CVS drugs - Anti-hypertensives and anti-clotting Flashcards
What are three indications for ACE inhibitors?
Hypertension
Heart failure
Renal dysfunction
Give three contraindications for ACE inhibitors
Pregnancy
Renovascular Disease
Aortic Stenosis
Give four ADRs of ACE inhibitors
Dry cough due to bradykinin
Angio-oedema
Renal Failure
Hyperkalaemia
What is the mechanism of action of an ACE inhibitor?
Inhibition of angiotensin converting enzyme
Reduced bradykinin breakdown
How do ACE inhibitors lower BP? (3)
- Decreased sympathetic drive
- Peripheral vasodilation
- Decreased aldosterone
Give a DDI of ACE inhibitors
Beta blockers - both lower blood blood pressure
Aspirin, at a push?
What is the indication for angiotensin receptor blockers?
Hypertension
Give three situations in which it would be unwise to give an angiotensin blocker
- Pregnancy
- Renovascular disease
- Aortic stenosis
Give two ADR of angiotensin receptor blockers
Renal Failure
Hyperkalaemia
What is the mechanism of action of angiotensin receptor blockers
Antagonism of angiotensin 2 receptor => AT1R
What are four indications for B blockers?
Angina
Post MI
Hypertension, especially in younger patient
Arrhythmias
Give five contra-indications for B blockers
Asthma (non-selective only) Bradycardia Hypotension AV-block Congestive heart failure
Give 7 ADRs of beta blocekrs
Bronchospasms Fatigue Insomnia Dizziness Cold extremities Hypotension and bradycardia Death in diabetic hypoglycaemia
Give two DDIs of B blockers
Prevents salbutamol actions
Verapamil -> both –ve inotropes
What is the mech of action of B blockers
Antagonise β1 receptors => negative ionotropic and chronotropic effect
Inhibits renin
What is the indication for direct renin inhibitor
Hypertension
Give four ADRs for direct renin inhibitors
Angio-oedema,
hyperkalaemia,
hypotension,
GI disturbances
What is the mechanism of action of direct renin inhibitors
Antagonises Renin, preventing the conversion of Angiotensinogen Angiotensin I.
Reduces plasma renin activity by 50-80%
40h t ½
Elimination in faeces