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Pharmacology 201 > Framingham and Drug Discovery > Flashcards

Framingham and Drug Discovery Flashcards

1
Q

What is the #1 killer of humans world wide?

A

cardiovascular disease

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2
Q

What is the #1 killer of killer in Canadians?

A

cancer

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3
Q

In the past, what was the number one killer of humans in Canada?

A

cardiovascular disease

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4
Q

Before the early the 20th century, what was the most common cause of death?

A

Infections

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5
Q

Who invented antibiotics?

A

Alex Flemming

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6
Q

Before antibiotics how did they cure the bubonic plague?

A

By boiling water, using aseptic techniques, and pest control (rats).

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7
Q

Why was there less death after the second world war?

A

Due to the increase in nuclear weapons

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8
Q

Who was Franklin D Rosevelt?

A

He was a former US president. He passed away from a long battle with cardiovascular disease.

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9
Q

What did Franklin D Rosevelt do while in power?

A
  • brought unemployment rates down
  • major public projects
  • won the Pacific War
  • leap in technology
  • Manhattan nuclear bomb project
  • Allies vs Nazi Germany
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10
Q

What is the Framingham Heart Study?

A

Designed by the US government, the Framingham Heart Study was used to determine where cardiovascular diseases come from.

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11
Q

When did the Framingham Heart Study start?

A

1948

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12
Q

Where did this study take place?

A

Framingham Massachusetts.

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13
Q

Why did they chose Framingham for this study?

A

It was mostly a homogenous white, middle class community.

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14
Q

What are the 4 Framingham discoveries?

A

Cigarette Smoking, Hypertension, Cholesterol, and Diabetes all lead to increased risk for CVD.

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15
Q

Why was cigarette smoking seen as beneficial in the past?

A

Smoking induces coughing, which would allow one to get the mucus out of the longs.

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16
Q

What are the side effects of smoking and CVD?

A
  • Cigarette smoke increases your chances at a myocardial infarction by 3 in middle age men.
  • if you are older between the ages of 40-49, your risk increases to 6 times.
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17
Q

Can this be reversed?

A

Smoking cessation can lessen the risk of heart disease.

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18
Q

What is the second Framingham discovery?

A

Hypertension

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19
Q

What are some of the symptoms of Hypertension?

A

Usually hypertension is a silent killer, but at other times some symptoms like dizziness, troubled vision and nose bleeds can persist.

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20
Q

How does hypertension increase the risk of heart disease?

A

The heart starts to build up (fat) plaque deposits in small microtears, which harden the arteries. As a result, the heart has to work harder to pump blood since the arteries are constricted.

21
Q

Those with Hypertension are seen to have blood pressures of….?

A

> 140/90mmHg.

22
Q

What is Essential Hypertension?

A

More than 80% of Hypertension cases are due to an unknown cause

23
Q

What is Secondary Hypertension?

A

Hypertension is due to a secondary medical condition.

24
Q

What are the severe symptoms of hypertension? KIHS

A

Kidney Damage
Increased mortality
Heart Failure
Stroke

25
Q

What is the third Framingham discovery?

A

High levels of LDL cholesterol can lead to CVD.

26
Q

What is LDL cholesterol?

A

This is the type of cholesterol that leads to CVD. It is a low density lipoprotein that send cholesterol to the tissues, and the excess is sent back to the liver with HDL.

27
Q

Is cholesterol soluble?

A

Cholesterol is a lipid and not soluble in water. It needs lipoproteins to make it soluble.

28
Q

So what does LDL do to the body that causes CVD?

A

As it is sent from the liver to remote tissues, it can get stuck in tissues. It then builds up as plaque and can obstruct blood flow to the heart.

29
Q

What is done to open up the arteries when they are blocked?

A

Stents are like balloons that re-open the arteries in the heart to allow for increased blood flow. This is a popular procedure and an individual who gets one, can resume their daily life after 24 hours.

30
Q

Why is HDL considered “good” cholesterol?

A

HDL takes stuff from the arteries back to the liver and does not get stuck along the way. Higher levels of HDL decrease your risk at CVD.

31
Q

In the clinic how do they predict the chances of CVD?

A

By calculating your LDL/HDL ratio or total cholesterol/HDL.

32
Q

What is the fourth Framingham discovery?

A

High glucose aka Diabetes, (usually type 2) can also cause CVD.

33
Q

Glucose

A

Glucose is bad for the vessels so it should be compartmentalized in the muscle (for energy) or in the liver for storage. High glucose affects all organs like the liver/eyes and kidney.

34
Q

What is a glucose tolerance test?

A

It checks how well insulin is working, by taking a blood test every 15 minutes.

35
Q

Why are women protected from CVD with diabetes?

A

This is unknown.

36
Q

You are diabetic if you have more than…..

A

7 millimolar/L

37
Q

Why is the Framingham Study noted as the ‘Risk Factor”?

A

It shows that there is great population variability that affects the incidence of cardiovascular disease.

38
Q

How to decrease risk of CVD from smoking?

A

Cessation of smoking by using alternatives such as Nicoderm or Nicorette gum. Additionally the use of the drug Chantix (Nicotine Receptor Blocker) has a similar structure to Nicotine.

39
Q

How to decrease risk of CVD if you have Hypertension?

A

Decrease the amount of Sodium in your diet, and exercise. Also you can take hypertensive meds.

40
Q

What are the bad hypersensitive meds that are not used anymore?

A

Hexamethonium (not a very specific drug)

Hydralazine (too many negative side effects)

41
Q

What are the best hypertensives? ABCD

A

Diuretics are the best and most cost efficient drug for hypertension.

  • ACE inhibitors, Angiotensin Receptor Blockers, and alpha receptor blockers.
  • Beta Blockers
  • Calcium Channel Blockers
42
Q

Can BP decrease naturally during the year?

A

Yes, during the summer months BP tends to decrease.

43
Q

Can High Cholesterol be prevented?

A

Your body can make its own cholesterol and it can be reabsorbed in the intestine. You can attain it from food. Cholesterol is very hard to maintain or change.

44
Q

What drug is used to decrease High Cholesterol?

A

Statins like Lovastatin are HMG CoA reductase inhibitors, and can decrease the risk by 37%.

45
Q

How does Lovastatin work?

A

It works by slowing down the production of Cholesterol in the body to decrease the amount that may build up.

46
Q

How do drugs that decrease glucose levels decrease CVD?

A

Type 1 Diabetes: Happens due to the low amount of insulin in the body due to damage in pancreas where insulin is made. Supplements are given to provide more insulin.
Type 2 Diabetes: Individuals who make sufficient insulin but cannot use it due to resistance. Supplements like Metformin help by providing extra insulin. Insulin is needed to use the sugars from foods to provide energy.

47
Q

What are the net effects discovered by the Framingham Heart Study?

A

CVD can be reduced with lifestyle change and medication.

48
Q

What is the Framingham Risk Calculator?

A

Based on the risk parameters (smoking, cholesterol, hypertension, diabetes) you can see your 10 year risk of CVD.

Pharmacology 201 (20 decks)

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