Common CV drugs Flashcards
what are 3 examples of anti-cholesterol drugs?
1) statins
2) fibres
3) PCSK 9 Inhibitors
what are 2 examples of statin drugs?
1) simvastatin
2) atorvastatin
what are 2 examples of PCSK9 inhibitors?
1) evolocumab
2) alirocumab
what are 4 types of drugs used as anti-hypersensitive drugs?
1) thiazide diuretics
2) beta blockers
3) vasodilators
4) mineralocorticoid antagonists
what are the 4 example of vasodilators that act as anti-hypersensitive drugs?
1) calcium antagonists
2) alpha blockerrs
3) ACE inhibitors (ACEI)
4) angiotensin receptor blockers (ARB)
what is an example statin drug used as an anti-cholesterol?
Simvastatin
what is the drug simvastatin, an anti-cholesterol drug, do?
blocks HMG CoA reductase
when is the drug simvastatin, an anti-cholesterol drug, used?
Used in;
- hyper-cholesterolaemia
- diabetes
- angina/MI
- CVA/TIA
- High risk of MI & CVA
what are the side effects of the drugs simvastatinn, an anti-cholesterol drug?
- myopathy
- rhabdomyolysis … renal failure
what is an example fibrate drugs used as an anti-cholesterol?
Bezafibrate
when is the drug bezafibrate, the anti-cholesterol drug, used?
Used in;
- hyper-triglyceridaemia
- low HDL cholesterol
what is familial hypercholesterolemia?
what are the symptoms?
a genetic conditioning characterised by high cholesterol levels
- it makes the body unable to remove low density lipoprotein (LDL) cholesterol from the blood.
Symptoms;
- visible cholesterol on the skin e.g. eyes
what type of anti-cholesterol drug is used to treat family hyper-cholesterolaemia?
PCSK 9 inhibitors
how do the PCSK 9 inhibitors work?
= inhibit the binding of PCSK 9 to LDLR, PCSK9 inhibitor increasing the number roof lDLRs available to clear LDL, thereby lowering LDL-C levels
what is hypertension?
abnormally high blood pressure
RECAP
- What are the 4 types of drugs that are anti-hypersensitive used to treat hypertension?
1) thiazide diuretics
2) beta blockers
3) vasodilators
4) mineralocorticoid antagonist
What do Diuretics do?
they block Na re-absorption in the kidneys
what are the 2 types of dietetics?
1) thiazide diuretics
2) loop dietetics
what is the stronger diuretic - loop or thiazide diuretic?
LOOP diuretic is STRONGER.
- thiazide are milder
what is an example drug of a thiazide diuretic?
bendrofluazide
when is the drug bendrofluazide, thiazide diuretic, used?
used in hypertension
what is an example of a drug used as a loop diuretic?
furosemide
when is the frug furosemide, loop diuretic used?
used in heart failure
what are the side effects of diuretics?
1) hypokalaemia = tiredness
2) arrhythmias (low K+)
3) hyperglycaemia = diabetes
4) increased uric acid = gout
5) impotence
what are the 2 beta receipts that beta blockers can block??
1) B1 adrenoceptor
2) B2 adrennoceptor
what are the 2 types of beta blockers?
1) cardioselective Beta blockers
2) non-selective beta blockers
what type of receptor do cardio-selective beta blockers block?
Beta 1 receptor
what are 2 example drugs of cardio-selective beta Blockers?
1) atenolol
2) bisoprolol
when are the drugs atenolol & bisoprolol, cardioselective beta blockers used?
1) angina
2) acute coronary syndrome
3) myocardial infarction
4) hypetension
5) heart failure
what type of receptor do non-selective beta blockers block?
block B1 and B2 receptors
what are 2 example drugs of non-selective beta blockers used?
1) propranolol
2) carvedilol
when are the drugs propranolol and carvedilol, non-selective beta blockers used?
used in;
1) migraines
2) thyrotoxicosis
what are the side effects of beta blockers?
1) tired
2) heart failure
- they can worsen heart failure in short term, especially in cardiogenic shock
3) cold peripheries
RECAP;
- what are the 4 types of drugs used as vasodilators which act as anti-hypersensitive drugs?
