Cardiovascular Pharmacology Flashcards
Ramipril
ACE inhibitor, reduction in production of angiotensin II and decreasing the breakdown of bradykinin, used to treat hypertension and congestive heart failure.
Adverse effects include:
- Shakiness
- Dry cough
- Dizziness and light-headedness due to low blood pressure
- Fatigue, especially in the early stages
- Mouth dryness in the early stages
- Nausea
- Fainting
- Signs of infection (e.g., fever, chills, persistent sore throat)
- Chest pain
- Neutropenia
- Impotence
T1/2 = 2-4 hours
Lisinopril
ACE inhibitor, reduction in production of angiotensin II and decreasing the breakdown of bradykinin, used to treat hypertension and congestive heart failure.
Adverse effects include:
- Chills, signs of infection
- Dark urine (melanuria)
- Decreased urination (oliguria)
- Difficulty swallowing or breathing (signs of angioedema)
- allergic reaction (anaphylaxis)
- Hoarseness
- Itching
- Yellowing of skin or eyes (jaundice)
- Abdominal pain
- bloating
- vomiting
- Chest pain or tightness
- lightheadedness
- fainting
- Dry cough
- Fever
- Joint pain
- Rash
- Diarrhea
- nausea
- Drowsiness
- headache
- tiredness
- Muscle cramps
- Dry mouth
- Serious (possibly fatal) liver problems
- Impotence
- Dizziness
- Faintness
T1/2 = 12 hours
Enalapril
ACE inhibitor used in the treatment of hypertension, diabetic nephropathy and some types of chronic heart failure.
Adverse effects include:
- raised serum creatinine
- dizziness
- hypotension
- syncope
- dry cough
- angioedema
T1/2 = 11 hours
Adrenaline
Hormone and neurotransmitter used in cardiac arrest, anaphylaxis, asthma and croup.
Adverse effects include:
- palpitations
- tachycardia
- arryhthmias
- anxiety
- panic attack
- headache
- tremor
- hypertension
- acute pulmonary oedema
T1/2 = 2 minutes
Amiodarone
Amiodarone is a class III antiarrhythmic agent used for various types of cardiac dysrhythmias, both ventricular and atrial (shock-refractory VF, haemodynamically stable VT, AF). Still used to treat arrhythmias that are otherwise difficult to treat with other medications.
It prolongs phase 3 of the cardiac action potential. Additionally, shows beta blocker and potassium channel blocker like actions on the SA and AV nodes. Chemically resembles thyroxine.
Adverse effects include:
- ILD
- thyroid dysfunction
- corneal deposits
- abnormal liver enzyme results
- jaundice, hepatomegaly and hepatitis (rare)
- light-sensitive blue/grey discolouration of the skin
- peripheral neuropathies
- gynecomastia
- epidiymitis
T1/2 = 58 days
Candesartan
angiotensin 2 inhibitor
irbesartan
angiontensin 2 inhibitor
losartan
angiontensin 2 inhibitor
aspirin
Analgaesic, antipyretic, antiplatelet and anti-inflammatory medication. Antiplatelet effect by inhibition of thromboxane A2. Irreversible inhibition of COX 1 and 2 has downstream effects on production of prostaglandins and thromboxanes.
Used at low doses to prevent heart attacks, strokes and thrombus formation in those at risk.
Adverse effects include:
- GI bleed
- Reye’s syndrome (encephalopathy and fatty liver)
T1/2 is dose dependent
- low dose = 2-3 hours
- high dose = 15-30 hours
Bendroflumethiazide
Bendroflumethiazide (bendrofluazide) is a thiazide diuretic which works by inhibiting sodium absorption at the beginning of the distal convoluted tubule (DCT). Potassium is lost as a result of more sodium reaching the collecting ducts. Bendroflumethiazide has a role in the treatment of mild heart failure although loop diuretics are better for reducing overload. The main use of bendroflumethiazide was in the management of hypertension but recent NICE guidelines now recommend other thiazide-like diuretics such as indapamide and chlortalidone.
Common adverse effects
- dehydration
- postural hypotension
- hyponatraemia, hypokalaemia, hypercalcaemia
- gout
- impaired glucose tolerance
- impotence
Rare adverse effects
- thrombocytopaenia
- agranulocytosis
- photosensitivity rash
- pancreatitis
Amlodipine
Dihydropyridine-type Ca2+ channel blocker used in the treatment of hypertension and angina.
Adverse effects include:
- peripheral oedema and fatigue
- gynaecomastia
- impotence
- depression
- insomnia
- tachycardia
- gingival enlargement
- erratic behaviour
- hepatitis and jaundice (rare)
T1/2 = 30-50 hours
Diltiazem
Ca2+ channel blocker
Nifedipine
Ca2+ channel blocker
Verapamil
Ca2+ channel blocker
Clopidogrel
Oral thienopyridine-class antiplatelet agent used to inhibit clot formation in coronary heart disease, peripheral vascular disease and cerebrovascular disease, as well as prevent myocardial infarction.
Irreversibly binds the P2Y12 adenosine diphosphate (ADP) chemoreceptor on platelet cell membranes leading to inhibition of platelet aggregation.
Adverse effects include:
- bleeding
- severe neurtropaenia
- thrombotic thrombocytopaenia purpura
T1/2 = 7-8 hours
