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Cardiovascular > cardiovascular pharmacology > Flashcards

cardiovascular pharmacology Flashcards

1
Q

What are the vascular smooth muscle innervated by?

A

Sympathetic nerves

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2
Q

What is vascular tone?

A

The degree of constriction experienced by a blood vessel relative to its maximally dilated state.

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3
Q

What is the mechanism of vascular smooth muscle contraction?

A

1) Stimulation of angiotensin II type 1 receptors and alpha adrenergic receptors –> Activates phospholipase C.
2) This produces the 2nd messenger IP3
3) IP3 stimulates release of ca2+ from the sarcoplasmic reticulum –> raised conc of ca2+
4) Raised ca2+ activates calmodulin –> which activates myosin light chain kinase (MLCK)
5) MLCK phosphorylates myosin light chain (myosin - LC)
6) Phosphorylated myosin -LC interacts with actin-myosin cross-bridges - INITIATES VASCULAR SMOOTH MUSCLE CONTRACTION

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4
Q

List some types of vasodilators

A

ACE inhibitors, AT1R antagonists, calcium channe; blockers, potassium channel blockers

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5
Q

How do ace inhibitors cause vasodilation?

A

inhibits the formation of angiotensin II

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6
Q

How is angiotensin II formed?

A

Kidney secretes renin, renin cleaves the prohormone angiotensinogen to angiotensin I
Ang I is then converted to angiotenin II by angiotensin converting enzymes (ace) - CAUSES VASOCONTRICTION AND RAISES BP

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7
Q

What do ace inhibitors do?

A

They inhibit the renin- angiotensin system by inhibiting the conversion of angiotensin I to angiotensin II
They also decrease the breakdown of bradykinin causing vasodilation as a result

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8
Q

What does increase in bradykinin do?

A

causes vasodilation

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9
Q

What are some of the effects of angiotensin AT1 stimulation?

A
  • Aldosterone secretion from adrenal glands
  • Renal NaCl reabsorption
  • Vasoconstriction
  • Stimulation of thirst
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10
Q

What are the effects of angiotensin AT2 receptor

A

vasodilation through bradykinin and NO release

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11
Q

What do ACEi end in?

A

PRIL e.g ramipril

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12
Q

What do angiotensin II receptor blockers do?

A

Inhibit the binding of ang II to the AT1 receptor, promoting vasodilation.

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13
Q

What is the name of the other pathway that produces angiotensin II

A

Chymase pathway

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14
Q

What do angiotensin II receptor blockers end in?

A

SARTAN e.g losartan

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15
Q

Describe the mechanism of smooth muscle relaxation (WITH Nitric oxide)

A

NO increases the level of cGMP within the cell.

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16
Q

What is glyceryl trinitrate

A

a prodrug - used to treat MI and pulmonary oedema. CAUSES VASODILATION

17
Q

How does vasodilation occur?

A

1) Agonist stimulation of beta-2-adrenergic receptors –> lead to activation of adenylate cyclase –> producing the second messenger cAMP.
2) cAMP activates protein kinase A which has several effects such as reducing calcium conc and reducing myosin light chain phosphorylation

18
Q

Give an example of Beta-2- agonist

A

Salbutamol - used in asthma

19
Q

What is arterial thrombosis?

A

Atherosclerosis plaque ruptures, activating coagulation and platelets which form big clot/ thrombus.

20
Q

What is percutaneous coronary intervention?

A

Non-surgical widening of the coronary artery - using balloon stent - used in MI, angina.

21
Q

What is thromboxane?

A

Induces platelet aggregation

22
Q

What is cox enzyme?

A

Cyclooxygenase - its responsible for the production of thromboxane

23
Q

How does aspirin work as antiplatelet?

A

Inactivates COX 1 enzymes - suppressing production of thromboxane.

24
Q

What are ADP receptors?

A

These are found on the surface of platelets - activate them

25
Q

How does phioenopyridines act as antiplatelets?

A

works by inhibiting the p2y12 adp receptor - forming a disulfide bridge with the platelet adp receptor

26
Q

What are the two main types of anticoagulants?

A

Vitamin K antagonists and heparins

27
Q

What is warfarin?

A

very commonly used anticoagulant - used in the treatment of thrombosis and embolism

28
Q

How does it work?

A

it is structurally similar to vitamin K, and it inhibits vitamin K epoxidide reductase

29
Q

What is heparin?

A

it is a blood thinner

30
Q

What are the two clinically used heparins?

A

low molecular weight and unfractioned

31
Q

How does heparin work?

A

activating antithrombin III which is a serpin. Serpins inhibit thrombin and factor 10a

Cardiovascular (9 decks)

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