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CVS 2023 > CVS drugs > Flashcards

CVS drugs Flashcards

1
Q

What are ACE inhibitors used for?

A

Heart failure and hypertension

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2
Q

Example of ACE inhibitor

A

Perindopril

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3
Q

What do ACE inhibitors do for the heart?

A

Decrease blood pressure
= Reduce afterload of heart

Decrease blood volume
= decreased preload

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4
Q

When is angiotensin 2 receptor blocker used?

A

Heart failure
Hypertension
if cant tolerate ACE inhibitors

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5
Q

ARB exambple

A

Losartan

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6
Q

Diuretics used

A

Hypertension and Heart failure

Loop diuretics especially useful in congestive HF

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7
Q

Example of diuretic

A

Furosemide

Reduces pulmonary and peripheral oedema (decreased blood volume)

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8
Q

Ca2+ channel blockers example

A

Dihydropyridine act on smooth muscle cells (not for arrythmias)
eg Amlodipine, nicardipine

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9
Q

How do dihydropyridine Ca2+ blockers work?

A

Decrease peripheral resistance
Decrease arterial BP
Reduce afterload

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10
Q

Other type Ca2+ blockers

A

Verapamil and Diltiazem reduce force of contraction

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11
Q

When are Ca2+ blockers used?

A

Hypertension, angina, coronary spasm, SVT

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12
Q

What are positive inotropes?

A

Increase contractility and cardiac output

eg cardiac glycosides and B adrenergic agonists

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13
Q

Cardiac glycosides example and explain

A

Digoxin (from foxglove)

Blocks Na+K+ATPase = rise in Na+ intracellular

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14
Q

What occurs when cardiac glycoside blockes Na+K+ATPase

A

Rise in intracellular Na+ (pump pumping it out)
Decreased concentration gradient for secondary active transport of Ca2+ out of cell
Na+Ca2+ exchanger has less activity
Increase Ca2+ intracellular concentration

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15
Q

What does an increase in intracellular Ca2+ mean?

A

More Ca2+ stored in ER

Increase force of contraction

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16
Q

What else do cardiac glycosides do?

A

Increase vagal activity
Slows AV conduction
Slows HR

17
Q

When are cardiac glycosides used?

A

Heart failure with arrhythmia (eg atrial fibrillation)

18
Q

B adrenoreptor agonists example

A

Dobutamine

19
Q

What does dobutamine do?

A

Selective for B1 adrenoreceptors
Stimulates these in SA and AV node on ventricular myocytes
= increase contractility and HR

20
Q

When is dobutamine used?

A

Cardiogenic shock

Acute but reversible heart failure (eg after heart surgery)

21
Q

How should you treat heart failure?

A

NOT with cardiac glycosides
These relieve symptoms but just make heart work harder and not good in long term

reduce workload with ACEi, ARBs, diuretics, Beta blockers

22
Q

What are nitrates used for?

A

Angina (from ischaemia)

23
Q

What do nitrates do?

A

React with thiols (SH groups)
Nitric oxide released (when NO2 is reduced)
= vasodilation

24
Q

What effect does nitrates mostly have?

A

VASODILATION ON VEINS

25
Q

Examples of organic nitrates

A 
GTN spray (quick, short)
Isosorbide (longer acting)
26
Q

How does nitric oxide cause vasodilation

A

Nitric Oxide activates guanylate cyclase
Increase cGMP
Lower intracellular Ca2+
Relaxation of smooth muscle

27
Q

Why do organic nitrates act on veins?

A

Less endogenous NO already there?

so has a stronger effect

28
Q

Primary and secondary action NO

A

Primary:
vasodilation of venous system = lower venous pressure and preload
(heart fills less, force of contraction reduced, lowers O2 demand)

Secondary:
acts on collateral coronary arteries
improves O2 delivery to ischaemic myocardium

29
Q

What do organic nitrates not do?

A

THEY DO NOT Dilate arterioles

30
Q

Treating angina summary

A

Reduce work load:
Organic nitrates
B adrenoreceptor blockers
Ca2+ channel antagonists

Improve O2 supply:
Ca2+ channel antagonists

31
Q

Which conditions increase risk of thrombus?

A

Atrial fibrillation
Acute MI
Mechanical prosthetic valves

32
Q

Antithrombotic drug types

A

Anticoagulants - prevent venous thromboembolism

Antiplatelets - prevent platelet aggregation and thrombus formation

33
Q

Anticoagulants

A

Heparin/fractionated heparin (inhibits thrombin)
Warfarin (antagonises Vit K)
DOACS (eg Dabigatran inhibit factor 10/thrombin)

34
Q

Antiplatelet drugs

A

Aspirin
Clopidogrel

used after MI to prevent thrombus

CVS 2023 (26 decks)

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