Case 5 Flashcards
What is Aspirin?
Pain killer, anti inflammatory, antipyretic
Taken in low doses as an anti platelet drug
What is the active agent in aspirin
Salicylic acid
What does aspirin treat
Pain, headaches, fever, heart attacks and strokes
Mechanism of action of aspirin
Suppresses production of prostaglandins and thromboxane, carried out by irreversible inactivation of cyclooxygenase (COX) enzyme
COX responsible for formation of prostaglandins and thromboxane
Prostaglandins
Inhibition of prostaglandin production has anti inflammory effects
Thromboxane
Thromboxane A2 produced by activated platelets
Stimulates activation of new platelets
Increases platelet aggregation
Leads to formation of blood clots
Irreversibly blocking formation of thromboxane A2 in platelets produces inhibitory effects on platelet aggregation
Side effects of aspirin
Irritation of stomach lining, nausea, vomiting, abdominal pain, bleeding, Reye’s syndrome
What is Bisoprolol?
B1 adrenergic receptor antagonist
Used to treat angina pectoris, hypertension and heart failure
Administered by mouth
Mechanism of action of bisoprolol
Blocks B1 adrenergic receptors
Decreases adrenergic stimulation of heart muscle and pace maker cells
Side effects of bisoprolol
Breathing difficulties, fatigue, cold extremities, sleep disturbances, hypotension, bradycardia
What is Ticagrelor?
Anti platelet drug
Used in prevention of thrombosis in myocardial infarction with ST elevation
Usually given in combination with aspirin
Mechanism of action of ticagrelor
Platelet aggregation inhibitor
Blocks adenosine diphosphate (ADP) receptors of platelets. ADP used in activation and aggregation of platelets
Side effects of ticagrelor
Dyspnea, various types of bleeding
What is atrovastatin?
A statin used for lower blood cholesterol levels
Stabilises plaque and prevents stroke through anti inflammation
Mechanism of action of atrovastatin
Competitive inhibitor of HMG-CoA reductase enzyme (enzyme found in liver and involved in catalysis of hepatic cholesterol biosynthesis)
Inhibition of this enzyme decreases cholesterol synthesis increasing expression of LDL receptors on hepatocytes
Increases LDL uptake by hepatocytes, decreasing LDL cholesterol in blood
Side effects of atrovastatin
Weakness, dizziness, headache, raised concentration of hepatic enzymes
What is glyceryl trinitrate
Also known as nitroglycerin
Used to treat heart failure and prevent and treat angina
Vasodilator
Mechanism of action of glyceryl trinitrate
Prodrug, must be denitrated in liver to produce active metabolite nitric oxide
Nitric oxide increases levels of cGMP (cyclic guanosine monophosphate)in smooth muscle cells of blood vessels
Causes activation of Intracellular protein kinases in response
Cause relaxation of vascular smooth muscles, leading to vasodilation and increased blood flow
Side effects of glyceryl trinitrate
Large doses may cause flushing, headache and fainting
What is ramipril?
ACE inhibitor (angiotensin-converting enzyme inhibitor)
Used to treat high blood pressure, fluid retention and heart failure
Mechanism of action of ramipril
ACE inhibitors act by interfering with action of enzyme that converts inactive angiotensin 1 to powerful artery constrictor angiotensin 2
Absecence of ACE allows arteries to widen and blood pressure decreases
Side effects of ramipril
Dry cough
What is HMG-CoA reductase enzyme?
Enzyme found in liver involved in catalysis of hepatic cholesterol biosynthesis
