How common drugs work Flashcards
Name 3 conditions that ACE-i are used to treat?
Hypertension
Heart Failure
Kidney diseases
ACE-i block the conversion of angiotensin I to angiotensin II which is a potent ______
vasoconstictor
ACE-i causes vasodilation which reduces ______ ______
peripheral resistance
ACE-i reduce peripheral resistance which means there is less resistance for the heart to pump blood against, so reduces the ____ _______
blood pressure
As well as lowering levels of angiotensin II, ACE-i also decrease the secretion of ______
aldosterone
Where is aldosterone made?
Zona glomerulosa of adrenal gland
Aldosterone promotes ____ and ____ retention
sodium and water
ACE-i decrease secretion of aldosterone which means less sodium and water is retained leading to decreased blood _____ and _____
volume
pressure
ACE-i and ARBs have also been shown to have beneficial effects on teh heart preventing adverse c______ r__________ where the structure and function of heart changes in response conditions like heart failure or hypertension
cardiac remodelling
Name some common ACE-inhibitors
Ramipril
Lisinopril
Enalapril
Perindopril
What does ARBs stand for?
Angiotensin II Receptor Blockers
What are ARBs commonly used to treat?
Hypertension
Heart failure
Kidney diseases
ARBs work by blocking the action of angiotensin II at its _____ on blood vessels and other tissues
receptors
ARBs block the angiotensin II receptors, blocking its action, leading to v_____
vasodilation
Vasodilation due to ARBs leads to decrease in _______ _____ so there is less resistance for heart to pump against
peripheral resistance
ARBs also reduce the secretion of _____
aldosterone
What are the results of ARBs reducing the secretion of aldosterone?
Less sodium and water retention so blood volume decreases and blood pressure is lowered
Name some common ARBs
Candesartan
Losartan
Irbesartan
Valsartan
What are CCBs commonly used to treat?
Hypertension
Angina
Certain heart arrhythmias
CCBs primarily work by blocking calcium channels in the cells of the ____ and ____ _____
heart and blood vessels
What are the calcium channels in the heart and blood vessels responsible for?
Allowing calcium ions in for muscle contraction
By blocking calcium channels in smooth muscle cells of blood vessels, CCBs cause…
smooth muscle cells to relax leading to vasodilation
Vasodilation caused by CCBs reduces peripheral resistance, making it easier for the heart to pump blood and ultimately resulting in…
decreased blood pressure
How do CCBs affect heart muscle itself?
Reduced influx of calcium ions leads to decreased force of cardiac contraction.
The decreased force of cardiac contraction from CCBs helps to decrease workload on the heart and reduces ______ demand
oxygen (beneficial in angina)
Non-dihydropyridine CCBs also decrease the ____ ____ by inhibiting activity of the SA node. This is helpful in certain heart rhythm disorders where slower heart rate is desired
heart rate
Name some common CCBs
Amlodipine
Felodipine
Nifedipine
Diltiazem
Verapamil
What conditions are thiazide diuretics used to treat?
Hypertension
Heart failure
Oedema
Thiazide diuretics block the ______-______ s______ i the renal tubules
sodium-chloride symporter (NCC)
Thiazide diuretics prevent the reabsorption of _____ ions by blocking the NCC in the distal convoluted tubules
sodium
Thiazides block sodium reabsorption in the DCTs, promoting excretion of ____ and ____ in the urine
sodium and water
Thiazides increase sodium and water excretion which therefore decreases the ____ _____ and ______
blood volume and pressure
Thiazide diuretics can cause mild _______ which contributes to reduced blood pressure (mechanism not fully understood)
vasodilation
Thiazides decrease blood volume and promote vasodilation, helping to reduce _____ _____ decreasing the load on the heart
peripheral resistance
Name some thiazides
Bendroflumethiazide
Hydrochlorothiazide
Chlortalidone (thiazide-like-diuretic)
What are beta-blockers used to treat?
Hypertension
Angina
Heart failure
Certain heart rhythm disorders
Beta-blockers block effects of a____ and other similar hormones on b__-_____ receptors in the body
adrenaline
beta-adrenergic
Beta-adrenergic receptors are found in various tissues including the _____, ____ _____ and ____
heart, blood vessels and kidneys
Beta-blockers block beta-adrenergic receptors in the heart , the effect of adrenaline is reduced leading to a decrease in ____ ____
heart rate (useful in hypertension, angina and certain heart arrhythmias)
Beta-blockers also reduce the force of contraction of the heart which decreases _____ of heart and reduces _____ demand
workload
oxygen
(beneficial in angina and heart failure)
Beta-blockers can help lower blood pressure by reducing ____ ____ and decreasing the activity of the ___ which regulates heart rate and blood pressure
cardiac output
SNS
How can beta-blockers help stabilise heart rhythm and prevent arrhthymias?