1) calcium antagonists
2) alpha blockers
3) ace inhibitors
4) angiotensin receptor blockers
what are the 2 types of calcium antagonists?
1) dihydropyridines
2) rate limiting calcium antagonists
what is an example drug of dihydropyridines, a calcium antagonist?
amlodipine
when is the drug amlodipine, dihydropyridine a calcium antagonists used?
1) hypertension
2) angina
what are the side effects of the drug amlodipine, dihydropyridine a calcium antagonists?
1) ankle oedema
what are 2 example drugs of rate limiting calcium antagonists, a calcium antagonist?
1) verapamil
2) diltiazem
when are the drugs verapamil & diltiazem , rate limiting calcium antagonists, a calcium antagonists used?
1) hypertension
2) angina
3) supra-ventricular arrhythmias (AF, SVT)
what drug should not be used in combination with drugs verapamil & diltiazem , rate limiting calcium antagonists, a calcium antagonists?
beta blockers
what do angiotensin convening enzyme inhibitors do?
= block angiotensin I which would become angiotensin II
what is an example drug of angiotensin converting enzyme inhibitor?
Lisinopril
when is the lisinopril drug, an angiotensin converting enzyme inhibitor used?
1) hypertension
2) heart failure
when is the angiotensin converting enzyme inhibitor good and bad for kidneys?
Good for kidneys;
= in diabetic nephropathy
Bad for kidneys;
= in renal artery stenosis
what are the side effects of angiotensin converting enzyme inhibitors?
1) cough
2) renal dysfunction
3) angioneurotic oedema
when should the angiotensin converting enzyme inhibitors never be used?
never used in pregnancy induced hypertension
what do angiotensin receptor blockers block?
block angiotensin II receptors
what is an example drug for an angiotensin receptor blocker?
losartan
when are angiotensin receptor blockers used?
1) hear failure
2) hypertension
when is the angiotensin receptor blocker good and bad for kidneys?
Good for kidneys;
= in diabetic nephropathy
Bad for kidneys;
= in renal senses
what are the side effects of angiotensin receptor blocker?
1) renal dysfunction
2) no cough
when should angiotensin receptor blockers never be used?
in pregnancy induced hypertension
what do alpha blockers block?
they block alpha adrenoceptors to cause vasodilation
when are alpha blockers used?
1) hypertension
2) prostatic hypertrophy
what is an example drug used as an alpha blocker?
= doxazosin
what are the side effects of alpha blockers?
postural hypotension
what do mineralocorticoid antagonists do?
block aldosterone receptors
give examples of mineralocorticoid antagonists used?
what are mineralocorticoid antagonists used?
1) eplerenone
2) sprinolactone
- used in heart failure & resistant hypertension
what are the side effects of mineralocorticoid antagonists?
1) renal impairment
2) hyperkalaemia
3) gynaecomastia
what are 3 types of anti-anginal drugs that could be used?
1) vasodilators
2) slow heart rate
3) metabolic modulator
what are 3 examples of vasodilator, anti-anginal, drugs?
1) nitrates
2) nicorandil
3) calcium antagonists
what 3 drugs slow heart rate, anti-anginal drugs?
1) beta blockers
2) calcium antagonists
3) ivabradine
what is an example of a metabolic modulator, anti-anginal drug?
Ranolazine
In the category nitrates, which is a vasodilator, what is a type of nitrate used?
veno-dilator
what is an example veno-dilator, a type of nitrate which is a vasodilator?
Isosorbide monorirate
when are venodilators, a nitrate which is a vasodilator used?
1) angina
2) acute heart failure
what are the side effects of venodilators, a nitrate which is a vasodilator?
- headache
- hypotension/collapse
what is the tolerance of venodilators, a nitrate which is a vasodilator?
Leave 8hour/day nitrate-free
what do nicorandils, a vasodilator drug, do?
a K+ ATP channel activator
what are the side effects of nicorandils, a vasodilator?
- headache
- mouth / GI ulcers
what does the drug ivabradine, a drug that slows the heart rate, do?
- If channel modulator in the sinus node.
where does the dug ivabradine, a dug that slows the heart rate, work?
- it only slows the heart rate in sinus rhythm.
- it does NOT work in atrial fibrillation
what is a possible side effect of the drug ivabradine, a drug that slows the heart rate?
visual disturbances
what does the drug ranolazine, a metabolic modulator do?
