Drugs acting on heart and circulation Flashcards
ACEi
Ramipril, captopril, lisinopril
MoA - Inhibits conversion of angiotensin I to II. Blocks vasoconstriction
Indication - Hypertension, diabetic nephropathy, heart failure
Adverse effects - cough, hyperkalaemia
Interactions - Lithium, NSAIDs
ARBs
Losartan, valsartan
MoA - Blocks angiotensin-renin system
Indication - Hypertension, diabetic nephropathy, heart failure
Adverse effects - hypotension, fatigue
Interactions - Diuretics
Neprilysin inhibitors
Sacubitril (in combination with the ARB valsartan)
MoA - Inhibition of natriuretic peptide breakdown
Indication - Heart failure (with reduced ejection fraction)
Adverse effects - Hypokalaemia, hypoglycaemia
Beta blockers
Bisoprolol, atenolol (beta-1 selective), propranolol (Beta-1 and beta-2 selective)
MoA - Negative inotropic/chronotropic agent
Indication - Hypertension, stable angina
Adverse effects - bradycardia, bronchospasm
Interactions - NSAIDs, digoxin
Alpha blockers
Doxazosin
MoA - Vasodilator, decreases total peripheral resistance
Indication - Hypertension
Adverse effects - Dizziness, headache
Interactions - Hypotensive drugs
Calcium channel blockers
Amlodipine, nifedipine, diltiazem
MoA - Blockade of vascular smooth muscle contraction
Indication - Hypertension, stable angina
Adverse effects - ankle swelling, oedema
Interactions - Beta blockers, digoxin
Nitrates
Glyceryl trinitrate (GTN), Isosorbide mononitrate (ISMN)
MoA - Nitric oxide release, leading to smooth muscle relaxation and vasodilation
Indication - Acute angina pectoris (GTN), heart failure
Adverse effects - Hypotension, headache
Interactions - Antihypertensives
Sympathomimetics
Adrenaline, dobutamine, noradrenaline
MoA - Adrenergic stimulation, increased inotropy
Indications - Cardiac arrest, cardiogenic shock
Adverse effects - Arrhythmia
Antiplatelet drugs
Aspirin, clopidogrel
MoA - Inhibition of thromboxane synthesis (aspirin). Inhibition of platelet activation by ADP (clopidogrel).
Indications - Primary and secondary relief for CVD, anticoagulant prophylaxis
Adverse effects - GI irritation and bleeding
Interactions - Anticoagulants
Anticoagulants - coumarin
Warfarin
MoA - Inhibition of Vitamin K epoxide reductase complex (VKORC1) enzyme
Indication - DVT, prophylaxis of stroke from AF
Adverse effects - Abnormal bleeding
Interactions - multiple drug interactions, notably NSAIDs, diuretics
Anticoagulants - direct thrombin inhibitor
Dabigatran
MoA - Inhibitor of thrombin (also called Factor IIa)
Indication - Prophylaxis of venous thromboembolism post-surgery
Adverse effects - abnormal bleeding
Anticoagulants - direct Factor Xa inhibitors
Apixaban, edoxaban, rivaroxaban
MoA - Inhibition of Factor Xa in coagulation cascade
Indications - Prophylaxis of stroke from AF; DVT
Adverse effects - abnormal bleeding
Thrombolytics/fibrinolytics
Alteplase, streptokinase, urokinase
Indication - Activation of plasminogen for proteolytic breakdown of thrombus heparin
Indications - Myocardial infarction, ischaemic stroke
Anticoagulants - heparins
Dalteparin, tinzaparin, enoxaparin (low molecular weight); unfractionated heparins
Indication - Inactivation of thrombin and Factor Xa via complexing antithrombin III
Indication - Prophylaxis of venous thrombosis and pulmonary embolism
Adverse effects - abnormal bleeding
HMG-CoA reductase inhibitors
Simvastatin, atorvastatin
MoA - Inhibition of mavelonate pathway required for cholesterol synthesis
Indications - Hypercholesterolaemia, risk of CVD and stroke
Adverse effects - myalgia
Interactions - verapamil, macrolides
