Drugs For PVD Flashcards
1) What is Cliostazol?
2) What are the 3 effects of Cliostazol use?
1) Reversible inhibitor of PDE3 (so reduces breakdown of cAMP). It is an antiplatelet drug and a vasodilator.
2) inhibition of PDE3 causes:
Vasodilation (As inhibits cellular adenosine reuptake)
inhibition of platelet activation and aggregation
Prevention of release of prothrombotic inflammatory substances.
How is Cliostazol metabolised?
Hepatic metabolism by CYP450 enzymes.
1) List 4 adverse effects of Cliostazol and Cliostazol like drugs.
2) Give 2 drug interactions of Cliostazol.
1) Diarrhoea, headache, palpitations and tachycardia, Blood dyscrasias, Milrinone (similar drug) can increase mortality in people with heart failure.
2) Increased risk of bleeding when combined with Aspirin/ clopidogrel.
Dose should be reduced when used with other drugs that also inhibit CYP450 ( Clarithromycin/ Itraconazole/ Erythromycin/ Omeprazole).
Apart from Cliostazol, name another drug useful in the pharmacological treatment of PVD, and give a brief mechanism of action.
Naftidrofuryl oxalate - promotes production of high energy phosphates ATP in ischaemic tissue by activating the mitochondrial enzyme succinic dehydrogenase.
Overall causes arterial vasodilation and reduced platelet aggregation.
What is the surgical treatment that can be offered if quality of life is significantly impaired by claudication or tissue integrity is at risk?
When is this surgery particularly used?
Percutaneous transluminal angioplasty, often along with insertion of a stent. Alternatively, bypass surgery.
PTA usually used for stenoses above the inguinal ligament, otherwise bypass surgery used.
1) When does NICE recommend use of Naftidrofuryl Oxalate in PVD?
2) How long would you be advised to take this drug for?
1) For the treatment of leg pain triggered by exercise due to intermittent claudication.
2) 3-6 months to see if it improves symptoms. If treatment is not effective at thus time, it will be stopped.
Name the 4 overall classes of drugs which might be used in order to treat peripheral vascular disease.
1) Statins
2) Antihypertensives
3) Anti-platelets
4) Naftidrofuryl Oxalate
