SM 132a - CAD Pharmacology Flashcards

All pharmacology related to CAD, may contain info from other lectures

1
Q

Valsartan, Losartan, Irbesartan, and Candesartan are which type of drug?

A

Angiotensin receptors blockers (ARBs);

They block the effects of angiotensin II on the AT1 receptor

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2
Q

Give some examples of direct-acting thrombin inhibitors

A

Bivalirudin, lepirudin, argatroban, dabigatran

Dabigatran can be taken orally, usually used for outpatients

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3
Q

Which anticoagulants might be used for a patient with CAD?

A

Any of the following

  • Unfractionated heparin
  • LMWH
  • Fondaparinux
  • Direct-acting thrombin inhibitors
  • Warfarin
  • Factor Xa inhibitors
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4
Q

List some relevant aldosterone receptor antagonists

(aka Mineralcorticoid Receptor Antagonists, aka MRAs)

A

Spironolactone

Eplerenone

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5
Q

What kind of drugs end in -pril?

A

ACE inhibitors

Lisinopril

Ramipril

Perindopril

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6
Q

Which ARB is best for diabtics with renal dysfunction?

A

Losartan

Irbesartan

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7
Q

Which ARB is best for patients with heart failure?

A

Valsartan, candesartan

Note: Valsartan is used in patients with heart failure and LV systolic dysfunction after heart attack (MI);
Valasartan = Valentine = hearts

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8
Q

Abciximab, eptifibatide, and tirofiban belong to which drug class?

What is their mechanism of action?

A

Antiplatelet agent (intravenous)

Gp IIb/IIIa inhibitors

(use in patients undergoind angioplasty and stenting, and to stabilize patients with NSTEMI awaiting intervention)

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9
Q

Lisinopril, ramipril, and perindopril are examples of what kind of drug?

A

ACE inhibitors

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10
Q

In which patients are ARBs useful?

A
  • Heart failure (valasartan, candesartan)
  • LV systolic dysfunction post-MI (valasartan)
  • Renal dysfunction in diabetics (lorsartan, irbesartan)
  • Hypertension (all)
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11
Q

Clopidogrel, prasugrel, and ticagrelor belong to which drug class?

What is their mechanism of action?

A

Antiplatelet agent (oral)

ADP receptor blockers

(Use flowwign stenting of a coronary artery)

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12
Q

What is the mechanism of action of ACE inhibitors?

What are the effects?

A

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(
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13
Q

What kind of drugs end in -xaban?

A

Oral Factor Xa inhibitors

  • Rivaroxaban
  • Apixaban
  • Edoxaban
  • Betrixaban
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14
Q

Which direct-acting thrombin inhibitor would be prescribed for outpatients?

Why?

A

Dabigatran

It can be taken orally

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15
Q

Why are antithrombin drugs used in treating coronary artery disease?

A

The final common pathway of most coronary artery events involves activation of clotting pathways and platelets.

Thus, anticoagulants and anti-platelet agents are recommended

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16
Q

In which patients can ACE inhibitors be used?

A
  • Hypertension
  • Heart failure
  • Renal protection
  • Following MI (especially if LV systolic dysfunction_
  • CAD (chronic, stable)
17
Q

Give some examples of oral factor Xa inhibitors

A

-xaban

Rivaroxaban

Apixaban

Edoxaban

Betrixaban

18
Q

Which ARB is best for patients with hypertension?

A

All of the -sartans would work

19
Q

What kind of drugs end in -sartan?

A

Angiotensin Receptor Blockers (ARBs)

Valsartan

Losartan

Irbesartan

Candesartan

20
Q

What is the mechanism of action of angiotensin receptor blockers?

What are the effects?

A

Inhibit the binding fo angiotensin II to its AT1 receptor. This inhibits the actions of angiotension II on vasculature, kidney, and heart

  • Inhibit vasoconstriction
  • Prevent cell growth (prevent remodeling)
  • Inhibit Na+/H2O Retention
  • Inhibit sympathetic activation
21
Q

Give an example of a direct renin inhibitor

A

Aliskiren

22
Q

What are the effects fo aldosterone receptor antagonists?

A

Decrease blood pressure

Inhibit Na+ retention (K+ sparing)

Decrease myocardial fibrosis

23
Q

Which patients would benefit from valsartan?

A

Valsartan is used in patients with heart failure and LV systolic dysfunction after heart attack (MI)

(Valasartan = Valentine = hearts)