Drugs to treat Cardiovascular Disease Flashcards
Medication for angina
Anti-anginals, relieve pain + prevent angina attacks
- Nitrates
- Beta Blockers
- Calcium Channel Blockers
Medication for Hypertension
High BP may need treatment with 1 or more drugs
- Vasoldilators
- Diuretics
- Angiotensin converting enzyme (ACE) inhibitors
Medication for Congestive Heart Failure
Treated with medications that increase myocardial contractions. Blood vessels may also need to be narrowed.
- ACE inhibitors
- Diuretics
- Cardiotonics
- Vasoconstrictors
Medication for Rhythm Disorders
Normalise HR by affect the nervous system that controls HR.
- Beta Blockers
- Calcium Channel Blockers
How is hypertension treated with thiazide diuretics?
Inhibits Na+ and Cl- transporters in DCT of kidney ∴ increasing Na+ and Cl- excretion.
PUT SIMPLY
- INHIBITS SODIUM REABSORPTION + INCREASES NA= EXCRETION + URINE VOLUME
What bad side effects do thiazide diuretics cause which requires monitoring?
- inc. K+/Mg2+ excretion
- decr. Ca2+ excretion
What type of patients would thiazide diuretic use be less effective in?
Patients with renal impairments
How is hypertension treated with beta blockers?
- Block beta adrenoceptors in the body.
- Stimulate beta receptors in the heart ∴ inc. force of contraction.
- Stimulate BR in the kidney ∴ inc. renin release
OVERALL EFFECT: - inc. cardiac output, vascular resistance and Na+ & H2O retention
How can we characterise a beta blocker just by looking at the drug name?
always end with ‘-ol’
How is hypertension treated with ACE inhibitors?
- competitively inhibit the formation of angiotensin II from angiotensin I ∴ stops formation of ACE.
- angiotensin II v good at vein CONSTRICTION (not what we want).
- Promotes aldosterone release
How is hypertension treated with angiotensin II antagonists?
Block AGT II receptors to mediate vasoconstriction and hormone aldosterone (kidney function) release.
Renal function must be monitored.
What are angiotensin II antagonists contraindicated in?
Patients with renal impairment
How is hypertension treated with calcium channel blockers?
Decreases Ca2+ influx into the heart + heart conduction system ∴
decreases heart contractility ∴
decreases electrical impulses in heart ∴
promotes vasodilation
All drugs metabolised by liver.
How do we decide the choice of therapy for hypertension?
See flow chart in word doc.
1.
<55 yrs = first line ACE inhibitor or AGTII blocker
>55 yrs OR black African/caribbean of any age = calcium channel blocker
2.
for both ages/all races = ACE inhibitor or AGTII blocker or calcium channel blocker
3.
for both ages/all races = ACE inhibitor or AGTII blocker or calcium channel blocker OR thiazide-like diuretic
4.
still no luck, consider expert advice
What groups do we give special considerations to when treating hypertension?
- Pregnant Women
- Ethnic Groups
- Elderly (renal function)
- Diabetes
- Renal disease
