Pharmacology Flashcards
1
Q
ACE inhibitors
Used for, MOA, SE
A
- Dilation of vessels and reduced aldosterone secretion for hypertension, HF and post MI
- Inhibits ACE and stops conversion of angiotensin I to II
- SE include a dry cough and urticaria, hyperkalaemia (red skin rash), alcohol compounds hypotensive effects
- ACE found in endothelial cells of lungs
*Good prognostic affect for chronic heart failure - Reversed by NSAIDS
E.g. Ramapril, lisinopril
2
Q
Satins
Used for, MOA, SE
A
- Used to lower LDL cholesterol levels (angina and high BP)
- Inhibits HMG coA reductase enzyme in liver cells, cells can’t make cholesterol, making more LDL receptors and so more LDL pulled from blood circulation
- SE include: pain in muscles (rhabdomyolysis/myalgia), GI disturbance,
E.g. simvastatin, atorvastatin
- Give ezetimibe if can’t tolerate statin
3
Q
Anti platelet drugs
Used for, examples
A
- Secondary prevention, angina, peripheral vascular disease
- Aspirin, clopidogrel, prasugrel, ticagrelor, cangrelor, dipyridamole
4
Q
Aspirin
Used for, MOA, CI SE
A
- Anti platelet drug
- Inhibits cox 1 enzyme, preventing thromboxane A2 availability to activate platelets
- Secondary prevention for those at risk
- SE include: GI irritation, hypersensitivity reactions (rashes and asthma), Reyes syndrome in children (vomiting, brain damage), increased bleeding time
5
Q
Clopidogrel, prasugrel, ticagrelor, cangrelor + ticlopidine(order of potency)
Used for, MOA, CI, SE
A
- Inhibitor of ADP reducing platelet activation
- Mediating GPII/IIIa, reducing aggregation by blocking GPII/IIIa receptor on platelets plasma membrane, inhibiting fibrinogen binding
- Secondary prevention, when the patient is intolerant of aspirin, stop before operation
- SE include: GI irritation and bleeding, dyspepsia (indigestion), hypersensitivity reactions (skin and liver), dyspnoea (adenosine kept in lungs)
6
Q
Dipyridamole
Used for, MOA, CI, SE
A
- Anti platelet drug directly inhibiting thromboxane
- Phosphodiesterase inhibitor, preventing adenosine uptake, leading to dilation and reduced platelet activation
- Prevents thromboembolism in patients with prosthetic valve, given with
aspirin for secondary prevention such as stroke - SE include: GI irritation and bleeding, dizziness, flushing, headache, myalgia, chest pain and hypersensitivity reactions
7
Q
Anticoagulant drugs
Used for, examples
A
Prevents blood liquid turning to gel (clotting)
Warfarin, heparin,
8
Q
Warfarin
Used for, MOA, CI, SE
A
- Anti coagulant drug (allows blood to flow easier) - Preventing DVT, pulmonary embolism, atrial fibrillation
- Inhibits enzyme vitamin K epoxide reductase (reducing vitamin K for clotting factors 1972)
- Avoided during pregnancy as its a teratogen (can cross placenta)
- SE include: Haemorrhage, unexplained fall in Hb, GI upset, skin and tissue necrosis, alopecia, liver toxicity
9
Q
Heparin
Used for, MOA, CI, SE
A
- Anti coagulant drug - Prevention of DVT and pul ovary embolism,
- Activates antithrombin 3, inhibiting thrombin and factor 10 so less fibrin created for net
- SE include: Haemorrhage, rarely osteoporosis, hypersensitivity reactions, thrombocytopenia, reduced aldosterone secretion,/ hypokalaemia
- Large so can’t be absorbed across the placenta or into GI tract - Cant be given orally
10
Q
Nitrates
Used for, examples
A
Anti anginal medication
GTN spray, patches, isosorbide mono and dinitrate
11
Q
Nitrates
Used for, MOA, SE
A
- Angina medication
- Bind to receptor on smooth muscle, stimulating guanalate cyclase, increasing cGMP, decreasing calcium levels, casing vasodilation
- Headache, flushing, hypotension with syncope, tachycardia (all vasodilators), methaemoglobinaemia (rare)
12
Q
Isosorbide dinitrate, mononitrate and nitrate patches
A
- Isosorbide nitrates (long acting) - Good gut absorption but mono nitrate has better bioavailability
- Patches (less favourable) - Absorption depends on skin contact (sweating)
- Care when defibrillator is used as nitrates are highly explosive
- GTN spray (acute angina) - Under the tongue, bypassing the systemic system (buccal absorption giving a rapid effect)
13
Q
CCB’s
Used for, examples
A
- Calcium channel blockers prevent vasoconstriction and cause vasodilation by blocking L type calcium channels - Slow down heart (verapamil and diltiazem)
- Dihydropyridines - amlodipine, felodipine, lercanidipine, nifedipine… diltiazem, verapamil
14
Q
CCB’s Dihydropyridines
Used for, MOA, CoI, SE
A
- Non rate limiting CCB (used for hypertension and angina)
- Binds to and blocks depolarised L type ca channel, less ca for calmodulin, reaction - relaxing smooth muscle
- Aortic stenosis, LVOT (hypertrophic cardio myopathy), severe MI depression
- SE include: Headache, flushing, low BP, peripheral oedema
- Often causes tachycardia so give a beta blocker as well
E.g. Amlodipine, felodipine, lercanidipine, nifedipine
15
Q
Diltiazem and verapamil
Used for, MOA, CoI, SE
A
- Rate limiting CCB (used for angina, hypertension and dysrhythmias)
- Bind to and block hyper polarised L type ca channels, less ca, less ca-troponin, relaxing smooth muscle and cardiac muscle
- Diarrhoea, exacerbation of HF and heart block/stopping conduction between the atria and the ventricles (sick sinus syndrome), steal effect/worsening angina (verapamil)
