Pharmacology

Question 1

ACE Inhibitors

Example

Actions, Exercise

Answer 1

Angiotensin Converting Enzyme Inhibitors

Ramipril

1) Prevent the conversion of Angio I to Angio II - which increases vasodilation and reduces BP, reduced afterload and myocardial work
2) Reduced BP, dry irritating cough so cannot do continuous exercise, Increased exercise capacity

Question 2

ARB’s

Example

Actions, Exercise

Answer 2

Angiotensin Receptor Blockers

Losartan

1) Inhibit the angio II receptors from binding therefore causing vasodilation, reduced afterload and myocardial work, reduces aldosterone production
2) Reduced BP, increased exercise capacity and dry cough

Question 3

Beta-Blockers

Example

Actions, Exercise

Answer 3

Propranolol

1) Bind to beta-adrenergic receptors and inhibit catecholamines therefore reducing HR and BP and inflammation, reducing afterload, negative inotropic and chronotropic effects
2) Reduced BP, postural hypotension

Question 4

Ivabradine

Actions, Exercise

Answer 4

1) Acts directly on the SA node and reduces haemodynamic stress, improves angina, less side effects than beta blockers
2) Reduced HR and increases in ETT

Question 5

Calcium Channel Blockers

Example

Actions, Exercise

Answer 5

Verapamil

1) Prevents calcium from entering the SMC’s therefore reducing BP, reduced afterload, negative ino and chronotropic effects, vasodilation
2) Reduced BP, HR can reduce

Question 6

Diuretics

Example

Actions, Exercise

Answer 6

Furosemide

1) Increases urine excretion from the kidneys, reducing plasma volume therefore reducing BP, removes salt and water from the body, reduced myocardial work and reduced preload and afterload
2) Must be close to a toilet, achy legs, dehydration common

Question 7

Nitrates

Actions, Exercise

Answer 7

1) Imitate NO - improves vasodilation, reduce superoxide radicals and oxLDL, reduce platelet stickiness

Reduced preload and afterload and increase perfusion, long-acting and short-acting (GTN Spray)

2) Postural hypotension, reduced BP after GTN so have to wait for 5 mins to go back to normal

Question 8

Warfarin

Actions, Exercise

Answer 8

1) Interferes with the coagulation cascade, reduces chance of blood clots, blood thinning, extreme drug and medicine, not used alongside aspirin, but can take ibuprofen with it
2) Equipment safety and accidents nullified, fatal bleeding can occur and always check for bruising

Question 9

Ticagrelor

Actions, Exercise

Answer 9

1) Inhibits platelet aggregation and thrombus formation, therefore thinning the blood and reducing blood clot chances - so blood clots are smaller and less likely to occur, take alongside aspirin
2) Fatal bleeding, Dyspnoea, SOB