Drugs - Anti-anginal + Anti-thrombotics | Flashcards
Anti-anginal drugs - 3 classes
Vasodilators
Slow heart rate
Metabolic modulator
3 types of anti-anginal vasodilators
Nitrates
Nicorandil
Calcium antagonists - dyhydropyridines
Anti-anginal’s that Slow heart rate - 3
Beta blockers
Rate limiting calcium antagonists
Ivrabradine
Metabolic modulator anti-anginals - 1
Ranolazine
Nitrates - examples + function
GTN tablets or spray - glyceryl trinitrate
Vasodilator that mainly reduces systolic BP
Isosorbide mononitrate/dinitrate,
Widen and relax blood vessels allowing more blood to get to the heart
Nitrates - uses
Angina
Acute heart failure
Nitrates - side effects
Headaches
Hypotension
Collapse
Can become tolerant
Nicorandil - function
Potassium ATP channel opener
Vasodilator
Nicorandil - side effects
GI + mouth ulcers
Headaches
Dihydropyridine calcium antagonist - examples
Amlodipine
Rate limiting calcium antagonists - examples
Diltiazem
Verapamil
Ivrabradine
Anti-anginal
Affects funny current channel at SA node
Slows sinus rhythm
Increases chance of AF
Ranolazine
Late sodium channel modulator
Decreases calcium load on heart
Effective in refractory angina
Anti-thrombotic drugs - 3
Anti-platelets
Anticoagulants
Fibrinolytic drugs
Anti-platelets - examples
Aspirin
Clopidogrel
Prasugrel
Ticagrelor
Anti-platelets - function + uses
Prevent new thrombosis
Angina
Acute MI
Strokes
Aspirin
Thins blood
Stops mild inflammation and pain
NSAID
Clopidogrel
Prevents platelets sticking together
Anti-platelets - side effects
Haemorrhage
Peptide ulcer
Asthma caused by aspirin sensitivity
Anticoagulants - examples + administration - 4
Heparin - IV
Warfarin - oral
Rivaroxaban
Dabigatran
Anticoagulants - function and use
Prevent new thrombosis by blocking clotting factors
Used in :
DVT
PE
NSTEMI
AF
Which clotting factors do heparin and warfarin block
2, 7, 9, 10
Which clotting factors do Rivaroxaban and Dabigatran block
Rivaroxaban - factor 10a
Dabigatran - factor 2a
Factor 10a normally converts prothrombin 2 to thrombin 2a
Anticoagulants - side effects + how to reverse
Haemorrhage anywhere
Vitamin K forms clotting factors so reverses effect
Fibrinolytic drugs - examples
Streptokinase
Tissue plasminogen activator (tPA)
Fibrinolytic drugs - function
Dissolves formed clot
Fibrinolytic drugs - use
Used in:
STEMI
Select cases of PE and CVA
Also in strokes
Used more in poor countries
Fibrinolytic drugs - side effects + avoid in…
Haemorrhage - serious risk
Avoid in:
Recent haemorrhage
Trauma
Bleeding tendencies
Severe diabetic retinopathy
Peptic ulcer
