Common Cardiovascular Drugs Flashcards by Charis Gibson

Anti-cholesterol Drugs?

Statins
Fibrates
PCSK 9 Inhibitors

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Examples of statins?

Simvastatin

Atorvastatin

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Examples of PCSK 9 inhibitors?

Ecolocumab,

Alirocumab

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What does PCSK stand for?

Proprotein convertase subtilisin/kexin type 9

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Anti-hypertensive drugs?

Thiazide diueretics
Beta blockers
Vasodilators

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Examples of vasodilators?

Calcium antagonists
Alpha blockers
ACE inhibitors
Angiotensin Receptor blockers

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When are patients given fibrates fro high cholesterol?

When they can’t tolerate statins

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What do statins do?

Blocks HMG Co-A reductase

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What is HMG Co-A Reductase?

rate-controlling enzyme of the mevalonate pathway, the metabolic pathway that produces cholesterol and other isoprenoids.

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What are statins used in?

Hypercholesterolaemia 
Diabetes
Angina/MI
Stroke/Mini stroke (CVA/TIA)
High risk of- MI/CVA

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Side effects of statins?

Myopathy

Rhabdomyolysis - renal failure

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Myopthay

Disease where muscle fibers do not function properly- cause muscle spasms and muscular weakness

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Rhabdomyolysis

Rhabdomyolysis is the breakdown of damaged skeletal muscle. Muscle breakdown causes the release of myoglobin into the bloodstream. … If you have too much myoglobin in your blood, it can cause kidney damage.

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Example of a fibrate?

Bezafibrate

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What are fibrates used in?

Hypertriglyceridaemia

Low HDL cholesterol

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Symptoms of hypercholesterolemia?

Xanthomas- fatty deposits around tendons

Cholesterol deposits around eyes

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What is used to treat familial hypercholesteroleamia?

PCSK 9 Inhibitors- alirocumba, evolocumab

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How does PCSK- 9 inhibitor work?

By inhibiting the binding of PCSK 9 to LDLR, it increases the number of LDLRs available to clear LDL, thereby lowering LDL-C levels.
LDLR= low density lipoprotein receptors

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What can high BP cause if not treated?

Stroke, aterioschlerosis, kidney failure, heart attack/heart failure, blindness

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What do Diuretics do?

Block Na+ reabsorption in kidneys

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What are thiazide diuretics sued for?

Mild hypertension eg bendrofluazide

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Which is stronger loop diuretics or thiazide?

Loop

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What are loop diuretics used for?

Heart failure

example of one-Furosemide

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Side effects of diuretics?

Hypokalaemia (tired)
Arrhythmias 
Hyperglycaemia (diabetes)
Increased uric acid= gout 
Impotence

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What do beta blockers do?

Block B1 &B2 adrenoceptors

What do cardioselective beta blockers do?

Only block Beta 1 receptors

What are cardioselective beta blockers used in?

``` Angina Acute coronary syndrome Myocardial infarction Hypertension Heart failure ```

What do non-selective B blockers do?

Block B1 and B2 receptors

Examples of non selective beta blockers

Propranolol | carvedilol (alpha and beta blocker)

Examples of cardioselective B blockers?

Atenolol | Bisoprolol

What are non-selective Beta blockers used for?

Thryotoxicosis- XS of thyroid hormone in body | Migraine

Beta blocker side effects?

Asthma- contraindicated for brittle/severe asthma Tired Heart Failure- can worsen heart failure in short term Cold peripheries

How many types of calcium antagonists?

The types of calcium antagonist?

Dihydropyridines | Rate limiting calcium antagonists

Example of dihydropyridines?

Amlodipine

What are dihydropyridines used for?

Hypertension and angina

Side affects of dihydropyridines? *common question*

Ankle oedma

Examples of rate limiting calcium antagonists?

Verapamil | Diltiazem

What are rate limiting calcium antagonist used in?

Hypertension Angina Supraventricular Arrhythmias (AF, SVT)- atrial fibrilation, Supraventricular tachycardia

What are calcium antagonists used to treat?

Hypertension and angina

What can't you use rate limiting calcium antagonists with?

Beta blockers

What do angiotensin converting enzyme inhibitors do?

Block angiotensin 1 from becoming angiotensin 2

Example of an angiotensin converting enzyme inhibitor?

Lisinopril

What are angiotensin converting enzyme inhibitors used for?

Hypertension | Heart Failure

When are ACE inhibitors and angiotensin receptor blockers good for the kidneys?

Diabetic nephropathy

When are ACE inhibitors and angiotensin receptor blockers bad for the kidneys?

Renal artery stenosis

Side effects of angiotensin converting enzyme inhibitors?

Cough Renal dysfunction Angioneurotic oedema

When do you not use ACE inhibitors or angiotensin receptor blockers?

In pregnancy induced hypertension

What do patients who cant have ACE inhibitors usually have instead?

Angiotensin receptor blockers

What do angiotensin receptor blockers do?

Block angiotensin 2 receptors

Example of an angiotensin 2 receptor?

Losartan

What are angiotensin receptor blockers used for?

Hypertension and heart failure

Side effects of angiotensin receptor blockers?

Renal dysfunction | No cough

What do alpha blockers do?

Block alpha adrenoceptors to cause vasodilation

What are alpha blockers used in?

Hypertension | Prostatic hypertrophy

Example of an alpha blocker?

Doxazosin

Side effects of alpha blockers?

Postural hypotension

What do mineralocorticoid antagonists do?

Block aldosterone receptors

What are mineralocorticoid antagonists used to treat?

Heart failure | Resistant hypertension

Examples of mineralocorticoid antagonists?

eplerenone | spironolactone

Side effects of mineralocorticoid?

Gynaecomastia- moobs Hyperkalaemia- high blood potassium levels Renal impairment

Anti-anginal vasodilators?

