Pharmacology of CV Disease Flashcards

1
Q

What can hypertension cause?

A

End organ damage

Brain - strokes, heart failure, renal failure, hypertensive retniopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How tx hypertension?

A
  1. Non-pharmacologically - lifestyle (less fat, salt, alcohol, smoking cessation)
  2. Antihypertensives (CAB TA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name 5 anti-hypertensives?

A

Ca channel blocker, ACE inhibition, beta blockers, thiazide, ARBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain use of thiazide diuretics in hypertension

A

Inhibit reabsorption of NaCl in proximal/ early distal tubule
Cheap and used first line
E.g bendroflumethiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain use of ACE inhibitors in hypertension

A

Inhibit conversion angiotensin I –> AG2
Side effect: prevent bradykinin breakdown = dry cough
e.g Ramapril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain renin-angiotensin pathway - what does the end product cause?

A

Angiotensinogen –> angiotensin I (renin)
Angiotensin I –> Angiotensin II (ACE)
Angiotensin II –> Receptors (A2R)
Aldoesterone production -reabsorb H20/ Na = raise BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain use of ARBs in hypertension?

A

Angiotensin II receptor antagonist - similar to ACE but doesn’t involve bradykinin - no dry cough
e.g Losartan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain use of Ca Channel blockers in hypertension?

A

Cause vasodilation by decreasing systemic vascular tone

- dipine e.g amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do atherosclerotic plaque form?

A
  1. Defect in blood vessel lining
  2. Fatty streak form - lipid accumulation in foamy macrophage in tunica intima
  3. Fibrolipid plaque formed as collagen deposited = fibrous cap that bulge into lumen
  4. Cause lymphocyte accumulation
  5. If cap become unstable - plaque can be exposed to blood = thrombosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does atherosclerosis progress to thrombosis?

A

Virchow triad: stasis, hyper coagulability, endothelium injury

  1. Fatty steak enlarge = atherosclerosis
  2. Increase turbulence due to protrusion - loss endothelium and collagen exposure
  3. Platelet activation and adherence of fibrin meshwork to trap RBC
  4. Further increase turbulence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a thrombosis made from?

A

Layer platelet, fibrin and entrapped RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drugs can be used for angina?

A

NPCB

Nitrates, potassium channel activator, ca channel blockers, beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Use of beta blockers in angina?

A

Lower myocardial O2 demand by decreasing HR and contractibility
Can’t be withdrawn suddenly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Use of nitrates in angina?

A

Oral or sublingual - quicker access to systemic circulation
Nitric oxide produced on endothelial surface = smooth muscle relaxation and arterial and venous dilation
Decrease myocardial demand
Some problem with tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Use of potassium channel blockers in angina?

A

Cause arterial and venous dilation

Second line therapy - mucocutaneous ulceration but no prob with tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are anti-platelet drugs and give some examples?

A

Inhibit platelet aggregation and arterial thrombosis formation
Aspirin, clopidogrel, oral anti-platelet

17
Q

How does aspirin work?

A

Anti-platelet that blocks cycle-oxygenase - inhibit production thromboxane (activates platelets)

18
Q

How does clopidogrel work?

A

ADP receptor (P2Y12) inhibitor

19
Q

How do oral- antiplatlets work?

A

P2Y12 inhibitor and aspirin = amplification

20
Q

How do statins work?

A

HMG CoA reductase inhibitor - inhibit enzyme in liver used for cholesterol synthesis

21
Q

What drugs are used to tx heart failure?

A

DAAB - diuretic, ACE inhib, aldosterone antag, beta blockers

22
Q

What role do diuretics have in heart failure?

A

Eliminate Na/H20 - decrease acute symptoms caused by fluid retention
e.g thiazide, loop, potassium sparing

23
Q

How do aldosterone antagonise work in heart failure?

A

Competitive antagonist for aldosterone receptor

24
Q

What is used for tx of tachycardia?

A

Digoxin, oral anti-arrhythmics

25
Q

How does digoxin work and for what?

A

AF - block Na+/K+ ATPase - increase ca = increase vagal tone - slow conduction