Na+ retention)
4) Vascular growth, hyperplasia and hypertrophy

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3
Q

What are the main ways that the sympathetic NS leads to increase in BP?

A

1) NAd is vasoconstrictor so ^ TPR
2) Positive chronotropic and inotropic effects
3) Increased renin release

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4
Q

What are the main ACE inhibitors and what diseases are clinically indicated, and main side effects?

A

__pril (Ramapril, Enalapril, Perindopril)
- HT, HF and Diabetic Nephropathy
SE: Hypotension, Hyperkalaemia, Acute renal failure and Teratogeny of pregnancy

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5
Q

Why do ACEi lead to increased kinin production and what are the side effects as a result?

A
  • Converts bradykinin to inactive peptides, so inhibition causes kinin build up
    Dry chronic cough, rash and anaphylactoid reaction
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6
Q

What are ARB’s, which receptor do they work on and what are the medication examples/

A

Angiotension 2 receptor blockers
- AT-1 receptor
__artan (Candesartan, Valsartan, Losartan)

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7
Q

What diseases are ARB indicated and what are the potential side effects?

A

Diseases: HT, HF and Diabetic Nephropathy
SE: Hypotension, hyperkalaemia, renal dysfunction and rash

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8
Q

Where do CCB’s work, examples and diseases indicated?

A
  • L type Ca2+ channels
  • ___pine (Amlodipine, Felodipine), Diltiazem and Verapamil
  • Diseases: Hypertension, IHD and Arrhythmia
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9
Q

Where do the different types of CCB’s work?

A

DH: Arterial Vasodilators (Amlodipine etc.)
Verapamil: Heart as -ve chrono and ino
Diltiazem: Heart and Vasculature

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10
Q

What are the different side effects of CCB from different abilities?

A

VD: Flushing, Headache and Oedema

  • ve Inotropic: Worsening Cardiac Failure
  • ve Chronotropic: Bradycardia and Atrioventricular block
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11
Q

What are the main side effects of Verapamil?

A

1) Worsening Cardiac Failure (-ve inotropic)
2) Bradycardia (-ve chronotropic)
3) AV block (-ve chronotropic)
4) Constipation

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12
Q

What are beta blockers disease indicated and some examples?

A

Diseases: IHD, HF, HT and Arrhythmia
BB: Bisoprolol (B1 selective), Atenolol and Propanolol (B1/2 non selective)

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13
Q

What are the main side effects of beta blockers?

A

Fatigue, Headache, Nightmares, Bradycardia, Hypotension, Cold Peripheries, Erectile Dysfunction and Bronchospasm

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14
Q

Where do thiazides work and what is an example?

A

DCT

Bendroflumethiazide (__thiazide)

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15
Q

What are some examples of loop diuretics?

A

Furosemide, Bumetanide

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16
Q

What is a potassium sparing diuretic and why are they especially effective?

A

Spironolactone, with anti-aldosterone effects

17
Q

In what diseases are diuretics indicated and what are their main side effects?

A

D: HF and HT
SE: Hypovolaemia, hypotension, reduced serum electrolytes, increased uric acid, ED and impaired glucose tolerance

18
Q

What are the lines of treatment for hypertension?

A

1st Line: CCB’s

2nd: Combine ACEi/ARB with CCB’s
3rd: Combine above with thiazide diuretic

19
Q

What metabolises ANP/BNP and why does this help treat heart failure?

A

NEP - Metabolises ANP/BNP,

Inhibitors increase levels of ANP/BNP in serum

20
Q

What are the main functions of ANP/BNP?

A

Increased renal excretion of Na+ and water

Vasoldilation and inhibit aldosterone release

21
Q

Which nitrates are pharmacologically used?

A

1) Isosorbide mononitrate

2) GTN spray

22
Q

How do nitrates work in treating HF and what are the main potential side effecs?

A

Treat: Venodilators, reducing preload and BP
SE: Headache, syncope and tolerance

23
Q

What classification groups anti-arrhythmic drugs?

A

Vaughan Williams classification

24
Q

What are the VW class of drugs and examples?

A

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)

25
Q

How does digoxin work, main disease indicated and Se?

A
  • Inhibits Na+/K+ pump, so AP = ^ +ve and ACh released from PS nerves
  • Bradycardia, V AV conduction and ^ FOC
    SE: Nausea, vomiting, diarrhoea, confusion
    Disease: AF and severe heart failure
26
Q

What drugs prolong QT interval and what are the main side effects of these drugs?

A

Sotalol and Amiodarone
SE: Pro-arrhythmic effects, Interstitial pneumonitis, abnormal LF, hyper/hypothyroidism, sun sensitivity, skin discolouration, corneal micro-deposits, optic neuropathy

27
Q

How doe Na+ CB blockers work in treating ventricular tachycardia?

A

Block inactivation gate of sodium channel

28
Q

What additional property makes propranolol the most useful beta blocker to help control the arrhythmias which occur immediately following a heart attack ?

A

It can also block sodium channels.

29
Q

It can also block sodium channels.

A

The Na+/K+/2Cl- transporter.

30
Q

How are BB good in chronic heart fialure?

A

Block reflex sympathetic responses which stress the failing heart

31
Q

Doxazosin can be used in the treatment of hypertension. How does this drug work?

A

It is an alpha 1 receptor antagonist.

32
Q

How do beta blockers provide symptom relief in angina?

A
  1. They reduce O2 demand by slowing heart rate (negative chronotrope).
  2. They reduce O2 demand by reducing myocardial contractility (negative inotrope).
  3. They increase O2 distribution by slowing heart rate.
33
Q

What drug might you give to someone with angina caused by coronary artery vasospasm?

A

Amlodipine.

2a Cardio (9 decks)

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