``` Nitrates Nicorandil (K ATP channel opener) Calcium antagonists (Dihydropyridines) ```

Anti-anginal drugs that slow heart rate?

Beta blockers Calcium antagonists (Diltiazem, verapamil) Ivabradine

Anti-anginal metabolic modulator?

Ranolazine (late sodium channel modulator) | Modulating cardiac metabolism

What do nitrates do?

They are venodilators

Examples of nitrates?

Isosorbide monoritrate

What are nitrates used to treat?

Angina | Acute heart failure

Side effects of nitrates?

Headache | Hypotension/collapse

What is common procedure when treating with nitrates?

8 hour per day nitrate free

What is nicorandil used for?

It is a potassium channel activator

Side effects of nicorandil?

Headache | Mouth/GI ulcers

What does ivabradine do?

I(f) channel modulator in the sinus node

Side effects of ivabradine?

Altered visual disturbance

When does ivabradine slow heart rate?

Only in sinus rhythm doesn't work in atrial fibrillation

What is ranolazine?

Late sodium channel modulator

What does ranolazine do?

Decreases calcium load on heart

What is ranolazine effective in?

Refractory angina

Anti-thrombatic drugs?

Antiplatelet drugs Anticoagulants Fibrinolytics

Examples of antiplatelet drugs?

Aspirin, Clopidogrel, Prasugrel, Ticagrelor

Examples of anticoagulants?

``` Heparin Fondaparinux Warfarin Rivaroxaban Dabigatran Edoxaban ```

Example of fibrinolytics?

Streptokinase | tPA

What do antiplatelet agents prevent?

New thrombosis

What are antiplatelet drugs used in?

Angina acute MI CVA/TIA patients at high risk of MI/CVA

Side effects of antiplatelet drugs?

Haemorrhage anywhere Peptic ulcer-> haemorrhage Aspirin sensitivity -> asthma (aspirin is antiplatlet drug)

How heparin is administered?

IV only

How warfarin is adminsitered?

Oral only | It blocks clotting factors (2, 7, 9, 10)

What do anticoagulants do?

Prevent new thrombosis

What are anticoagulants used in?

Deep vein thrombosis Pulmonary embolism Atrial fibrillation NSTEMI- Non-ST-elevation myocardial infarction.

Side effects of anti-coagulants?

Haemorrhage anywhere

Directions of use for anti-coagulants?

Control dose carefully by international normalised ratio

How are anticoagulants reversed?

Vitamin K - Rivaroxaban - Dabigtran

What do fibrinolytic drugs do?

Dissolve a formed clot

When do you use fibrinolytic drugs?

Use in STEMI Pulmonary embolism CVA

Side effects of fibrinolytic drugs?

serious risk of haemorrhage

When to avoid using fibrinolytic drugs?

``` Recent haemorrhage- some CVAs Trauma Bleeding tendencies Severe diabetic retinopathy Peptic ulcer ```

Heart failure drugs?

``` ACE inhibitors ARBs Beta blockers Mineralocorticoid antagonists Neprilysin Inhibitors Diuretics Digoxin ```

Two effects of digoxin?

Blocks atrial-ventricular (AV) conduction - produces a degree of AV conduction delay Increases ventricular irritability which produces ventricular arrhythmias

What is digoxin good to treat?

Atrial fibrillation

Why is it bad if digoxin is given in XS?

Heart rate falls too much giving bradychardia and heart block

Digoxin side effects/toxicity?

``` Nausea vomiting Yellow vision Bradychardia Heart block Ventricular arrhythmias ```

Example of Neprilysin inhibitor?

Salcubitril Valsartan

What is neprilysin inhibitor?

ARB and endopeptidase inhibitor

Side effects of neprilysin inhibitor?

Hypotension Renal impairment Hyperkalaemia Angioneurotic oedema

What are diuretics used in?

Chronic cardiac failure (CCF) Hypertension NOT gout

What are B-blockers used to treat?

Angina Hypertension (PVD) CCF NOT asthma

What are ACE inhibitors/ARB used in?

CCF | Hypertension

What is salcubitril Valsartan used to treat?

CCF

What is Ivabradine used to treat?

CCF | Angina

What are Ca++ antagonists used to treat ?

Hypertension | Angina

What are mineralocorticoids antagonists used ti treat?

CCF | Hypertension

What are nitrates used to treat?

Angina | CHF- Congestive heart failure

Biggest side effect of iysinprol?

Cough