Drugs Flashcards
What are indications for ACE inhibitors?
Hypertension (<55 first line)
Chronic heart fibrillation
MI secondary prevention
What is ramipril?
ACE inhibitor
What is lisionpril?
ACE inhibitor
What is captopril?
ACE inhibitor
How do ACE inhibitors work?
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
What are indications for angiotensin-II-antagonists?
Hypertension (<55 first line)
Chronic heart fibrillation
MI secondary prevention
Used when ACEI causes persistant cough
How do angiotensin-II-antagonists work?
Competitively block the action of angiotensin II at the angiotensin AT1 receptor
Same effect as ACEI
What is losartan?
ARB
What is valsartan?
ARB
What is irbesartan?
ARB
What is candesartan?
ARB
What are indications for centrally acting hypertensive drugs?
Hypertension (specialist use only)
Hypertension in pregnancy
How do centrally acting hypertensive drugs work?
Methyldopa is an a2 receptor agonist - reducing systemic resistance and therefore blood pressure
Moxonidine is an imadazoline receptor antagonist - also reducing sympathetic discharge
What is methyldopa?
Centrally acting hypertensive drug
What is moxonidine?
Centrally acting hypertensive drug
What are indications for thiazide type diuretics?
Hypertension (first line in Afro-Caribbean people)
How do thiazide type diuretics work?
Inhibit sodium reabsorption, causing urinary excretion of sodium and resulting in reduced extra cellular volume and reduced blood pressure
What is indapamide?
Thiazide type diuretic
What is cloratalidone?
Thiazide type diuretic
What are indications for spironlactone?
Resistant hypertension
Heart failure
How does spironlactone work?
Competitively inhibits aldosterone receptors - blocking the reabsorption of sodium resulting in reduced extra cellular volume and reduced blood pressure
What is aldosterone antagonist potassium sparing diuretic?
Spironlactone
What are indications for loop diuretics?
Pulmonary oedema (usually due to chronic heart failure)
Peripheral oedema
How do loop diuretics work?
Prevent reabsoprtion of sodium and therefore water, reducing BP
Also causes systemic and pulmonary vasodilation, reducing preload
What is bumetanide?
Loop diuretic
What is furosemide?
Loop diuretic
What is torasemide?
Loop diuretic
What are indications for potassium sparing diuretics?
Chronic heart failure
Hypertension
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
What is amiloride?
Potassium sparring diuretic
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
How does aspirin work?
Inhibits platelet thomboxane production - which usually stimulates platelet aggregation and vasoconstriction
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
What does clopidogrel do?
Inhibits ADP receptor activated platelet aggregation
Prodrug which must be activated in the liver
What are indications for low molecular weight heparin?
Unstable angina
NSTEMI
STEMI
DVT/PTE
How does low molecular weight heparin work?
Anticoagulant - prevents clotting of the blood by inhibiting activated factor X
What is enoxaparin?
Low molecular weight heparin
What is enoxaparin?
Low molecular weight heparin