Coronary Heart Disease and Stroke Drugs Flashcards
What are Nitrovasodilators?
Used to treat angina. E.g: Glyceryl Trinitrate (GTN).
Fast Acting.
How do NVs work?
They produce Nitric Oxide. This causes the muscles to relax and the vessels dilate.
Side effects of Nitrates?
Throbbing headache from cerebral vasodilation. Dizziness from lowered BP
What are statins?
Lipid-lowering drugs (cholesterol)
Side effects of statins?
GI upset
Abnormal liver tests
Muscle problems
Fibrinolytic Agents? (FAs)
Used to treat stroke
What do FAs do?
Activate plasminogen to form Plasmin - plasmin is the clot buster, it breaks down fibrin in a clot to dissolve the clot.
Give the name of a Fibrinolytic agent…
Alteplase/Streptokinase
Given IV
Short -acting
What is a problem with Alteplase?
Effective only if given within the first 3 hours of the stroke. But the ischaemic event must be confirmed before giving the drug.
Anti-platelet drugs?
Used to treat stroke.
What do anti-platelet drugs do?
Reduce platelet adhesion and activate aggregation to dissolve clot.
Aspirin action for stroke…
Inhibits COX1 and prevents thromboxane formation.
Dipyridamole?
Anti-platelet drug used to treat stroke. Inhibits thromboxane synthase and prevents thromboxane formation. Often used in conjunction with aspirin.
Which anti-platelet drug antagonises actions of ADP and ADP receptors?
Clopidogrel
What is Abciximab?
An anti-platelet drug which prevents linking of platelets to fibres.
After a stroke/TIA how quickly does aspirin have to be given?
Within the first 24 hours (300mg)
What is Heparin?
An anti-coat drug. Iv administration. Activates body’s own anti-clotting molecule - Antithrombin III. This then blocks the formation of fibrinogen to fibrin - the final stage in clot formation.
Which ant-coagulant acts on the liver to inhibit the enzyme Vitamin K reductase?
Warfarin.
How long does Warfarin take to act?
Days. Dose must be monitored via INR.
How do you reverse anticoagulation urgently?
Give clotting factors.
Side effects of anticoagulants?
should not be given to patients who are at risk of bleeding e.g GI ulcers, spinal puncture, recent trauma, TB and pregnancy. Can cause bleeding gums, nausea, GI upset and diarrhoea. Warfarin has been associated with alopecia and dermatitis.
How do statins work?
Inhibit the enzyme HMG-CoA. This reduces the amount of cholesterol produced by the liver.
Examples of statins?
Simvastatin, Atorvastatin, Pravastatin etc etc
