SCR - Medications Flashcards
Mechanism of action of warfarin ?
Vitamin K antagonist - inhibits the synthesis of vitamin K depending clotting factors factor II, VII, IX, X, protein C and S.
Mechanism of action of apixaban ?
Direct clotting factor Xa inhibitor.
Why are patients put on anti-coagulant medication ?
Acute MI, AF, DVT, pulmonary embolism, mitral valve stenosis, replacement prosthetic heart valves.
What are the side effects of anti-coagulant medication ?
Increased clotting time and risk of haemorrhage.
Check INR - should be between 2-4.
Mechanism of action of aspirin ?
Antiplatelet, antipyretic and analgesic - COX-1 and COX-2 inhibitor blocking synthesis of thromboxane.
Mechanism of action of beta blockers ?
Blocks beta 1 and 2 receptors blocks adrenaline, slowing signals to the heart - used to reduce blood pressure, HR.
Examples - propranolol (non-selective), atenolol (selective).
What are the side effects of beta blockers ?
Lichenoid reactions, exacerbate asthma and heart failure.
Why do patients take beta blockers ?
Reduce blood pressure, heart rate, ventricular fibrillation following MI.
Mechanism of diuretics ?
Increase salt and water loss in the kidneys to reduce blood volume and cardiac workload.
Examples - Bendroflumethiazide, furosemide.
Why do patients take diuretics ?
Hypertension and heart failure.
What is the side effects of diuretics ?
Xerostomia and dehydration.
Mechanisms of action of lipid lowering drugs ?
HMGcoA reductase inhibitors which inhibit cholesterol synthesis in the liver.
Examples - simvastatin, atorvastatin.
Why do patients take lipid lowering drugs ?
High cholesterol.
Mechanism of action of an ACE inhibitor ?
Inhibit conversion of angiotensin 1 to 2 (which is a vasoconstrictor).
Triggers aldosterone which promotes salt and water loss and reduction in plasma volume, via renin-angiotensin system.
Example - ramipril, lisnopril.
What are the side effects of ACE inhibitors ?
Lichenoid reaction.
What are ACE inhibitors used to treat ?
Hypertension and heart failure.
Mechanism of action of calcium channel blockers ?
Acts on smooth muscle, blocking calcium channels (calcium channel antagonist) causing vasodilation and reduction in blood pressure and slows conduction.
Example - amlodipine and nifedipine - peripheral vessels, veramipril - central vessels.
What is the side effects of calcium channel blockers ?
Gingival overgrowth.
Mechanism of nitrates ?
Dilate veins reducing the preload of the heart and resistance of arteries - reduces workload of the heart and afterload and reduces oxygen needs of heart (reduces ischaemic pain).
Example - GTN spray.
Mechanism of action of proton pump inhibitors ?
Inhibits the release of acid via the proton pump irrespective of stimulation.
Example - omeprazole, lansoprazole.
Mechanism of action of anti-TNF alpha therapy ?
Blocks TNF-alpha inflammatory action - cytokine produced by monocytes during acute inflammation, so controls inflammatory process.
Example - infliximab.
Mechanism of action of salbutamol (beta-2 agonist) ?
Beta-2 agonist, binds to receptor causing bronchodilation.
Mechanism of action of montelukast ?
Prevents mast cell degranulation.
Mechanism of action of beclomethasone MDI ?
Reduces airway oedema, reduces mucous production and improves airway patency.
