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Cardiovascular System > Drugs > Flashcards

Drugs Flashcards

1
Q

What are the two groups of drugs used to treat heart failure?

A

Drugs that increase cardiac output

Drugs that reduce workload of the heart

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2
Q

Why are drugs that increase cardiac output not often used to treat heart failure?

A

Have negative long-term effects on heart

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3
Q

What are the drugs that increase cardiac output?

A

Cardiac glycosides

B1 adrenoceptor agonists

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4
Q

How do cardiac glycosides work?

A

Block Na+ K+ ATPase

Increase vagal activity

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5
Q

What is the effect of the Na+ K+ ATPase being blocked?

A

Increase in intracellular conc. of Na+
Decreased activity of Na+ Ca2+ exchanger, due to reduced diffusion gradient of Na+ to enter cell
Increased intracellular Ca2+ conc.
More Ca2+ stored in sarcoplasmic reticulum

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6
Q

What are the effects of more Ca2+ in SR?

A

More Ca2+ released during action potentials
Higher intracellular Ca2+ conc.
Increases contractility
Positive inotropy - increased force of contraction

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7
Q

What are the effects of increasing vagal activity?

A

Decrease in heart rate

Decrease in AV node conduction velocity

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8
Q

When are cardiac glycosides used to treat heart failure?

A

When the patient has an arrythmia also e.g. atrial fibrillation

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9
Q

What is an example of a beta adrenoceptor agonist?

A

Dobutamine

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10
Q

What is dobutamine used to treat?

A

Cardiogenic shock

Acute heart failure

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11
Q

What are the types of drugs that reduce workload of the heart?

A

ACE inhibitors

Beta adrenoceptor antagonists

Diuretics

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12
Q

How do ACE inhibitors work?

A

Prevent action of ACE

Prevent it from converting angiotensin 1 into angiotensin 2

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13
Q

How does less angiotensin 2 reduce the workload of the heart?

A

Decreased sodium and water retention
reduced blood volume
reduced preload of heart
reduced force of contraction

Decreased vasoconstriction
decreases TPR, blood pressure
reduced afterload of heart

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14
Q

What can be used instead if an ACE inhibitor is not tolerated by the patient?

A

Angiotensin 2 receptor blocker

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15
Q

How do diuretics work?

A

Increase excretion of water, less reabsorption
decreased blood volume
reduced preload
reduced force of contraction

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16
Q

What are the two groups of drugs used to treat angina?

A

Drugs that reduce workload of heart

Drugs that increase blood supply to heart

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17
Q

What are the drugs that reduce workload of the heart?

A

Beta adrenoceptor antagonists

Ca2+ channel blockers

Organic nitrates

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18
Q

What are the drugs that increase blood supply to heart?

A

Organic nitrates

Ca2+ channel blockers

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19
Q

What type of cell do organic nitrates act on?

A

Vascular smooth muscle cells

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20
Q

What do organic nitrates react with in smooth muscle cells? What does this release?

A

Thiol -SH groups

Releases NO2-, reduced to NO

21
Q

What are some examples of nitric oxides?

A

Glyceryl trinitrate (GTN)

Isosorbide dinitrate

22
Q

What is the effect of NO?

A

Vasodilation

23
Q

How does NO cause vasodilation?

A 
Activates guanylate cyclase
converts GTP into cGMP
cGMP activates PKG
PKG decreases intracellular Ca2+ conc.
causes relaxation of smooth muscle cell
24
Q

What type of blood vessels do organic nitrates mostly act on?

A

Veins - venodilation

Collateral coronary arteries

25
Q

How does venodilation reduce workload of the heart?

A

Lowers venous pressure
reduced preload of heart
reduced force of contraction

26
Q

How does collateral coronary artery dilation increase blood supply to heart?

A

Collateral coronary arteries bypass blockage in coronary artery
increased blood flow through bypass
to ischaemic area

27
Q

How significant is collateral coronary artery dilation in increasing blood supply to heart?

A

Not very significant

because there aren’t many end arteries

28
Q

When might collateral coronary arteries develop?

A

With myocardial ischaemia
in order to increase blood supply to the area
by bypassing the blocked coronary artery

29
Q

Why do organic nitrates mostly act on the veins?

A

Because there is less endogenous nitric oxide in veins

so it has a greater effect in the veins

30
Q

Which heart conditions carry an increased risk of thrombus formation?

A

Atrial fibrillation
Acute MI
Prosthetic heart valves

31
Q

Why does atrial fibrillation carry an increased risk of thrombus formation?

A

Atria not contracting properly

Blood becomes stagnant, pools

32
Q

Where in the atria do thrombi tend to form?

A

Auricles

33
Q

What are the types of antithrombotic drugs? How are they different?

A

Anticoagulant drugs - prevent blood clot formation

Antiplatelet drugs

34
Q

What are the different anticoagulant drugs?

A

Heparin

Fractionated heparin

Warfarin

35
Q

How is heparin given?

A

IV

36
Q

How does heparin work?

A

Inhibits thrombin

37
Q

How is fractionated heparin given?

A

Subcutaneous injection

38
Q

How is warfarin given?

A

Orally

39
Q

How does warfarin work?

A

Antagonises action of Vit. K

40
Q

What is an example of an antiplatelet drug?

A

Aspirin

41
Q

When is aspirin used?

A

Following acute MI

Or if have high risk of MI

42
Q

When timeframe is heparin used for?

A

For short-term action

43
Q

What timeframe is fractionated heparin used for?

A

For more long-term action

44
Q

What are the different groups of drugs used to treat hypertension?

A

ACE inhibitors

Ca2+ channel blockers

Diuretic

Beta blockers

A1 adrenoceptor antagonists

45
Q

How do Ca2+ channel blockers treat hypertension?

A

Cause relaxation of smooth muscle in blood vessels
so vasodilation
decreases TPR, blood pressure

46
Q

How do diuretics treat hypertension?

A

Decrease water retention
reduce blood volume
reduced preload, SV, CO
reduce blood pressure

47
Q

How do beta blockers treat hypertension?

A

Reduce heart rate
reduce force of contraction, SV

reduce CO, blood pressure

48
Q

How do A1 adrenoceptor antagonists treat hypertension?

A

Prevent vasoconstriction of smooth muscle in blood vessels
giving vasodilation
reduce TPR, blood pressure

49
Q

How do ACE inhibitors treat hypertension?

A

Prevent formation of angiotensin 2

reduced sodium, water retention
reduced blood volume
reduced preload, SV, CO
reduced blood pressure

reduced vasoconsriction, increased vasodilation
reduced TPR, blood pressure

Cardiovascular System (22 decks)

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