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Year 1-Cardiovascular System > Drugs Used in Treatment of the CVS > Flashcards

Drugs Used in Treatment of the CVS Flashcards

1
Q

Name two types of Ischaemic heart disease.

A

Angina
MI (myocardial infarction)

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2
Q

Give two examples of cerebrovascular disease.

A

Transient ischaemic attack
Thrombotic stroke

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3
Q

Give an example of an arrhythmia.

A

Atrial fibrillation

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4
Q

What is atheroclerosis?

A

Narrowing of arteries making it difficult for blood to flow through them

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5
Q

What can cause atheroclerosis?

A

Smoking and high wall stress can cause vessel damage and therefore can result in atherosclerosis.
High BP

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6
Q

Discuss the cell’s healing process in terms of atheroclerosis.

A

Activation of platelets
Releases inflammatory cells
Inflammatory cells incorporate w cholesterol and form a fibrous cap

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7
Q

Give some examples of anti-platelet drugs.

A

Aspirin
Clopidogrel/ Ticagrelor

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8
Q

What does aspirin inhibit the production of?

A

Thromboxane A2

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9
Q

What do Clopidogrel/ Ticagrelor inibit?

A

Block a specific ADP receptor on the surface on the platelet

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10
Q

When are antiplatelets used if referring to primary prevention?

A

Before cardiovascular disease is diagnosed.

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11
Q

When are antiplatelets used if referring to secondary prevention?

A

After CV disease diagnosis.

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12
Q

When may a person be started on anti-platelet drugs for primary prevention?

A

If they are at high risk- diabetes etc

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13
Q

Which drug with you give alongside clopidogrel/ Ticagrelor?

A

Aspirin

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14
Q

Who and when would you give aspirin?

A

-Patients w stable angina
-Patients w previous CABG (coronary artery bypass graft).
-For two weeks after a patient has had a stroke or TIA (Transient ischemic attack)

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15
Q

When would you give a patient clopidogrel?

A

TIA/Stroke patients after the initial acute phase of treatment
Combination with Aspirin- following Percutaneous Intervention in stable patient

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16
Q

When would you give a patient ticagrelor?

A

In combination with Aspirin in all patient with ACS for upto 1 year in NHSG

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17
Q

What is the main side effect of antiplatelets?

A

Bleeding

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18
Q

Which conditions can beta blockers reduce mortality rates in?

A

IHD and Heart failure

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19
Q

Which conditions can beta blockers reduce symptoms in?

A

Angina, atrial fibrillation and SVT (Supraventricular tachycardia)

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20
Q

List some examples of beta blockers.

A

Bisoprolol
Carvediol
Atenolol
Metoprolol
Propranolol

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21
Q

How do beta blockers work?

A

Via beta receptors

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22
Q

Where would you find beta 1 receptors?

A

Predominant receptor in the Heart- SA, AV Nodes and myocardial cells.

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23
Q

Where would you find beta 2 receptors?

A

Smooth muscle eg Airways, Peripheral vasculature
Skeletal muscle cells

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24
Q

What do Beta 1 receptors in the kidneys do?

A

Reduce secretion of renin

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25
Q

What are the positive effects beta 1 receptor blockers?

A

Slows heart rate and conduction
Increases Diastolic Time
Reduces BP
]Protects heart from effects of Catecholamines (stress hromones)

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26
Q

What are the negative effects of beta 1 receptor blockers?

A

Reduces contractility
High doses can lead to bradycardia and heart block

27
Q

What are the positive effects of beta 2 receptor blockers?

A

Reduces tremor

28
Q

What are the negative effects of beta 2 receptor blockers?

A

Potentially lethal bronchospasm in asthmatics
Can cause vasoconstriction

29
Q

Give examples of beta blockers which are mediated by beta 1 receptors.

A

Atenolol
Bisoprolol
Carvediol
Metoprolol

ABC (idk if this helps)

30
Q

Give an example of a beta blocker which is mediated by both beta 1 and 2 receptors.

A

Propanolol

31
Q

What is the purpose of the Renin- Angiotensin- aldosterone axis?

