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CTP > Drugs > Flashcards

Drugs Flashcards

1
Q

Name an ace inhibitor, how they act and Side-effects - hypertension and HF

A

Lisinopril and rimapril
Prevent ace from converting angiotensin I to angiotensin II. This will reduce blood volume and therefore help hypertension.
Side-effects include hypotension dry cough hyperkalaemia agioedema and renal failure

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2
Q

Name in ARB how it works and the side-effects - Hypertension and HF

A

Candesartan and losartan
Acts by blocking angiotensin II at the AT1 receptor
No dry cough or angio-oedema

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3
Q

Name The three types of CCB - Hypertension

A 
Dihydropyridine = Amlodipine
Non-dihydropyridine = phenylalkylamines (verapamil) and benzothiazapine (diltiazem)
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4
Q

Name the functions of the three CCB’s - hypertension

A

Amlodipine acts on peripheral vasculature
Verapamil is a negative chronotrope and Ionotrope; prolongs the action potential and therefore slows the heart rate
Diltiazem is a mixture between both

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5
Q

Name a thiazide like drug and its actions - hypertension

A

Bendroflumethiazide

Inhibits sodium chloride transporter in DCT and therefore reduces blood volume reducing hypertension

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6
Q

State how spirilactone acts - hypertension and HF

A

It’s an aldosterone receptor antagonist

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7
Q

Name some beta-blockers and how they work in reducing hypertension + side-effects (+HF)

A

Labetalol, bisoprolol and metoprolol
Decreases sympathetic tone, reduces myocardial contraction and reduces renin secretion
Side-effects include bronchospasm, heart block, Raynauds, Legarthy, Impotence and mask tachycardia

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8
Q

Name an alpha receptor blocker, how it functions and side-effects - hypertension

A

Doxazosin
Selectively antagonises alpha-1 receptors to reduce peripheral vascular resistance
Side-effects include postural hypotension which can lead to dizziness syncope and fatigue

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9
Q

What are the contra indications and cautions for an ace inhibitor - Hypertension and HF

A

Contra indications; renal artery stenosis, AKT, pregnancy, breastfeeding
Cautions; NSAIDS, Potassium increasing drugs and antihypertensives

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10
Q

Contra indications and cautions for ARB’s - Hypertension and HF

A

Contra indications; renal artery stenosis, AKD, (risk of renal failure especially where construction of a front arterial is needed) pregnancy and breastfeeding (due to pressure effects and damage to fetal bone and skull)
Cautions; potassium increase in drugs (already at risk of hyperkalaemia)NSAIDS and other antihypertensive agents

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11
Q

Which drug is meant to be used in pregnancy for hypertension

A

Labetalol

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12
Q

Contra indications and cautions for dihydropyridine - hypertension

A

Contra indications; unstable angina, severe aortic stenosis
Cautions; amlodipine and Simvastatin together Because it increases the effect of the Statin and other antihypertensive agents

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13
Q

Contra indications for phenylalkyamines And side-effects - Hypertension

A

Side-effects include constipation bradycardia heart block and cardiac Phalia
Contra indications; Poor left ventricular function and an AV nodal conduction delay
Cautions; beta-blockers, antihypertensive and a antiarrhythmics

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14
Q

Contra indications and cautions and side-effects of thiazide like drugs -hypertension

A

Side effects; hypokalaemia, hyponatraemia, hyperuricaemia, arrhytmia increased glucose and triglyceride
Contra indications; hypokalaemia, hyponatraemia and gout
Cautions; NSAIDS and potassium decreasing drugs

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15
Q

Contra indications and cautions for spirilactinlnone -Hypertension and HF

A

Contra indications; hyperkalaemia and addisons

Caution; potassium increaseimg drugs, ACE inhibitors and ARB

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16
Q

Contra indications and cautions for beta-blockers - Hypertension and HF

A

Contra indications; asthma, hepatic failure, haemodynamic instability
Cautions: verapimil and diltiazem - asystole!

17
Q

What is a caution of an alpha receptor blocker

A

A dihydropyridine

18
Q

Carbonic anhydrase inhibitor - how they work - diuretics

A

Inhibit the carbonic anhydrase enzyme which converts water and carbon dioxide to bicarbonate. Less resorption of HCO3 in PCT. This carries out sodium

19
Q

Carbonic anhydrase inhibitor side-effects - diuretics

A

Do you lose sodium HCO3
Hypokalaemic metabolic acidosis
Tolerance develops after 2 to 3 days

20
Q

Uses of Carbonic anhydrase inhibitors - diuretics

A

Glucoma

Mountain sickness

21
Q

How osmotic agents work and example of one – diuretics

A

Mannitol causes osmosis into the lumen due to incomplete increased oncotic pressure of manitol

22
Q

Side-effects of mannitol - Diuretics

A

Water loss
Reduce intracellular volume
Hypernatraemia risk

23
Q

Uses of osmotic diuretics

A

Reducing high intracerebral pressure

24
Q

Statin - name some and how they function

A

Atorvastatin and simvastatin
Both of these act to inhibit HMG-coA which decreases cell cholesterol increasing the LDL receptor expression and LDL clearance

25
Q

Difference between simvastatin and atorvostatin

A 
Simvastatin = half life of 2 hours - take at night 
Atorvastatin = half life of > 30 hours which means can be taken in the morning and work at night but for ease of patients still take all statins at night
26
Q

Prescription of statin for primary and secondary prevention

A

20 mg for primary with >10% risk

80mg for secondary

27
Q

Complications and cautions of statins

A

Contraindications- GI upset, myalgia and rhabdomyalsis
Cautions- amlodipine (will increase potency of drug), grapefruit juice (higher dose because inhibitsCYP from working) pregnancy and breast feeding (because feaotus needs cholesterol)

28
Q

How do fenofibrates work - cholesterol

A

Work by upregulating LPL by activating the transcription factor PPARalpha = increased TG uptake and fatty acid uptake by the liver.
Usually co-prescribed

29
Q

Cautions and contraindications of fenofibrates - cholesterol

A

Cautions - gall stones and myositis (muscle inflam)

Contraindications - warfarin (can potentiate wafarin causing more bleeding)

30
Q

How does ezetimibe work and its dosing - cholesterol

A

Works by inhibiting NPC1L1 so cholesterol uptake in the gut is reduced = 15% cholesterol reduction and 20% LDL reduction.
Also acts as synergistic with simvastatin and is often used if high doses of statins aren’t tolerated.
Standard dose is 10mg

31
Q

Ezetimibe contraindications and cautions

A

Contraindications - GI upset and abdo pain

Cautions - hepatic

32
Q

How much cholesterol reduction do you aim for in secondary prevention

A

Aim for 4 total cholesterol and 2 LDL

33
Q

How does alirocumab work

A

Works by inhibiting PCK9 which usually promates LDL receptor internalisation

CTP (2 decks)

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