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CR > Drug treatments for CVD > Flashcards

Drug treatments for CVD Flashcards

1
Q

Describe which meds you would prescribe for whom in hypertension

A
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2
Q

describe the roles of the vascular endothelium (5)

A

angiogenesis
metabolism
thrombosis
platelet activation
lymphocytes traffic
VSMC (vascular smooth muscle cells) proliferation
inflammation
vascular tone

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3
Q

name 4 main types of CVD

A

stroke and tia (mini stroke)
coronary heart disease
peripheral arterial disease
aortic disease

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4
Q

what is optimal and normal bp

A

O: <120, <80
N: <130, <85

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5
Q

first line hypertension pharmacotherapy <55 and not black pt

A

Ace inhibitor

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6
Q

first line hypertension pharmacotherapy >55 and/or black pt

A

calcium channel blocker

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7
Q

when would you use an Ace inhibitor for a black pt

A

other risks factors eg coronary ht disease or CKS

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8
Q

what is the first step of the RAAS pathway

A

activation of JG cells - prorenin turns to renin

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9
Q

what does renin do?

A

converts angiotensinogen (liver) to angiotensin I

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10
Q

how is angiotensin I turned to Angiotensin II

A

ACE

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11
Q

where do you find ACE

A

lungs and kidneys

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12
Q

what does A II do in teh proximal tubule

A

promotes Na+ reuptake

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13
Q

what does A II do in the adrenal cortex

A

promotes release of aldosterone

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14
Q

what does aldosterone do?

A

promotes Na+ reabsorption in distal tubule

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15
Q

what does A II bind to in teh vascular system

A

GPCR

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16
Q

which hormonw causes vasoconstriction in systemic vasculature

A

A II

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17
Q

in which vessels does most vasoconstriction happen

A

arterioles

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18
Q

what does A II stimulate in the brain?

A

ADH release

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19
Q

what is natriuresis

A

excretion of Na+ in the urine

20
Q

what are the two angiotensin related antihypertensives

A

ACE inhibitors and angiotensin II receptor antagonists (losartan)

21
Q

what do Ca2+ channel blockers do

A

decrease vasoconstriction

22
Q

what are the 2 types of diuretics

A

loops and thiazide

23
Q

what do thiazide diuretics do

A

inhibit NaCl cotransporter in distal CT therby causing naturesis

24
Q

what to loop diuretics do

A

inhibit Na-K-Cl cotransporter in loop of Henle causing naturesis

25
Q

what are some dangers of loop diuretics

A

loss of calcium, loss of K

26
Q

what is the name of a dihydropyridine CCB and what are some side effects

A

amlodipine

flushing, oedema, headaches

27
Q

name a non-dihydropyridine CCB

A

diltiazem

28
Q

when should you not use diltiazem

A

heart failure

29
Q

why is diltiazen contraindicated

A

in heart failure because is negative chrono and ionotrope

30
Q

what is the first line treatment for angina

A

lower cholestrerol, dietary changes

31
Q

what pharmacotherapy an you use for angina

A

GTN spray, B blockers, ACE inhibitors

32
Q

what does GTN do?

A

ultimately venodilation - converts to NO,
increases cyclic GMP, diminished actin-myosin cross bridges

33
Q

which medicine is absolutely contraindicated with GTN and why

A

viagra - severely low bp

34
Q

what is decreased with low doses of GTN

A

preload

35
Q

what receptors does adrenaline bind to

A

BETA 1!!!

36
Q

what is a beta blocker

A

BETA 1 and2 receptor antagonist

37
Q

what is angina

A

heart ischaemia caused by problems with coronary arteries

38
Q

how do calcium channel blockers help angina

A

decrease afterload
decrease SVR
increase O2 supply to coronary arteries by dilating them (so more blood comes)

39
Q

signs/symptoms of heart failure

A

oedema (peripheral and/or pulmonary)
dyspnoea
lack of energy
raised JVP
pulmonary crackles

40
Q

what is the cardiac result of heart failure(2)

A

reduced CO
increased intracardiac pressure

41
Q

what is the critical measurement in the diagnosis of types of heart failure

A

ejection fraction

42
Q

what are the 3 EF versions

A

> 50 preserved
40-50 borderline
<40 reduced

43
Q

with preserved ejection fraction HF what should you prescribe

A

diuretics

44
Q

with reduced EF what should you prescribe

A

ACE- i and B blocker, then MRA (mineralocorticoid receptor antagonist)

45
Q

what is an MRA

A

Mineralocorticoid receptor antagonist eg spiranolactone. Diuretic

46
Q

how does GTN reduce preload

A

vasodilation - increases capacitance in the body so less blood goes back to the heart

47
Q

what is the difference between low and high doses of gtn

A

low - decreased preload
high - decreased preload AND afterload bc arteries also dilated

CR (12 decks)

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