drug treatments for cvd

Question 1

what are the 4 main types of CVD?

Answer 1

o Coronary heart disease
o Strokes and TIAs
o Peripheral arterial resistance
o Aortic disease

Question 2

what is the treatment rationale for CVD?

Answer 2

direct disease pathology back towards normal function

Question 3

what increases the risk of CVD?

Answer 3

high blood pressure

Question 4

define hypertension

Answer 4

blood pressure of 140/90

Question 5

what is stage 2 hypertension?

Answer 5

160/100 mmHg

Question 6

what is severe hypertension?

Answer 6

180/110 mmHg

Question 7

how is hypertension managed?

Answer 7

amend modifiable factors like lifestyle/environment, reduce salt and smoking
pharmacotherapy - drugs

Question 8

explain the treatment ladder of hypertension

Answer 8

A: given if aged under 55 years
C: given if aged over 55 years.
A+ C: A combination is given in Step 2,
A+C+ D: Thiazide-like diuretic is added in Step 3.

Question 9

how do ace inhibitors work?

Answer 9

Inhibits angiotensin II (a vasoconstrictor) –> vasodilation of small resistance arteries –> lowers blood pressure

Question 10

name examples of ACE inhibitors

Answer 10

ramipril

enalapril

Question 11

what are side effects of ace inhibitors?

Answer 11

K+ retention

cough

Question 12

how do diuretics work?

Answer 12

act at different parts of the nephron to increase water output in the urine  reduces blood pressure

Question 13

name the types of diuretics

Answer 13

loop diuretics
thiazides
potassium sprang diuretics

Question 14

how do loop diuretics work?

Answer 14

Inhibit Na+ K+ 2Cl- symporter in the thick ascending limb of the loop of Henle

Question 15

how do thiazides work?

Answer 15

Inhibits reabsorption of sodium and chloride ions for the distal convoluted tubules. Block Na+/Cl+ symporter. Acts on the ascending loop of Henle

Question 16

how are potassium sprang diuretics used?

Answer 16

in conjunction with other diuretics to prevent hypokalemia

Question 17

what is the mode of action of calcium channel blockers?

Answer 17

Block Ca entry to vascular smooth muscle and myocardial cells  interrupt excitation-contraction coupling

Question 18

give an example of a calcium channel blocker

Answer 18

amlodipine

Question 19

how does amlodipine work?

Answer 19

vasodilation –> reduces systemic vascular resistance

Question 20

what are side effects of amlodipine?

Answer 20

flushing
headache
oedema

Question 21

what is angina?

Answer 21

Pain arising from ischemic heart disease of myocardial muscle (due to plaque formation)

Question 22

what is the treatment for angina?

Answer 22

• Vasodilators = nitrates and calcium blockers

* Cardiac depressants = calcium blockers and beta blockers

Question 23

what are typical symptoms of heart failure?

Answer 23

breathlessness, ankle swelling and fatigue

Question 24

what are typical signs of heart failure?

Answer 24

elevated JVP, pulmonary crackles and peripheral oedema

Question 25

what causes heart failure?

Answer 25

structural and/or cardiac abnormality –> decreased cardiac output or increased intracardiac pressure at rest

Question 26

what is the ejection fraction?

Answer 26

a measurement of the percentage of blood leaving your heart each time it contracts

Question 27

how is heart failure diagnosed?

Answer 27

clinical history, physical exam and an ECG

Question 28

what are the goals of treatment in patients with heart failure?

Answer 28

to improve their clinical status, functional capacity & quality of life, prevent hospital admission & reduce mortality