= a late sodium channel modulator
= decreases calcium load on heart
in what type of angina is the drug ranolazine, a metabolic modulator, effective?
effective in REFRACTORY anginna
what is acute coronary syndrome?
= describes a range of conditions associated with sudden, reduced blood flow to the heart.
what are 4 common anit-thrombotic drugs?
1) anti-platelet drugs
2) anti-coagulants
3) Fibrinolytic’s
4) Warfarin
name 4 types of anti-platelet drugs?
1) aspirin
2) clopidogrel
3) prasugrel
4) ticagrelor
name 2 types of ani-coagulant drugs?
1) heparin
2) fondaparinux
how is the drug fondaparinux, an anti-coagulant, usually administered?
sub-cutaneously
what are 3 other drugs that perform a similar function to warfarin?
1) Rivaroxaban
2) dabigatran
3) Edoxaban
how is the drug edoxaban usually administered?
oral
what are 2 types of fibrinolytic drugs?
1) tPA
2) streptokinase
what do the 4 anti-platelet agents;, aspirin, clopidogrel, ticagrelor and prasugrel prevent?
all prevent new thrombosis
in what cases are the 4 anti-platelet agents;, aspirin, clopidogrel, ticagrelor and prasugrel used?
1) angina
2) acute MI
3) CVA/TIA
4) patients @ high risk of MI & CVA
what are the side effects of the 4 anti-platelet agents;, aspirin, clopidogrel, ticagrelor and prasugrel?
- haemorrhage anywhere
- peptic ulcer = haemorrhage
- aspirin sensitivity = asthma
what are 4 types of anti-coagulant drugs thats prevent new thrombosis & how are they taken?
1) heparin IV use only
2) warfarin oral use only
3) Rivaroxaban
4) davigatran
what block clotting factors does warfarin possess?
block clotting factors;
- 2
- 7
- 9
- 10
when is warfarin used?
1) deep vein thrombosis
2) pulmonary embolism
3) NSTEMI
4) atrial fibrillation
what are the side effects of warfarin?
haemorrhage anywhere
how can warfarin be reversed?
Vitamin K
what type of factor of inhibitor is rivaroxaban?
Factor X a inhibitor
what type of thrombin factor is dabigatran?
thrombin factor IIa inhibitor
what does dabigatran convert?
Xa converts prothrombin II to thrombin IIa
when are fibrinolytic drugs used?
Use in STEMI;
- pulmonary embolism
- CVA
what are the side effects of fibrinolytic drugs?
= haemorrhage serious isk
what cases would you want to avoid using fibrinolytic drugs?
- recent haemorrhage
- trauma
- bleeding tendencies
- severe diabetic retinopathy
- peptic ulcer
what do anti-arrhythmic drugs treat?
treat atrial fibrillation
what are 7 examples of heart failure drugs?
1) ACE inhibitors
2) ARBs
3) beta-blockers
4) mineralocorticoid antagonists
5) diuretics
6) digoxin
7) neprilysin inhibitors
what are 2 examples of mineralocorticoid antagonists?
1) spironolactone
2) eplerenone
what is an example neprilysin inhibitor?
= salcubitril valsartan
what are the complex side effects from the drugs digoxin I and digoxin II do?
Digoxin I
= bad if its excessively blocks atrial ventricular AV conduction
Digoxin II
= increases ventricular irritability which produces ventricular arrhythmias
how does digoxin I block atrial ventricular AV conduction?
= produces a degree of A-V conduction delay
why is it bad if digoxin I blocks atrial ventricular AV conduction excessively?
- heart rate las too much causing bradycardia & heart block
Yes or No.
Is digoxin II ability to increase ventricular irritability which produces arrhythmias always bad?
yes - its always bad
what are the 4 side effects of digoxin toxicity?
- nausea, vomiting
- yellow vision
- bradycardia, heart block
- ventricular arrhythmias
what does the drug neprilysin inhibitor contain?
= salcubitril valsaran
Yes or No.
is neprilysin inhibitor superior too ACEI or ARB?
Yes - it is superior
what are the side effects of nepilysin inhibitor?
- hypotension
- renal impairment t
- hyperkalaemia
- angioneurmtic oedema
