drugs affecting vasculature and blood Flashcards

1
Q

nitrates use

A

angina

acute coronary syndrome

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2
Q

nitrates main effect

A

venorelaxation but arterial dilation at higher doses

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3
Q

nitrates mechanism

A

formation of NO, which inc intracellular cGMP, which activates PKG causing relaxation

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4
Q

nitrates AE

A
headache
hypotension 
fainting 
reflex tachycardia 
tolerance
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5
Q

nitrates - control side effect of reflex tachycardia

A

prescribe with beta blockers

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6
Q

antagonists of endothelia

A

bosentan and ambrisentan

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7
Q

what are endothelia antagonists used in

A

pulmonary hypertension

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8
Q

renin inhibitor

A

aliskiren

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9
Q

ACE inhibitor

A

lisinoPRIL

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10
Q

what do ACE inhibitors block

A

conversion of AGT1 to AGT2

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11
Q

ARB

A

loSARTAN

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12
Q

ACE effect

A

cause venous dilation - dec preload

and cause arteriolar dilation - dec afterload

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13
Q

ACE - what can happen on first dose

A

steep fall in BP

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14
Q

ACE - specific AE

A

dry cough - inc in bradykinin

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15
Q

ACE - AE

A

renal failure
angioedema
hyperkalaemia

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16
Q

ARB effect

A

similar to ACE but don’t cause dry cough

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17
Q

ACE and ARB contraindicated in

A

pregnancy - where hypertension is common

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18
Q

clinical use of ACE and ARB

A

hypertension

heart failure following MI

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19
Q

Ca channel blocker action

A

inhibit L type Ca channels in SM causing relaxation and vasodilation by blocking entry of Ca into cell

in the myocardium they also produce a negative inotropic effect b reducing calcium influx in phase 2 of the actin potential

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20
Q

dihydropiridines

A

amlodipine

21
Q

amlodipine AE

A

ankle oedema and headache

22
Q

amlodipine affinity

A

vascular muscle

23
Q

rate limiting

A

verapamil and diltiazem

24
Q

verapamil selectivity

A

cardiac L type channels

25
Q

verapamil effect

A

slows conduction of the AV node

negative inotropic effect

26
Q

what shouldnt one use Ca blockers with

A

beta blockers

27
Q

clinical uses of calcium channel blockers

A

hypertension
arrhythmias
angina

28
Q

what must you avoid using verapamil in

A

heart failure

29
Q

adverse effects of calcium channel blockers

A

AV block
tachycardia
verapamil - constipation
excessive vasodilation - hypotension, dizzy, flashing, ankle oedema

30
Q

K channel openers

A

minoxidil and nicorandil

31
Q

minoxidil use

A

severe hypertension - last resort

32
Q

minoxidil AE

A
reflex tachycardia (B blocker prevents) and salt and water retention 
inc hair growth
33
Q

nicorandil use

A

angina resistant to other treatments

34
Q

K channel openers AE

A

mouth gut ulcers

35
Q

A1-Adrenoceptor Receptor Antagonists

A

prazosin and doxazosin

36
Q

a1 ADR A use

A

hypertension

benign prostatic hyperplasia

37
Q

a1 ADR A AE

A

postural hypotension

38
Q

diuretics effect

A

inc excretion Na, CL and H2O

39
Q

thiazides act on

A

distal tubule - inhibit NaCl reabsorption

40
Q

which produce a stronger diuresis

A

loop agents

41
Q

diuretics cause an undesirable loss of what

A

K

leads to hypokalaemia - tired, stimulus for cardiac arrhythmias, metabolic alkalosis

42
Q

diuretics AE

A

hyperglycaemia - diabetes
impotence
inc uric acid - gout

43
Q

loop diuretics can cause what

A

hyponatraemia

44
Q

what are thiazides used in

A

mild heart failure and hypertension

45
Q

what are loop diuretics used in

A

acute pulmonary oedema, peripheral oedema and chronic heart failure
good in LVF

46
Q

K sparing diuretics

A

spironolactone

47
Q

spironolactone clinical use

A

severe chronic heart failure
resistant hypertension
ascites due to cirrhosis

48
Q

spironolactone AE

A

hyperekalaemia, gynaecomastia and renal dysfunction

49
Q

spironolactone suitable alternative

A

amiloride