By slowing electrical conduction in the heart and reducing automaticity of cardiac cells (ability to spontaneously generate electrical impulse)
Name some common beta-blockers
Atenolol (selective)
Bisoprolol (selective)
Metoprolol
Propranolol (non-selective)
Carvedilol (non-selective)
When are beta-blockers contraindicated?
Asthma (as beta-blockers can cause bronchoconstriction)
Heart block
Bradycardia
Alpha blockers are also known as alpha-adrenergic a_____
antagonists
What conditions are alpha blockers used to treat?
Hypertension
BPH
Certain circulatory disorders
Alpha blockers work by blocking adrenaline and noradrenaline at alpha-adrenergic receptors found on ____ _____ cells in blood vessels and other tissues
smooth muscle cells
Alpha-blockers causes relaxation of muscles leading to _____ which reduces peripheral resistance.
vasodilation
How are alpha blockers useful for BPH?
Relax smooth muscle in prostate gland and bladder neck to improve urinary flow
How may alpha blockers help manage circulatory disorders like Raynaud’s disease and peripheral vascular disease?
Promoting vasodilation and improving blood flow to affected areas
Name some common alpha-blockers
Doxazosin
Prazosin
Terazosin
What conditions are loop diuretics used to treat?
Heart failure
Kidney disease
Oedema
Loop diuretics work primarily by inhibiting which transporter in the thick ascending limb of the loop of Henle?
Sodium-Potassium-Chloride co-transporter (NKCC2)
What does the NKCC2 normally do?
Reabsorbs sodium, potassium and chloride ions from the urine back into the bloodstream
Loop diuretics inhibit the NKCC2 transporter so prevent the reabsorption of sodium, potassium and chloride ions leading to increased excretion of these ions and ____
water
Loop diuretics result in a significant increase in _____ ____ and reduction in ____ ______
urine volume
blood volume
True or false: loop diuretics are considered the most potent diuretics available
True
Capable of producing rapid and substantial increase in urine output
Loop diuretics increase urine output and reduce blood volume so can help reduce _____ in tissues and lower blood pressure
oedema
Loop diuretics can can cause h______, h______ and h______ due to increased excretion
hypokalaemia
hyponatraemia
hypomagnesemia
Electrolyte levels should be monitored regularly and supplementation may be required
Name some common loop diuretics
Furosemide
Bumetanide
Torasemide
What conditions are potassium-sparing diuretics used to treat?
Hypertension and heart failure
Potassium-sparing diuretics block ___ channels in the ___ and _____ ____ of the kidneys
sodium
DCT and collecting ducts
Potassium-sparing diuretics blocking sodium channels prevents reabsorption of sodium back into the blood so less ____ is reabsorbed leading to ______ urine production
water
increased
Potassium-sparing diuretics do not promote significant _____ secretion in the urine by blocking the exchange of ____ for _____ in the kidney tubules
potassium
sodium for potassium
When is it particularly useful to use a potassium-sparing diuretic?
Those at risk of potassium depletion:
Heart failure
Liver disease
Other meds that cause potassium loss
Some potassium-sparing diuretics are also _____ antagonists so can further reduce sodium reabsorption and potassium loss as well as exert beneficial effects on the heart and blood vessels
aldosterone
Name some common potassium-sparing diuretics
Spironolactone
Amiloride
Eplerenone
What conditions are statins prescribed to manage?
Primarily used to lower cholesterol levels in the blood
Lowers risk of cardiovascular events like heart attacks and strokes
Statins work by inhibiting what enzyme?
HMG-CoA reductase (3-hydroxy-3-methylglutaryl-coenzyme A reductase)
Plays key role in liver’s production of cholesterol
Statin inhibits HMG-CoA reductase thereby reducing the liver’s production of cholesterol and lower levels of ___ cholesterol in the bloodstream
LDL (low-density lipoprotein)
How do cells in the liver respond to the decrease in cholesterol synthesis due to statins?
Increase the expression of LDL receptors on their surface which help remove LDL cholesterol from the bloodstream and facilitating uptake into liver cells
So statins enhance clearance of LDL cholesterol from the blood
True or false: statins lower HDL cholesterol whilst moderately increasing LDL cholesterol
False
Statins lower LDL cholesterol whilst moderately increasing HDL cholesterol
Statins may have anti-_____ and antioxidant effects too helping stabilise atherosclerotic plaques reducing the risk of cardiovascular events
inflammatory
Name some common statins
Atorvastatin
Simvastatin
Rosuvastatin
Pravastatin