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Pharmacology -2nd Year > Coronary Heart Disease and Stroke Drugs > Flashcards

Coronary Heart Disease and Stroke Drugs Flashcards

1
Q

Which drugs are used to reduce oxygen demand in cardiovascular disease?

A

Beta-blockers (to reduce heart rate)

Nitrovasodilators (to reduce contraction strength)

Antihypertensives (to reduce arterial resistance)

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2
Q

Which drugs are used to increase oxygen supply in cardiovascular disease?

A

Antiplatelet drugs (decrease risk of clotting)

Cholesterol-lowering drugs (prevent atheroma formation, open up heart arteries)

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3
Q

During a myocardial infarction which drugs are used?

A

Major painkillers

Thrombolytics

Anti-arrhythmia drugs

Beta blockers

ACE inhibitors

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4
Q

What are the forms of glyceryl trinitrate?

A

Sublingual tablet

Nasal spray

Transdermal patch

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5
Q

Which of the clot-busting drugs must be administered within a few hours of onset of stroke in order to be effective?

A

Alteplase

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6
Q

What is the mechanism of action of nitrovasodilators?

A

Produce nitric oxide

Increases cGMP in muscle cells

Muscle relaxes

Vessels dilate

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7
Q

What are the side-effects associated with nitrovasodilators?

A

Throbbing headache (cerebral vasodilation)

Postural hypotension

Dizziness

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8
Q

Which drugs are cholesterol reducing?

A

Statins

Ezetimibe

Resins

Nicotinic acid

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9
Q

Which drugs are triglyceride reducing?

A

Statins

Fibrates

Omacor

Metformin

Nicotinic acid

Acipimox

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10
Q

What is the mechanism of action of statins?

A

Work as an HMG -CoA reductase inhibitor

HMG-CoA reductase is a rate-limiting step in cholesterol synthesis

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11
Q

What are the side-effects associated with statins?

A

GI upset

Abnormal liver tests

Myopathy (rare)

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12
Q

What are the two types of stroke?

A

Ischaemic stroke

Haemorrhagic stroke

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13
Q

In ischaemic stroke, what kind of lesion is produced?

A

A lesion with a central core surrounded by ischaemic penumbra

Due to necrosis and cerebral oedema and inflammation

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14
Q

What type of drugs are used to activate fibrinolysis?

A

Recombinant tissue plasminogen activators

eg. Alteplase

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15
Q

What are the mechanisms to inhibit platelet aggregation and thrombus formation?

A

Preventing GP11a/11b receptor expression

Preventing GP11a/11b receptor interaction

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16
Q

Which drugs are used to prevent GP11a/11b receptor expression?

A

Aspirin

Dipyridamole

Clopidogrel

17
Q

How does aspirin preventGP11a/11b receptor expression?

A

By inhibiting the COX1 enzyme

18
Q

How does dipyridamole preventGP11a/11b receptor expression?

A

By inhibiting thromoxane synthase and therefore preventing thromboxane formation

19
Q

How does clopidogrel preventGP11a/11b receptor expression?

A

By antagonising the actions of ADP at the purinergic receptors

20
Q

Which drug is used to prevent GP11a/11b receptor interaction and how does it work?

A

Abciximab

Binds to receptors to prevent linking of platelets to fibrinogen fibres

21
Q

What are the mechanisms of action of anticoagulant drugs?

A

Activation of antithrombin

Inhibition of vitamin K reductase

Direct selective inhibition of steps in the clotting cascade

22
Q

Which drugs work by activating antithrombin?

A

Heparins: Activate the body’s own antithrombin III

23
Q

What are the different types of heparin?

A

Original unfractionated heparin

Low molecular weight heparin (fragments of heparin)

24
Q

Which drugs work by inhibiting vitamin K reductase?

A

Warfarin

Acts on the liver to inhibit vitamin K reductase, which gradually diminishes the concentrations of clotting factors, so less fibrin can be made by the body

25
Q

What are the issues associated with warfarin?

A

Takes days to act

Very complex metabolism so dose must be individually adjusted

Interacts with many other drugs

26
Q

What long-term therapy is given for ischaemic stroke?

A

Antiplatelet therapy -to reduce the risk of further infarction

Secondary prevention (combined aspirin and dipyridamole)

Pharmacology -2nd Year (10 decks)

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