drugs for cardiovascular disease Flashcards
common conditions which require drug therapy
hypertension
arrhymia
ischaemic heart disease
heart failure
end organ damage for hypertension
brain (stroke)
heart (left ventricular hypertrophy- leads to ventricular failure)
kidney (renal failure)
eyes (hypertensive retinopathy)
risk factors for cerebrovascular atherosclerosis
hypertension smoking diabetes hyperlipidaemia obesity
non drug related treatment of hypertension
weight reduction
reduced fat/salt/alcohol
exercise
smoking cessatio
what do thiazide diuretics do and side effects
inhibit reabsorption of NaCl in the proximal/distal nephron tubules e.g. bendroflumethiazide electrolyte distrubance rash postural hypotension
LOWER BP
ACE inhibitors and side effects
inhibit conversion of angiotensin I to II side effects hypotension rash renal dailure hyperkalaemia
beta blockers
block cardiac beta 1 receptors in heart
reduce HP,bP and CO
contra indiacations of beta blockers
asthma
uncontrolled HF
Bradycardia
calcium channel antagonists
vasodilators (reduce systemic vascular tone, relax arteries)
e.g. amlodipine, verapamil
alphablockers
vasodilators
e.g. hydrazine, methyldopa
what can atherosclerosis lead to and presentations
stenosis and arterial thrombosis
un/stable angina
MI
HF
sudden death
anti anginal drugs
1) beta blockers
2) nitrates
3) calcium channel blocker
4) potassium channel activators
beta blockers for anigna
Lower myocardial oxygen demand by reduced HR, BP ad myocardial contractibility
i.e. less work so less O2 required
nitrates
Symptomatic relief of angina
- produces nitric oxide at endothelial surface leading to vascular smooth muscle relaxation, arteriolar and venous dilation
- reduce myocardial oxygen demand (lower preload and after load) and increase myocardial o2 supply (coronary vasodilation)
calcium antagonists
Lower myocardial oxygen demand
- reduce BP
- reduce myocardial contractility
- increase myocardial oxygen supply by dilating coronary arteries
potassium channel activators
dilate artieral/vein walls
what can atherothrombosis lead to
MI
stroke
CV death
limb ischaemia
examples of antiplatlet drugs
asprin
clopidogrel
prasugrel
ticagrelor
how does aspirin work
anti platter drug
blocks platelet cyclooxgenase (COX1) and production of thromboxane A2
what does P2Y12 do and what stops i
amplification pathway in platelets
ticagrelor
clopidogrel/prasugrel
statins
cholesterol lowering medication
- HMG CoA reductase inhibitor
heart failure
heart cannot maintain adequate CO or can do so but elevated filling pressure
drug treatments. for heart failure
diuretics
ACE inhibitors
beta blockers
aldosterone antagonists
types of tachycardia
atrial fibrillation /atrial flutter
supraventricular tachycardia
ventricular tachycardia
digoxin
blocks sodium potassium ATPase channel
intracellular levels altered
slows conduction across AV node
