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CV drugs Flashcards

1
Q

What are the drug classes used in treatment of hypertension?

A
  1. Vasodilators (ACE Inhibitors, ARBs, Alpha-antagonists)
  2. Calcium channel blockers
  3. Diuretics
  4. Beta-blockers
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2
Q

How do ACE inhibitors work?

A

-block conversion of angiotensin I to angiotensin II

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3
Q

ACEI used?

A

Lisinopril

side effects: dry cough, hypotension (precipitated by diuretics)

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4
Q

Angiotensin Receptor Blockers’ mode of action?

A

Competitive antagonists of AT1 receptor. ARBs cause venous and arteriolar dialation

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5
Q

ARB prescribed?

A

Losartan

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6
Q

CCBs’ mode of action?

A

Antagonists of the L-type Ca channels. Reduced Ca entry into smooth muscle causes reduced contraction/constriction and TPR

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7
Q

CCBs prescribed?

A

Amplodipine (a dihydropyridine)

Verpamil and Diltiazem

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8
Q

CCB side effects?

A

ankle oedema
hypotension
dizziness

Amlodipine is more selective for vascular smooth muscle - less side effects on myocardium.

Do NOT use CCB with Beta-blockers.

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9
Q

How do Thiazide-like diuretics work?

A

Promote Na excretion by inhibiting its reabsorption from the loop of Henle.

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10
Q

Thiazide diuretic prescribed?

A

Bendroflumethiazide

side effects:

  • hypokalaemia (tiredness, arrhythmias)
  • hyperglycaemia (diabetes)
  • hyperuricaemia (gout)
  • impotence
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11
Q

Used in resistant hypertension?

A

Spironolactone

Side effect: hyperkalaemia

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12
Q

Classes of anti-thrombolytic drugs?

A

Antiplatelet
anticoaggluants
fibrinolytics

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13
Q

Antiplatelet drugs prescribed?

A

Aspirin
Clopidogrel
Tricagrelor
Prasugrel

use: angina, MI, TIA, stroke

Side effects: haemorrhage

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14
Q

Anticoagulats prescribed?

A

Prevent new thrombosis
Warfarin (blocks clotting factors)
Heparin
Rivaroxaban (inhibits clotting factor Xa)
Dabigatran (inhibits factor IIa - thrombin)

side effects: haemorrhage

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15
Q

Fibirnolytic prescribed?

A

Streptokinase

  • (dissolves formed clots)
  • use in STEMI, PE
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16
Q

Classes of anti-cholsterol drugs?

A

statins
fibrates
ezetimibe
bile binding resins

17
Q

Statins used? Mode of action?

A

Simvastatin, Atorvastatin

Block the HMG CoA reductase, reducing LDL produciton in the liver.

Use in: hypercholesteraemia, angina/MI, TIA

18
Q

Side effects of statins?

A

myopathy
rhabdomyolysis
renal failure

NOT in pregnancy

19
Q

Fibrates used? Mode of action?

A

Bezafibrate, Gemifibrozil

Lower the trigylceride, LDL levels

Use for: hypertriglyceridaemia
low HDL cholesterol

20
Q

How does Ezetimibe work?

A

Inhibits cholesterol absorption in the duodenum.

Used with statins.

21
Q

Bile acid binding resins?

A

Colestyramine

Promote bile secretion, leading to increased conversion of cholsterol to bile components.

22
Q

Anti-anginal drug classes?

A
  • β Blockers
  • Ca2+ Channel Blockers
  • Nitrates
  • K+ channel Openers
23
Q

Examples of CCBs?

Mode of action?

A

Amlodipine,
Verapamil, Diltiazem

Inhibit calcium entry into vascular smooth muscle, causing peripheral arteriolar dilatation.

24
Q

CCB side effects?

A

ankle oedema
hypotension
dizziness

25
Q

β Blocker (cardioselective) prescribed?

A

Atenolol

Recuces heart rate and force, reducing the Oxygen requirement of the myocardium.

26
Q

β Blockers’ (Atenolol) side effects?

A

cold peripheries
bradycardia
fatigue
Long term - heart failure

Do NOT use in asthma.

27
Q

Nitrates used in angina?

How do they work?

A

GTN (glycerylnitrate)

Releases NO, which relaxes smooth muscle.
Dilates collateral arterioles in angina, directing blood to ischaemic zones.

Side effects: postural hypotension, tolerance

28
Q

Potassium Channel Opener used in angina?

A

Nicorandil

Promotes K+ efflux, causing hyperpolarisation, leading to muscle relaxation and coronary vasodilation.

Side effects: hypovolaemia (low BP).

29
Q

What are the antiarrhythmic drug classes?

A

Class I (IA, IB, IC)
Class II
Class III
Class IV

30
Q

How do Class I antiarrhytmic drugs work?

Examples?

A

Block voltage-activated Na+ channels

Disopyramide (IA)
Lignocaine (IB)
Flecanide (IC)

31
Q

How do Class II antiarrhytmic drugs work?

Example?

A

Antagonists of β-adrenoreceptors, slow down depolarisation in the SA and AV nodes.

Metaprolol

32
Q

How do Class III antiarrhytmic drugs work?

Example?

A

Block voltage-activated K+ channels, increasing the duration of the action potential.

Amiodarone

33
Q

How do Class IV antiarrhytmic drugs work?

Example?

A

Block voltage-activated Ca2+ channels, decreasing the force of contraction.

Verapamil

34
Q

Side effects of antiarrhythmic drugs?

A

phototoxicity
pulmonary fibrosis
thyroid abnormalities

35
Q

How do Inotropic drugs work?

Examples?

A

Modify the force or speed of contraction:

  • Digoxin
  • β-Adrenoceptor Agonists
  • Cakcium-sensitizers
36
Q

How does Digoxin work?

Side effects?

A

Blocks atrial-ventricular conduction, causing an AV delay.

Side effects: It increases ventricular irritability, causing ventricular arrhythmias.
Nausea, vomiting, bradycardia.

37
Q

What is the mode of action of β-adrenoceptor agonists?

Example? When is it used?

A

Increase force and rate of contraction.

Adrenaline (use in anaphylactic shock and cardiac arrest)

side effect: arrhythmias

38
Q

Example of Calcium-sensitizers?

When is it used?

A

Levosimedan
Binds to troponin C, sensitizing it to Calcium ions.

Use in: acute decompensated heart failure

39
Q

What is Atropine’s mode of action?

When is it used?

A

A non-selective muscarinic Ach receptor antagonist.

Increases HR at >600mg doses

Use for: first line in severe Bradycardia

CV (4 decks)

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