CVS drugs Flashcards
What CVS drugs prevent further disease
Anti platelet drugs
Lipid lowering drugs
Anti-arrhythmics
Anticoagulants
Diuretics
Ace-inhibitors
What CVS drugs reduce symptoms of current disease
Diuretics
Anti-arrhythmics
Nitrates
Calcium channel blockers
Ace-inhibitors
List 3 antiplatelet drugs
Aspirin
Clopidogrel
Dipyridamole
Prasugrel
Ticagrelor
How do anti-platelet drugs work
They inhibit platelet aggregation, prevent blood clots from forming by making them not stick together
They affect the number or function of platelets
How do anticoagulants work
They directly interfere with the coagulation cascade
How does aspirin work
Inhibits platelet aggregation by altering the balance between throboxane A2 and prostacyclin
Its irreversible for the life of the platelet
How does clopidogrel work
Inhibits ADP induced platelet aggregation
How does Dipyridamole work
Inhibits Platelet phosphodiesterase
How does ticagrelor work
P2Y12 receptor antagonist that prevents ADP-mediated P2Y12 dependent platelet activation and aggregation
How are anti plateletes normally used
Used in combination to increase the effect
Used to significantly reduce chance of heart attack or stroke
What antiplatelets are prescribed in conjunction with aspirin
Prasugrel, Ticagrelor
Name some oral anticoagulants
Warfarin
Rivaroxiban
Apixaban
Dabigatran
Edoxaban
Heparin
What is warafin and what is its effect
Coumarin based anitcoagulant
Inhibits synthesis of Vitamin K dependent clotting factors:
2, 7, 9,10 (slow – 2 days)
Protein C, Protein S (quick)
What is often used concurrently with aspirin at the initial start
Heparin
What must you assume with warafin
All drugs interact with it
What are statins and how do they work
Lipid lowering drugs
They are HMG coA Reductase inhibitors that inhibit cholesterol synthesis in liver
What are statins used for
reduce the level of cholesterol in your blood and protect the insides of your arteries therfore reducing the risk of angina, heart attack and stroke
List some statin drugs
atorvastatin (Lipitor)
fluvastatin (Lescol)
lovastatin (Mevacor)
pravastatin (Pravachol)
rosuvastatin (Crestor)
simvastatin (Zocor)
What possible side effects of statins are there
Possible myositis with other drug interactions includind some dental anti fungals
What antifungal Tx should you omit statins for
Fluconazole
What are beta blockers and how do they work
A drug that block the release of the stress hormones adrenaline and noradrenaline preventing increase in heart rate and reduces the force at which blood is pumped around the body as well as heart muscle excitability
Beta blockers can also block your kidneys from producing a hormone called angiotensin II lowering blood pressure
Why would Beta blockers be prescribed
treatment of angina, control blood pressure, prevent future heart attacks and Prevent unusual heart rhythms which can lead to heart attacks
Name some beta blockers
atenolol
bisoprolol
carvedilol
esmolol
metoprolol
nebivolol
propranolol
What is the difference between atenolol and propanolol
Atenolol is selective, effects B1 receptor only
Propanolol is not selective and affects B1&2 receptor
When would you not prescribe Beta blockers
Makes heart failure worst
Makes asthma worst
What are diuretics
Antihypertensive drug that Increases salt and water
loss as well as:
-Reducing plasma volume
-Reducing cardiac workload
What are diruetics used to treat
High blood pressure and heart failure
What are the two types of diruetics
Thiazide and loop
What are side effects of diruetics
Can lead to Na/K imbalance and lead to dry mouthNam
Name some loop and thiazide diruetics
Loop:
-torsemide
-furosemide
-bumetanide
Thiazide:
-chlorthalidone
-hydrochlorothiazide
-metolazone
-indapamide
What are nitrate drugs
Drugs used to treat angina that dilates arteries and veins to reduce preload to the heart, reduce cardiac workload and cardiac O2 consumption
What two types of nitrates are there and name one of each
Short acting- Glyceryl Trinitrate (GTN)
Long acting- Isosorbide Mononitrate
What way are nitrates adminstered and why
Sublingual, Transdermal, Intravenous
Because they are inactivated by first pass metabolism
What are Ca channel blockers
Drug used to used to lower blood pressure as they stop calcium from entering the cells of the heart and arteries
Also used to treat migraines
List Ca channel blockers
Amlodipine
Diltiazem
Felodipine
Isradipine
Nicardipine
Nifedipine
Nisoldipine
Verapamil
What are ACE inhibitors
Angiotensin-converting enzyme inhibitors are drugs that inhibit conversion of angiotensin I to angiotensin II and prevent aldosterone dependent reabsorption of salt and waterh
Resulting in relaxing of veins and arteries
what are ACE inhibitors used for
treatment of high blood pressure and heart failure
Name some ACE inhibitors
Enalapril
Ramapril
Lisinopril
(All are pril ending)
What is losartan (as well as other drugs ending in artan)
A angiotensin II blocker and used to treat high blood pressure
What are the side effects of ACE inhibitors
Dry cough
Headache and dizziness
Too much K in blood
What drugs to ACE inhibitors interact with
Potassium supplements and potassium-sparing diuretics
angiotensin receptor blocker
angiotensin receptor neprilysin inhibitor
direct renin inhibitor
What drugs do Ca channel blockers interact with
cardiovascular agents such as alpha-adrenergic blockers, beta-adrenergic blockers, digoxin, quinidine, and disopyramide
What drugs do nitrates interact with
Phosphodiesterase inhibitors (end in fil)
What drugs do diuretics interact with
cyclosporine (Restasis)
antidepressants such as fluoxetine, venlafaxine
lithium
digoxin
What is the mechanism of action for ace inhibitors
They prevent an enzyme in the body from making angiotensin 2, a substance that narrows blood vessels, this narrowing can cause high blood pressure and forces the heart to work harder
Angiotensin 2 also releases hormones that raise blood pressure
What is the mechanism of action for diuretics
They act by diminishing sodium reabsorption at different sites in the nephron, thereby increasing urinary sodium and water losses
What is the mechanism of action for nitrates
They have a direct relaxant effect on vascular smooth muscles anddilation of the coronary vessels improves oxygen supply to the myocardium
The dilation of peripheral veins, and in higher doses peripheral arteries, reduces preload and afterload, and thereby lowers myocardial oxygen consumption
What is the mechanism of action for statins
They are a selective non-competitive inhibitor of HMG-CoA reductase, the enzyme responsible for converting HMG-CoA to mevalonate in the cholesterol synthesis pathway
How do the B1&2 receptors work and what is the mechanism of action for beta blockers
Adrenaline and noradrenaline bind to B1 receptors and increase cardiac automaticity, conduction velocity and induce renin release leading to an increase in blood pressure. Binding to B2 receptors causes relaxation of the smooth muscles along with increased metabolic effects such as glycogenolysis
Beta blockers block the release of the stress hormones adrenaline and noradrenaline in certain parts of the body resulting in reduced heart rate and blood pressure
What conditions would put a pt on anticoagualtion for the rest of his life
Atrial fibrillation
DVT
Heart valve disease
Meachanical valves
Thrombophilia
What drugs interact with warafin
Aspirin, Azole antifungal drugs
Increase the INR
-Amiodarone
-Antibiotics
-Alcohol (With liver disease)
-NSAIDS
Reduce INR
-Carbamazepine
-Cholestyramine
-Alcohol (without liver diease)
