Drugs Flashcards
ACE Inhibitors / Angiotensin II Antagonists
Prescribed for:
Heart failure, hypertension
ACE inhibitor examples:
Ramipril, lisinopril, captopril.
Angiotensin II antagonist examples:
Losartan, candesartan.
ACE Contraindications:
Pregnancy / breastfeeding,
previous allergic reaction to ACE inhibitor.
ACE side effects
Hyperkalaemia, postural
hypotension, constipation, diarrhoea, nausea, vomiting.
Specific side effects: ACE inhibitors cause a persistent dry cough (due to rise in bradykinin) and angioedema.
Avoid potassium rich diets if not taking a drug which lowers potassium alongside (e.g., a thiazide or loop diuretic).
Statins
Hypercholesterolaemia (incl. familial),
hypertriglyceridemia, prevention of cardiovascular
events in those with atherosclerotic disease or diabetes
Statin examples
Simvastatin, Atorvastatin, Pravastatin, Rosuvastatin.
Statin mode of action
Competitively inhibits HMG CoA reductase an enzyme involved in cholesterol (and COQ10) synthesis.
Statin contraindications
Pregnancy, breastfeeding, liver disease.
Statin caution
High alcohol intake, liver disease history.
Statin Side effects
GIT disturbance, headaches, fatigue , insomnia, myositis
(inflammation of muscles), statin induced myopathy
*
Statin use can lead to rhabdomyolysis the breakdown of muscle cells. This can result in kidney disease and even failure. E xtra care needed with foods / supplements that may interfere with metabolism.
Statin Interactions
Important interactions with other drugs, so do check your medicine resources!
Grapefruit juice / pomegranate juice:
Significantly increases GI absorption of CYP3A4
substrates and increases peak levels of statins.
This combination should be completely avoided.
Statin: Nutrient depletion
CoQ10 (watch for muscle pain / fatigue).
Statin alternative
Red yeast rice: A combination of mevinic
acids and derivatives e.g., monacolin K (identical to the active in Lovastatin), and other constituents that exhibit cholesterol lowering activity. Combining with statins may increase overall side effects.
Diuretics
Prescribed for: Oedema due to heart failure, hypertension
Diuretics Examples
Furosemide (loop diuretic),
bendroflumethiazide (thiazide diuretic).
Spironolactone (potassium sparing diuretic).
Diuretics Mode of action
Inhibit reabsorption of filtrate from various
sections of the nephron (i.e., increased urine output), decreasing blood volume and pressure.
Diuretics contraindications
Metabolic imbalances
(hypokalaemia,
hyponatraemia,
hypercalcaemia), Addison’s disease.
Diuretics Caution
Exacerbates diabetes, gout and SLE. Elderly are susceptible to side effects!
Diurectics Side Effects
Hypokalaemia (can be dangerous), hypotension, GIT disturbance, impotence. Milk alkali syndrome may occur when thiazides are combined with large quantities of calcium carbonate!
Diurectics alternative
Taraxacum officinalis
——(dandelion) Acts as a diuretic but also supplies potassium (the leaf), unlike most pharmaceutical diuretics.
Digoxin
Prescribed for:
Atrial fibrillation, heart failure:
Digoxin: Mode of Action
Increases force of myocardial contraction and reduces conductivity within the atrio ventricular node.
Digoxin: Contraindications
Heart block, ventricular tachycardia.
Digoxin: Caution
Hypokalaemia and low blood magnesium can increase the risk of toxicity from digoxin!
Digoxin: Side Effects
Nausea, vomiting, diarrhoea, loss of appetite, abdominal pain, visual disturbance, arrhythmias. The elderly are especially susceptible to side effects.
Digoxin: Interactions
Hawthorn can increase myocardial contraction.
Concomitant use may require digoxin’s dose to be reduced.
Antacids
Prescribed for:
Gastro oesophageal reflux
disease (GORD), indigestion:
Antacids: Examples
Calcium carbonate, magnesium, aluminium