Summary of cardiovascular drugs Flashcards
What are examples of anti-hypertensive drugs? (3)
- Thiazide Diuretics
- Beta Blockers
- Vasodilators – calcium Antagonists, Alpha Blockers, ACE Inhibitors (ACEI), Angiotensin Receptor Blockers (ARB)
What are examples of anti-anginal drugs? (6)
- Beta Blockers
- Calcium Antagonists
- Nitrates
- Nicorandil
- Ivabradine
- Ranolazine
What are examples of anti-thrombotic drugs? (3)
- Anti-platelet drugs (aspirin, clopidogrel, prasugrel, ticagrelor)
- Anticoagulants (Warfarin, Rivaroxaban, Dabigatran)
- Fibrinolytics (streptokinase, tPA)
What are examples of anti-cholesterol drugs? (2)
- Statins
* Fibrates
What are examples of anti-arhythmic drugs? (1)
Digoxin
What do anticoagulants do? Fibinolytics?
- Anticoagulants - attack clotting factors
* Fibinolytics - dissolve clots
What do diuretics do?
- Block Na+ reabsorption in the kidneys (so pass more Na+ and water in urine)
What are thiazide diuretics used for? Are they mild or strong? Example?
- Hypertension
* Mild e.g. Bendrofluazide
What are loop diuretics used for? Are they mild or strong? Example?
- Heart failure
* Strong e.g. Furosemide
What are side effects of diuretics?
- Hypokalaemia ( causes tiredness + arrythmias)
- Hyperglycaemia (causes diabetes)
- Increase in uric acid (causes gout)
- Impotence (inability to sustain an erection)
What are cardioselective B-blockers? Example? What are they used to treat? (3)
- Only block B1 receptors
- e.g. Atenolol
- Angina, hypertension and heart failure
What are non-selective B-blockers? Example? What are they used to treat?
- Block B1 and B2 receptors
- e.g. propranolol
- Used in thyrotoxicosis (overactive thyroid)
What are side effects of beta-blockers? (4)
- B2 blockers prevent bronchodilation, worsening asthma (NEVER used in established asthma)
- Tired
- Heart failure*** (NOTE)
- Cold peripheries
*** Beta blockers good in medium/long term heart failure but can worsen heart failure in short term
What are 2 types of calcium antagonists?
- Dihydropyridines
* Rate limiting calcium antagonists
What is an example of a dihydropyridine? What are they used to treat? What is the side effect of dihydropyridines?
- Amlodipine
- Used in hypertension and angina NOT in heart failure!!
- Side effect: anke oedema (its a cosmetic side effect - not serious)
What are examples of Rate limiting calcium antagonists? (2)
What are they used to treat? (3)
What should they NOT be used in combination with?
- Verapamil, Diltiazem
- Used to treat hypertension, angina and supra ventricular arrhythmias (AF, SVT)
- AVOID use with beta-blockers
Why should Rate limiting calcium antagonists NOT be used with B-blockers?
They cause increased AV nodal delay and so do b-blockers so together will increase delay too much
What do alpha blockers do?
What are they used to treat? Example? Side effects?
- Block alpha adrenoceptors to cause vasodilatation
- Used to treat hypertension and prostatic hypertrophy
- e.g. Doxazosin
- Postural hypotension
What to angiotensin converting enzyme inhibitors do? Example? Used to treat?
How do they affect the kidneys?
- Block angiotensin I becoming angiotensin II
- e.g. Lisinopril
- Hypertension and heart failure
- Quite confusing cause they are good for kidneys in diabetic nephropathy but bad in renal artery stenosis
What are side effects of ACE-Inhibitors?
- Dry cough
- renal dysfunction
- Angioneurotic oedema
Why must kidney function be measured when treated with ACE-inhibitor? What is angioneurmtic oedema? When should ACEIs NEVER be used?
- ACEIs can result in renal dysfunction
- Angioneurmtic oedema - life-threatening side effect, skin gets blotchy and swollen - larynx can also swell blocking the airway
- NEVER use in pregnancy-induced hypertension as can damage foetus
What do angiotensin receptor blockers do? Example? What are they used to treat? Effect on kidneys?
- Block Angiotensin II Receptors
- e.g. Losartan
- Hypertension and heart failure
- Same as ACEIs - good for kidneys in diabetic nephropathy but bad in renal artery stenosis
How can you tell a drug is an ACE-I? ARB?
- ACEI - will end in -opril
* ARB - will end in -sartan
What are side effects of ARBs? Why are they preferred instead of ACE-Is sometimes? When are they NEVER used?
- Side effects: renal dysfunction (no cough tho so sometimes preferred instead of ACE inhibitors)
- NEVER use in pregnancy induced hypertension
What are nitrates? Example? Used to treat? (2)
- venodilators
- e.g. Isosorbide mononitrate
- Angina, acute heart failure
What are side effects of nitrates? (2)
What is a drawback of nitrates?
- Headache
- Hypotension/Collapse
- Tolerance is common so must leave 8hrs nitrate-free
What do anti-platelet agents do? Examples? (4)
Used to treat? (4)
- All prevent new thrombosis
- e.g. Aspirin, Clopidogrel, Ticagrelor, Prasugrel
- Treat angina, acute MI, CVA/TIA, patients at risk of CVA and MI
What are side effects of anti platelet agents?
- Haemorrhage anywhere
- Peptic ulcer predisposes to haemorrhage
- Those with asthma may be sensitive to aspirin
What do anticoagulants do? Examples? (2)
Used to treat?
- Prevent new thrombosis by blocking clotting factors 2, 7, 9 and 10
- e.g. heparin (IV) and Warfarin (oral)
- Treat DVT, PE, NSTEMI and atrial fibrillation
What are side effects of anticoagulants like Warfarin? What must be done as a result?
- Haemorrhage anywhere
* Must monitor Warfarin level in the blood (control dose carefully by INR = International Normalised Ratio)
