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Drugs Flashcards

1
Q

What are indications for ACE inhibitors?

A

Hypertension (<55 first line)

Chronic heart fibrillation

MI secondary prevention

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2
Q

What is ramipril?

A

ACE inhibitor

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3
Q

What is lisionpril?

A

ACE inhibitor

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4
Q

What is captopril?

A

ACE inhibitor

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5
Q

How do ACE inhibitors work?

A

Competitively inhibits the action of angiotensin converting enzyme (which converts angiotension I to II)

So reduces total peripheral resistance

Reduces blood pressure and end diastolic pressure

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6
Q

What are indications for angiotensin-II-antagonists?

A

Hypertension (<55 first line)

Chronic heart fibrillation

MI secondary prevention

Used when ACEI causes persistant cough

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7
Q

How do angiotensin-II-antagonists work?

A

Competitively block the action of angiotensin II at the angiotensin AT1 receptor

Same effect as ACEI

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8
Q

What is losartan?

A

ARB

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9
Q

What is valsartan?

A

ARB

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10
Q

What is irbesartan?

A

ARB

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11
Q

What is candesartan?

A

ARB

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12
Q

What are indications for centrally acting hypertensive drugs?

A

Hypertension (specialist use only)

Hypertension in pregnancy

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13
Q

How do centrally acting hypertensive drugs work?

A

Methyldopa is an a2 receptor agonist - reducing systemic resistance and therefore blood pressure

Moxonidine is an imadazoline receptor antagonist - also reducing sympathetic discharge

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14
Q

What is methyldopa?

A

Centrally acting hypertensive drug

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15
Q

What is moxonidine?

A

Centrally acting hypertensive drug

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16
Q

What are indications for thiazide type diuretics?

A

Hypertension (first line in Afro-Caribbean people)

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17
Q

How do thiazide type diuretics work?

A

Inhibit sodium reabsorption, causing urinary excretion of sodium and resulting in reduced extra cellular volume and reduced blood pressure

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18
Q

What is indapamide?

A

Thiazide type diuretic

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19
Q

What is cloratalidone?

A

Thiazide type diuretic

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20
Q

What are indications for spironlactone?

A

Resistant hypertension

Heart failure

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21
Q

How does spironlactone work?

A

Competitively inhibits aldosterone receptors - blocking the reabsorption of sodium resulting in reduced extra cellular volume and reduced blood pressure

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22
Q

What is aldosterone antagonist potassium sparing diuretic?

A

Spironlactone

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23
Q

What are indications for loop diuretics?

A

Pulmonary oedema (usually due to chronic heart failure)

Peripheral oedema

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24
Q

How do loop diuretics work?

