Systemic Drugs- cardiovascular Flashcards
What is the major cause of death?
Heart and cardiovascular disorders
What does prophylactic mean?
Intended to prevent disease
What are modifiable risk factors of cardiovascular disease?
- 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
Which diseases are hypertension a major risk factor for?
Stroke, myocardial infarction, heart failure, chronic kidney disease, premature death
How is hypertension diagnosed?
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
Describe the three stages of hypertension classification
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
How is hypertension treated?
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
Why is hypertension treated?
Reduces cerebrovascular disease and reduces MI (myocardial infarction)
If you are under 55 years old what first line treatment is given to the px?
ACE inhibitor
If you are over 55 years old or black px which two treatments could you be give to treat hypertension?
Calicum-channel blocker or thiazide-type diruetic
At what point would you start combining drugs and why would you not just increase the dose of that drug instead of combining?
If a single drug is not effective.
Increases the likelihood of adverse side effects, combining lower doses is better
Give four examples of ACE inhibitors
- Captopril
- Enalapril
- Lisinopril
- Ramipril
What are some side effects of ACE inhibitors?
- Cough
- Taste disturbance
- Angiodema
- First-dose hypotension
- Hyperkalaemia
What is the downside of a ACE inhbitor?
Expensive
What is the role of ACE?
Its role is to break down angiotensin I into angiotensin II (this causes increased BP)
What is an alternative way instead of using an ACE inhibitor to prevent angiotensin being formed?
Competitively inhibit the receptor which angiotensin II is binding to
Why would an angiotensin II receptor antagonist be used instead of an ACE inhibitor?
It has fewer side effects
Give three examples of an angiotensin II receptor antagonist
Losartan, Candesartan, Valsartan
- Tan
What does CCBs stand for?
Calcium channel blockers
How do CCBs work?
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
Give four examples of CCBs
1) Nifedipine
2) Amlodipine
3) Verapamil
4) Diltiazem
What do diuretics do?
Enhance excretion of salt and get rid of water by increasing urine production + salt composition
; act in different areas of the nephron
Name the main three classes of diuretics
- Thiazide
- Loop diuretic
- Potassium sparing
What is a risk of taking thiazide and why is this the case ?
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
