Cardiovascular Pharmacology Flashcards
Give 4 UE of ACE-Inhibitors.
Dry cough Hypotension Angioedema AKI Hyperkalaemia
What is the MOA of an ARB?
ARBs are angiotensin II receptor antagonists that inhibit the binding of angiotensin II to AT1 receptors.
Give 3 UE of ARBs.
Hypotension
AKI
Hyperkalaemia
Give 4 UE of B-blockers.
Fatigue
Bradycardia
Hypotension
Exacerbation of airway disease
What is the MOA of statins?
Statins are HMG-CoA reductase inhibitors (this enzyme catalyse the rate-limiting step in cholesterol synthesis).
What are 5 UE of statins?
Myalgia Myositis/Rhabdomyolysis GIT disturbance Raised LFTs Insomnia Rash
Name two options other than statins that can be used to control hyperlipidemia.
Fibrates
Ezetimibe
What is the MOA of fibrates?
Fibrates are agonists of PPAR-alpha nuclear receptors –> they increase gene transcription of lipoprotein lipase, ApoA1 and ApoA5 –> this increases hepatic LDL uptake.
What is the MOA of ezetimibe?
Ezetimibe is a cholesterol absorption inhibitor. It blocks the transport protein (NPC1L1) in the brush border of enterocytes that absorbs cholesterol.
What is the MOA of heparin:
Heparin activates antithrombin III.
By what routes can heparin be given? Why is this?
Heparin can be given subcutaneously or IV.
It cannot be given IM because this would cause a haematoma.
It cannot be taken orally because of (1) its charge and (2) its high molecular weight.
Give 4 UE of heparin.
Bleeding Thrombosis (paradoxical) Osteoporosis Hypoaldosteronism Hypersensitivity reactions
What is the MOA of warfarin?
Warfarin is a vitamin K antagonist. Vitamin K is essential for post-translational modification of several clotting factors (II, VII, IX and X). Warfarin inhibits the gamma-carboxylation of glutamic acid residues in these clotting factors, and the clotting factors are not effective.
How long does it take for warfarin to be effective after administration? Why is this?
It takes several days for warfarin to become effective because this is the time taken for already formed clotting factors to be degraded.
What kind of monitoring is used during warfarin therapy?
The effect of warfarin therapy is monitored using prothrombin time, which is expressed as an international normalised ratio (INR).
What are 4 UE of warfarin therapy?
Haemorrhage
Teratogenic
Necrosis of soft tissue
Hepatoxicity
Name 3 NOACs.
Dabigatran
Apixiban
Rivaroxaban
What is the MOA of dabigatran?
A direct thrombin inhibitor.
What is the MOA of apixiban and rivaroxaban?
Direct factor Xa inhibitors.
What is the MOA of aspirin?
Aspirin is a COX inhibitor, that works by causing irreversible acetylation of COX-1. This inhibits the aggregation of platelets.
Name 2 Adenosine (P2Y12) Receptor Antagonists.
Clopidogrel
Ticagrelor
Prasugrel
What is the MOA of clopidogrel, ticagrelor and prasugrel?
These drugs inhibit ADP-induced platelet aggregation by inhibiting the P2Y12 receptors.
Name 2 glycoprotein IIb/IIIa receptor antagonists.
Abciximab
Tirofiban
What is the MOA of abciximab and tirofiban?
Both are antagonists of the glycoprotein receptor IIb/IIIa and so inhibit platelet activation.
Abciximab is a monoclonal antibody against the receptor.
Tirofiban is an inhibitory ligand of the receptor.
Name 3 fibrinolytic drugs.
Streptokinase
Alteplase
Duteplase
Reteplase
What is the MOA of fibrinolytic drugs?
Fibrinolytic drugs alteplase, duteplase and reteplase are recombinant tissue plasminogen activator. They activate plasminogen –> plasmin, so that fibrin is degraded.
