other CVS drugs Flashcards
what can you use ACE inhibitors for apart from hypertension?
how?
what to use in a person who cant tolerate ACEi?
heart failue e.g. perindopril
ACEi decrease BP, this reduces after load of heart, less fluid = lower blood volume, reduced preload of heart, all of this reduces work load of the heart
AT1 inhibitors e.g.losartan
what are diuretics used for?
how?
hypertension and heart failure e.g. furosemide - loop diuretics
reduces blood volume and pulmonary and perioharl oedema
what are dihydropyridine Ca2+ channel blockers used for?
vascular smooth muscle - dialiate - reduce workload by reducing after load
angina, hypertension
what ate positive inotropes used for?
examples?
increase contractility and cardiac output
glycosides
Beta agonists
what are cardiac glycosides?
why arent they used much?
what plant are they from?
what is their function?
how do they effect heart rate?
what is their other use?
used to treat heart failure
they dont solve the long term problem
foxglove
block Na+/K+ ATPase - rise intra Na = NCX is less active = Ca2+ build up in cell = moer in SER = inc force of contraction
act on vagus nervre and inc its activity - slows HR
arrhythmia e.g. AF
what do B agonists do?
uses?
stimulate B1 receptors in heart at SA node and myocytes = inc HR and force of contraction
cardiogenic shock
acute reversible heart failure
what to use for heart failure?
ACEi, AT1i, diuretics - reduce workload
not glycosides
what do ntrites treat?
how?
what is GTN?
angina
NO is released in vascular smooth muscle and causes dilation - espesh in veins
quick short acting spray, can get other forms like tablets which are lobger lasting (isosorbide dinitrite)
how does NO cause vasodilation?
- NO activates guanylate cyclase
- this inc cGMP
- activates PKG
- lowers intracellular Ca2+
- relaxation of vascular smooth muscle
why does organic nitrates act on veins more?
less endogenous NO in veins
little effect on arterioles
what is the primary action of organic nitrites?
secondary?
venodilation = heart fills less = reduced force of contraction (starlings law)= reduced work load = lowers O2 demand
collateral coronary arteries dilate = more O2 suppply to ischaemic myocardium
what to change when treating angina? examples of drugs
- reduce workload- organis nitrites, Beta blockers, Ca2+ antagonists
- improve blood supply- Ca2+ antagonists, organic nitrates
what heart conditions can increase thrombosis ?
AF - stasis = clot
actute MI
prosthetic heart valves
antithrombotic drugs
anticoagulants?
antiplatelets?
prevent venous thrombus - heparin, warfarin, thrombin inhibitors - for DVT and AF
prevents arterial platelet thrombi - aspirin, clopidogrel - following or at risk of MI
