SM 132a - CAD Pharmacology Flashcards
All pharmacology related to CAD, may contain info from other lectures
Valsartan, Losartan, Irbesartan, and Candesartan are which type of drug?
Angiotensin receptors blockers (ARBs);
They block the effects of angiotensin II on the AT1 receptor
Give some examples of direct-acting thrombin inhibitors
Bivalirudin, lepirudin, argatroban, dabigatran
Dabigatran can be taken orally, usually used for outpatients
Which anticoagulants might be used for a patient with CAD?
Any of the following
- Unfractionated heparin
- LMWH
- Fondaparinux
- Direct-acting thrombin inhibitors
- Warfarin
- Factor Xa inhibitors
List some relevant aldosterone receptor antagonists
(aka Mineralcorticoid Receptor Antagonists, aka MRAs)
Spironolactone
Eplerenone
What kind of drugs end in -pril?
ACE inhibitors
Lisinopril
Ramipril
Perindopril
Which ARB is best for diabtics with renal dysfunction?
Losartan
Irbesartan
Which ARB is best for patients with heart failure?
Valsartan, candesartan
Note: Valsartan is used in patients with heart failure and LV systolic dysfunction after heart attack (MI);
Valasartan = Valentine = hearts
Abciximab, eptifibatide, and tirofiban belong to which drug class?
What is their mechanism of action?
Antiplatelet agent (intravenous)
Gp IIb/IIIa inhibitors
(use in patients undergoind angioplasty and stenting, and to stabilize patients with NSTEMI awaiting intervention)
Lisinopril, ramipril, and perindopril are examples of what kind of drug?
ACE inhibitors
In which patients are ARBs useful?
- Heart failure (valasartan, candesartan)
- LV systolic dysfunction post-MI (valasartan)
- Renal dysfunction in diabetics (lorsartan, irbesartan)
- Hypertension (all)
Clopidogrel, prasugrel, and ticagrelor belong to which drug class?
What is their mechanism of action?
Antiplatelet agent (oral)
ADP receptor blockers
(Use flowwign stenting of a coronary artery)
What is the mechanism of action of ACE inhibitors?
What are the effects?
Inhibit Angiotensin Converting Enzyme (ACE)
- Decreased production of Angiotensin II
- Prevent LV hypertrophy, fibrosis, remodeling
- Decreased retention of Na+, H2O
- Increased bradykinin (decreased degradation)
- Vasodilation
- Decreased platelet aggregation
- Decreased ischemia
- Cough (side effect(
- Vasodilation
What kind of drugs end in -xaban?
Oral Factor Xa inhibitors
- Rivaroxaban
- Apixaban
- Edoxaban
- Betrixaban
Which direct-acting thrombin inhibitor would be prescribed for outpatients?
Why?
Dabigatran
It can be taken orally
Why are antithrombin drugs used in treating coronary artery disease?
The final common pathway of most coronary artery events involves activation of clotting pathways and platelets.
Thus, anticoagulants and anti-platelet agents are recommended