A

Prevent reabsoprtion of sodium and therefore water, reducing BP

Also causes systemic and pulmonary vasodilation, reducing preload

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25
What is bumetanide?
Loop diuretic
26
What is furosemide?
Loop diuretic
27
What is torasemide?
Loop diuretic
28
What are indications for potassium sparing diuretics?
Chronic heart failure Hypertension
29
How do potassium sparring diuretics work?
Blocks sodium channels in the distal tube, thereby reducing sodium reabsorption and causing a loss of sodium and water Lowering extracellular volume and BP Also reduce potassium excretion in order to balance pH
30
What is amiloride?
Potassium sparring diuretic
31
What are indications for aspirin?
Secondary prevention of thrombotic cardiovascular diseases: Stable angina Unstable angina NSTEMI STEMI Abdominal aortic aneurysm Aneurysm Stroke/TIA Peripheral arterial disease/critical limb ischaemia
32
How does aspirin work?
Inhibits platelet thomboxane production - which usually stimulates platelet aggregation and vasoconstriction
33
What are indications for clopidogrel?
Monotherapy: peripheral arterial disease Ischaemic stroke MI (only if aspirin is contra-indicated) In combination with aspirin: TIA Ishaemic stroke ACS
34
What does clopidogrel do?
Inhibits ADP receptor activated platelet aggregation Prodrug which must be activated in the liver
35
What are indications for low molecular weight heparin?
Unstable angina NSTEMI STEMI DVT/PTE
36
How does low molecular weight heparin work?
Anticoagulant - prevents clotting of the blood by inhibiting activated factor X
37
What is enoxaparin?
Low molecular weight heparin
38
What is enoxaparin?
Low molecular weight heparin
39
What is trizeparin?
Low molecular weight heparin
40
What is the administeration of low molecular weight heparin?
Subcutaneous administration
41
What are indications for warfarin?
Prophylaxis: rheumatic heart disease atrial fibrillation after prosthetic valve insertion Prophylaxis and treatment: TIAs DVT/PTE
42
How does warfarin work?
Inhibits production of active clotting factors
43
How does digoxin work?
Cardiac glycoside which inhibits the Na/K ATPase pump, allows more calcium to be available for contraction Increases the force of myocardial contraction and reduces conductivity within the AV node
44
What are indications for digoxin?
Heart failure Atrial fibrillation/flutter
45
How does adenosine work?
Slows conduction through the AV node by inhibiting calcium channels Only administered by IV, very short half life
46
What are indications for adenosine?
Immediate termination of supraventricular tachycardia Diagnosis of SVT/VT
47
How does amioderone work?
Anti-arrhythmatic agent (class III) which increases the length of the repolarisation phase of the cardiac cycle
48
What are indications for amioderone?
Tachyarrhythmias Cardiac arrest
49
How does disopyramide work?
Class 1A antiarrhythmatic, inhibits sodium channels Prolongs action potential
50
How does lidocaine work?
Class 1B antiarrhythmic, inhibits sodium channels Shortens the action potential
51
How does flecainide work?
Class 1C antiarrhythmic, inhibits sodium channels Do not change the action potential
52
What are the different effects between class 1A, 1B and 1C antiarrhythmics due to?
Binding at different times
53
What are indications for disopyramide?
Tachyarrhythmias
54
What are indications for lidocaine?
Tachyarrhytmias
55
What are indications for flecainide?
Tachyarrhythmias
56
What is bisoprolol?
Beta blocker
57
What is atenolol?
Beta blocker
58
What is propanolol?
Beta blocker
59
How do beta blockers work?
Block beta-adrenoreceptors which blocks the sympathetic nervous system Reduces HR, BP and CO Reduces contractility (afterload) and systolic wall tension (force and velocity of contraction) Increases diastolic perfusion time and exercise threshold
60
What are indications for beta blockers?
Stable angina Unstable angina NSTEMI STEMI Chronic heart failure Marfan's syndrome (aortic dilation/dissection) Hypertension Tachyarrhythmias
61
How does ivabridine work?
Lowers the heart rate by its action on the sinus node
62
What are indications for ivabridine?
Angina (combination with beta blocker or when beta blocker is contraindicated) Mild to severe chronic heart failure (patients in sinus rhythm)
63
What is amlodipine?
Calcium channel blocker
64
What is felodipine?
Calcium channel blocker - vasodilator
65
What is verapamil?
Calcium channel blocker - rate limiting
66
What is diliazem?
Calcium channel blocker - rate limiting
67
How do calcium channel blockers work?
Prevent calcium influx into myocytes and smooth muscle lining vessels by blocking L-type calcium channels Relaxes arteries (vasodilation, reduce afterload) Reduces total peripheral resistance Reduces CO (rate limiting agents reduce HR and contraction force)
68
What are indications for calcium channel blockers?
Hypertension (\>55 first line) Stable angina
69
What is nicorandil?
Potassium channel blocker
70
How do potassium channel blockers work?
Actovate ATP-sensitive potassium channels leading to vasodilation of coronary vessels Activates guanylyl cyclase causing vasodilation of systemic and coronary vessels - reducing preload and afterload (reducing cardiac oxygen consumption)
71
What are indications for potassium channel blockers?
Angina
72
What is glyceryl trinitrate (GTN)?
Short acting nitrate
73
What is isosorbide mononitrate?
Long acting nitrate
74
How do nitrates work?
Metabolised in the cell to nitric oxide which activates guanylyl cyclase leading to decrease in intracellular calcium levels, causing Vasodilation, decreased venous return (reducing cardiac workload)
75
What are indications for nitrates?
Angina Acute left ventricular failure
76
What is alteplase?
Thrombolytics
77
What is streptokinase?
Thrombolytics
78
How do thrombolytics work?
Acts in the coagulation pathway by hydrolysing the peptide bond in plasminogen, activating the enzyme plasmin which promotes clot lysis
79
What are indications for thombolytics?
ANY CONDITION WHICH REQUIRES URGENT BREAKDOWN OF A CLOT: MI Stroke
80
How is GTN administered?
Sublingual spray Transdermal patches
81
What is simvastatin?
Statin
82
What is atorvastatin?
Statin
83
How do statins work?
Competatively inhibits and enzyme required for cholesterol production in the liver Reduces total and LDL plasma cholesterol
84
What are indications for statins?
Hyperlipoproteinaemia Primary prevention of coronary events Secondary prevention of cardiovascular events
85
What is a class 1A antiarrhythmatic drug, and what does it do?
Disopyramide Moderate Na-channel blockage, prolong action potential
86
What is a class 1B antiarrhythmic drug, and what does it do?
Lidocaine Weak sodium channel blockade, shortens the action potential
87
What is a class 1C antiarrhythmic drug, and what does it do?
Flecainide Strong sodium channel blockage, does not change the action potential
88
What do class 1A, 1B and 1C antiarrhythmic drugs do?
Reduce amplitude of action potential and conduction velocity
89
What are class II antiarrhthmic drugs?
Beta blockers
90
What are class III antiarrhythmic drugs?
Potassium channel blockers
91
What are class IV antiarrhythmic drugs?
Calcium channel blockers
92
What are class V antiarrhytmic drugs?
Others, such as digoxin
93
What are class II antiarrhythmics used for?
Atrial fibrillation
94
What are class III antiarrhythmics used for?
Sustained ventricular tachycardia Disrhythmias that are hard to treat
95
What are class IV antiarrhythmias used for?
Supraventricular tachycardia Rate control for atrial fibrillation and flutter

Cardiovascular System (41 decks)

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