A

Preserves circulating volume to maintain perfusion of the vital organs

32
Q

Renin- Angiotensin- aldosterone axis is central to the development of what?

A

Heart failure
Liver failure
Kidney failure

33
Q

Where is angiotensin produced?

A

Liver

34
Q

What happens to angiotensin?

A

Converted to Angiotensin 1 by Renin

35
Q

What converts angiotensin I into angiotensin II?

A

ACE- an Endothelial enzyme found predominantly in the lungs

36
Q

What does angiotensin II do?

A

Acts on the adrenals leading to the release of aldosterone

37
Q

Which two classifications of drug block the hormone system of Renin- Angiotensin- aldosterone?

A

Angiotensin converting enzyme inhibitors and angiotensin receptor antagonists (ARBS)

38
Q

ARBS are the first line antihypertensive treatments for which individuals?

A

Under 55 white or Asian patients

39
Q

What can ARBS do?

A

Reduction in mortality and progression of disease in IHD, CVD and renal disease with proteinuria
Prevent aberrant remodelling following MI
Reduction in symptoms in heart failure

40
Q

What is the mechanism of angiotensin II?

A

Potent vasoconstrictor

41
Q

What can aldosterone help to do?

A

Retention of Na (and therefore H20) at the expense of K in the DCT of the kidneys

42
Q

Give some examples of ACE inhibititors.

A

Ramipril
Lisinopril
Captopril
Perindopril

43
Q

What are the positive effects of ACE inhibitors?

A

Reduce blood pressure
Reduce afterload on heart
Prevents aberrant remodelling after MI
Reduces proteinuria

44
Q

What are the negative effects of ACE inhibitors?

A

Reduces perfusion pressure in glomerulus leading to renal impairment

45
Q

Give some examples of ARBS.

A

Losartan
Candersartan

46
Q

What are the positive effects of ARBS?

A

Reduce blood pressure
Reduce afterload on heart
Prevents aberrant remodelling after MI
Reduces proteinuria

47
Q

What are the negative effects of ARBS?

A

Reduces perfusion pressure in glomerulus leading to renal impairment

48
Q

Give two examples of aldosterone agonists.

A

Spironolactone and eplenerone

49
Q

What do Spironolactone and eplenerone do?

A

Enhanced diuretic effect, vasodilation
Reduces mortality in IHD and Heart failure

50
Q

What are some of the side effects of aldosterone agonists like spironolactone and eplenerone?

A

Renal impairment, hyponatraemia, hyper kalaemia
Gynaecomastia

51
Q

What is Entresto?

A

Combination of Valsartan and Sacubitil

Company name

52
Q

What does sacubitil do>

A

Inhibits breakdown natriuretic peptides eg. ANP and BNP

53
Q

What can entresto not be presecribed alongside?

A

ACE inhibitors

Increased risk of angioedema

54
Q

What can sacubitil do?

A

Increase diuresis, natriuresis and vasodilation

55
Q

Calcium channel blocker are used as what?

A

Antihypertensive agent

56
Q

Which conditions can calcium channel blockers reduce symptoms of?

A

Angina- both dihydropyridine and non dihydropyridine
AF/SVT- Non dihydropyridine only

57
Q

Name the two subdivions of calcium channel blockers.

A

Dihydropyridine
Non-Dihydropyridine

58
Q

What does Dihydropyridine do?

A

Block calcium entry into smooth muscle
Cause vasodilation
Less effect in pacemaking tissue

59
Q

What are the side effects of dihydopyridine?

A

Postural hypotension, peripheral oedema, tachycardia

60
Q

What does non-Dihydropyridine do?

A

Block calcium entry to smooth muscle
Blocks calcium entry in the myocardial pacemaking tissue
Slow SA node function
Slow AV conduction

61
Q

What are some of the side effects of non-dihydopyridine?

A

Bradycardia, heart block (particularly if prescribed with beta blocker), postural hypotension, peripheral oedema

62
Q

Give some examples of types of dihydopyridine

A

Amlodipine, felodipine, nifedipine

63
Q

Give some examples of types of non-dihydopyridine

A

Verapamil and Diltiazem

Year 1-Cardiovascular System (41 decks)

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