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Eye Disease > Systemic Drugs- cardiovascular > Flashcards

Systemic Drugs- cardiovascular Flashcards

1
Q

What is the major cause of death?

A

Heart and cardiovascular disorders

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2
Q

What does prophylactic mean?

A

Intended to prevent disease

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3
Q

What are modifiable risk factors of cardiovascular disease?

A
  • Better diet (reduce salt intake, limit alcohol consumption, 5 fruit and veg a day, reduce intake of saturated fat)
  • Stop smoking
  • More exercise (maintain healthy bmi, aerobic exercise)
  • Lipid modification
  • Hypertension treatment
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4
Q

Which diseases are hypertension a major risk factor for?

A

Stroke, myocardial infarction, heart failure, chronic kidney disease, premature death

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5
Q

How is hypertension diagnosed?

A

If clinic BP is 140/90 mmHg or higher , then it needs to be repeated at home and an average is taken using a HBPM or ABPM

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6
Q

Describe the three stages of hypertension classification

A

stage 1: clinic bp is 140/90 mmHg or higher AND ABPM or HBPM average is 135/85 or higher
stage 2: clinic bp is 160/100 mmHg or higher AND ABPM or HBPM average is 150/95 or higher
severe hypertension: clinic bp is 180 mmHg or higher or clinic diastolic BP is 110 mmHg or higher

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7
Q

How is hypertension treated?

A

Using a stepped approach, using low doses of several drugs to minimise adverse events and maximise compliance
- Aim is to reduce systolic to 140 and diastolic to 90

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8
Q

Why is hypertension treated?

A

Reduces cerebrovascular disease and reduces MI (myocardial infarction)

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9
Q

If you are under 55 years old what first line treatment is given to the px?

A

ACE inhibitor

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10
Q

If you are over 55 years old or black px which two treatments could you be give to treat hypertension?

A

Calicum-channel blocker or thiazide-type diruetic

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11
Q

At what point would you start combining drugs and why would you not just increase the dose of that drug instead of combining?

A

If a single drug is not effective.
Increases the likelihood of adverse side effects, combining lower doses is better

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12
Q

Give four examples of ACE inhibitors

A
  • Captopril
  • Enalapril
  • Lisinopril
  • Ramipril
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13
Q

What are some side effects of ACE inhibitors?

A
  • Cough
  • Taste disturbance
  • Angiodema
  • First-dose hypotension
  • Hyperkalaemia
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14
Q

What is the downside of a ACE inhbitor?

A

Expensive

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15
Q

What is the role of ACE?

A

Its role is to break down angiotensin I into angiotensin II (this causes increased BP)

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16
Q

What is an alternative way instead of using an ACE inhibitor to prevent angiotensin being formed?

A

Competitively inhibit the receptor which angiotensin II is binding to

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17
Q

Why would an angiotensin II receptor antagonist be used instead of an ACE inhibitor?

A

It has fewer side effects

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18
Q

Give three examples of an angiotensin II receptor antagonist

A

Losartan, Candesartan, Valsartan
- Tan

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19
Q

What does CCBs stand for?

A

Calcium channel blockers

20
Q

How do CCBs work?

A

Inhibit inward movement of calcium ions through slow L-type calcium channels in active membranes e.g cells of myocardium, cells with His-purkinje system and cells of vascular smooth muscle
- this effects cardiac contractility and causes vasodilation

21
Q

Give four examples of CCBs

A

1) Nifedipine
2) Amlodipine
3) Verapamil
4) Diltiazem

22
Q

What do diuretics do?

A

Enhance excretion of salt and get rid of water by increasing urine production + salt composition
; act in different areas of the nephron

23
Q

Name the main three classes of diuretics

A
  • Thiazide
  • Loop diuretic
  • Potassium sparing
24
Q

What is a risk of taking thiazide and why is this the case ?

A

Can lead to a potassium deficiency because it inhibits the absorption of sodium in the DCT (distal convoluted tubule)
*side note; its secondary role is reduces BP by vasodilation and reduction in blood volume

25
Q

Name three thiazides examples

A

Bendrofluazide
Hydrochlorthiazide
Indapamide

26
Q

What do loop diuretics do?

A

Inhibit absorption of sodium and potassium in the TAL of loop of henle

27
Q

When are loop diuretics used?

A

Renal and heart failure

28
Q

Give two examples of loop diuretics

A

Furosemide and Bumetanide

29
Q

When is potassium sparing used?

A

Used in conjunction with thiazide and loop diuretics

30
Q

Give two examples of potassium sparing?

A

Amiloride and Spironolactone

31
Q

How does increasing salt excretion lower blood pressure?

A

Generates increased amounts of urine which reduces blood volume which lowers BP

32
Q

Before CCBs, ACE inhibitors and diuretics, what was used to lower BP?

A

Beta-blockers

33
Q

Give two example of beta-blockers used to lower BP?

A

Atenolol and metoprolol

34
Q

How do beta blockers reduce BP?

A

Mechanism is unknown but we predict it involves:
1. Reduction in heart rate
2. Reduction in peripheral resistance
3. Inhibition of renin release

35
Q

What five less commonly used anti-hypertensive drugs which lower BP and how do they do this?

A

Doxazosin- alpha-adrenoceptor antagonist
Methyldopa and Moxonidine- centrally acting agents
Hydralazone and minoxidil- vasodilators

36
Q

What is angina?

A

Insufficient oxygen being supplied to the cardiac muscle due to the narrowing of coronary arteries

37
Q

What are two ways angina is treated?

A

By a stent or by using a vasodilator

38
Q

If a px has a clot in their heart, what condition will they get?

A

Myocardial infarction (heart attack)

39
Q

After having an heart attack which drugs may these patients be on?

A

Immediately- analgesia, thromboylsis, asprin
Prophylaxis- ACE inhibitors, aspirin, lipid lowering therapy

40
Q

What is the treatment of heart failure?

A

Diuretics, ACE inhibitors, nitrates, bet-blockers, Ionotropic drugs

41
Q

What do lipoproteins do ?
and name the two types?

A

Transport cholesterol around the body
LDL; Low density lipoprotein (bad)–> associated with athroema formation
HDL; high density lipoprotein (good)

42
Q

What is lipid modification ?

A

A cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease

43
Q

What drug is most commonly used to reduce cholesterol?

A

Statins; Simavastatin, atrovastatin, pravastatin

43
Q

What drug is most commonly used to reduce cholesterol + give examples?

A

Statins; Simavastatin, atrovastatin, pravastatin

44
Q

How do statins work?

A

Inhibit enzyme (HMG- CoA) increasing uptake of LDL from the blooD

Eye Disease (48 decks)

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