PBL 5 - PHARMACOLOGY - drugs used in CHD Flashcards
what is it when ischaemia of cardiac tissue from CAD is temporary?
angina
what does thrombus formation on an atherosclerotic plaque lead to?
permanently occludes the artery —> heart attack
what is coronary artery disease?
the process by which coronary arteries become clogged by atherosclerotic plaques
what is coronary heart disease?
the consequences of coronary artery disease
angina vs. heart attack
- angina = heart temporarily deprived of oxygen — not immediately fatal — heart attack in waiting
- heart attack = heart deprived of oxygen — muscle death —much more serious
why are people with angina or heart attack open to the development of dysrhythmias?
heart muscle becomes ischaemic and so it can’t maintain its resting membrane potential so easily
when do dysrhythmais occur?
when you get inappropriate firing of APs in the heart so you get disturbance of rhythm
how do dysrhythmias lead to pumping inefficiencies? the same pumping inefficiencies can also occur due to what?
they disturb the electrical rhythm of the heart but also the mechanical rhythm
the same pumping inefficiencies can also occur because of muscle death that you see inMI
when does HF come about?
when the heart can’t pump enough blood around to supply the body
what is primary vs secondary prevention of CHD?
- primary = stopping it happening
- secondary = stopping it recurring or worsening (after angina, HA, stroke)
what is the link between exercise and heart disease?
people with an active lifestyle have a lower BP, are less likely to be obsese — had a much lower risk of CHD (independent of their physiology)
describe lipoproteins role and structure
- transport lipids in plasma
- cholesterol and triglycerides in core
- phospholipid monolayer on outside — fatty acid tails facing the hydrophobic core
- apolipoproteins — can be recognised by receptors in tissue
how do we classify lipoproteins?
via DENSITY
- HDL
- LDL
- VLDL
- chylomicrons (have the lowest density of them all)
- there are also intermediates between LDL and VLDL
where is cholesterol synthesised?
hepatocyte = liver cell (major drug target)
cholesterol is used by the liver to make what?
bile acids
what happens to bile acids in the liver?
- secreted into the GI tract and act as a detergent, emulsifies dietary cholesterol and fats, and enables it to be taken up
- bile acids are recycled back to the liver
what happens to the dietary fats emulsified by bile acids?
dietary fats are taken up from the GI tract into chylomicrons
what do chylomicrons do?
transport fats to the tissue
what happens to the chylomicron remnant?
taken up by the liver where it delivers cholesterol
after the chylomicron remnant delivers cholesterol, what 2 kinds of lipoprotein does the liver produce?
- VLDL
- HDL