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Cardiovascular System > Cardiovascular drugs > Flashcards

Cardiovascular drugs Flashcards

1
Q

ACE inhibitors examples

A

ramipril, lisinopril

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2
Q

Main indications for ACE inhibitors

A

Hypertension- first line, heart failure, secondary prevention after MI

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3
Q

What do ACE inhibitors do

A

ACE inhibitors competitively inhibit angiotensin converting enzyme (ACE) and thus reduce the generation of angiotensin II and also consequently aldosterone. reduces sodium and water retention and leads to arterial and venous dilation

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4
Q

contraindications and cautions of ACE inhibitors

A

afro-caribbeans dont respond well- CCBs first line instead
May lower blood glucose in diabetes
Contraindicated in pregnancy
Be careful in combination with other drugs that can increase potassium eg thiazide like diuretics and potassium sparing diuretics

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5
Q

Adverse effects of ACE inhibitors

A

persistent dry cough, renal dysfunction, angioedema

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6
Q

Amiodarone main indications

A

arrhythmias particularly when other drugs are ineffective or contraindicated

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7
Q

Mechanism of action of amiodarone

A

Anti arrhythmic and anti adrenergic. blocks potassium channels so lengthens refractory period, blocks sodium, blocks alpha and beta receptors, weak calcium blocking effect, slows sinus rate and AV conduction and slightly prolongs QT interval

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8
Q

Contraindications of amiodarone

A

heart block, bradycardia, thyroid dysfunction, hypokalaemia, cardiomyopathy, congestive heart failure, severe resp or heart failure

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9
Q

adverse effects of amiodarone

A

corneal microdeposits, hypokalaemia, hepatic disorders, hyperthyroidism, resp disorders, phototoxic

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10
Q

Atropine indications

A

bradycardia

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11
Q

mechanism of action of atropine

A

binds to and inhibits muscarinic acetylcholine receptors, producing anticholinergic effects

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12
Q

contraindications of atropine

A

HF, coronary artery disease, hypertension, hyperthyroidism, tachycardia, arrhythmias, acute MI, GI obstruction

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13
Q

adverse effects of atropine

A

dry mouth, dizziness, blurred vision, nausea

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14
Q

aspirin main indications

A

ACS, ischaemic stroke, thromboprophylaxis in patients in high cardiovascular risk

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15
Q

aspirin mechanism of action

A

main antiplatelet, irreversibly blocks COX in platelets which inhibits TXA2 synthesis and production of antithrombotic prostaglandin I2 PGI2

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16
Q

contraindications of aspirin

A

avoid in active peptic ulceration and bleeding disorders

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17
Q

adverse effects of aspirin

A

GI bleeding and ulceration

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18
Q

Angiotensin receptor blockers ARBs examples

A

iosartan, valsartan

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19
Q

main indications of ARBs

A

hypertension, post MI, heart failure - when ACEi not tolerated

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20
Q

mechanism of action of ARBs

A

competitively inhibits the binding of angiotensin II to AT1 in many tissues including vascular smooth muscle and adrenal glands. causes vasodilation and blockage of aldosterone release

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21
Q

contraindications of ARBs

A

pregnancy, planning to be pregnant

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22
Q

adverse reactions to ARBs

A

dizziness (postural hypertension), hyperkalaemia, localised angioedema

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23
Q

alpha blockers main indications

A

resistant hypertension

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24
Q

alpha blockers example

A

doxazosin

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25
Q

beta blockers- cardioselective examples

A

atenolol, bisoprolol

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26
Q

beta blockers- non cardioselective examples

A

propranolol, carvedilol

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27
Q

cardioselective beta blockers main indications and mechanism of action

A

competitive inhibition of only B1 receptors, used in angina, ACS, MI, hypertension, heart failure. lowers heart rate and blood pressure

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28
Q

non-cardioselective beta blockers main indications and mechanism of action

A

block beta 1 and beta 2 receptors. used in thyrotoxicosis, migraine. lowers the HR and BP

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29
Q

contraindications and cautions of B Blockers

A

brittle asthma, can worsen HF in the short term

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30
Q

adverse effects of B blockers

A

tiredness, cold peripheries

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31
Q

calcium channel blockers examples

A

amlodipine, verapamil, diltiazem

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32
Q

mechanism of action of Ca channel blockers

A

interfere with inward displacement of ca ions through the slow channels of active cell membranes

33
Q

main indications of calcium channel blockers

A

hypertension, angina, supraventricular arrhythmias (AF, SVT- slows HR)

34
Q

contraindications of CCBs

A

should not be administered to patients being treated with a B blocker because they also depress cardiac electrical and mechanical activity and therefore addition of CCB augments the effects and cause heart block or bradycardia

35
Q

side effects of CCBs

A

dizziness, flushing, headache, nausea, ankle oedema

36
Q

types of antiplatelet medications

A

clopidogrel, ticagrelor, aspirin

37
Q

clopidogrel main indications

A

thromboprophylaxis in patients intolerant to aspirin, ACS when combined with aspirin has a synergistic action

38
Q

mechanism of action of clopidogrel

A

inhibits P2Y12 receptors (stops ADP binding)

39
Q

contraindications and cautions of clopidogrel

A

patients at increased risk of bleeding

40
Q

adverse effects of clopidogrel

A

GI bleeding and ulceration

41
Q

digoxin main indications

A

heart failure, arrhythmia, hypertension (4th line)

42
Q

mechanism of action of digoxin

A

inhibits Na-K-ATPase membrane pump resulting in increase in intracellular sodium and calcium increasing contraction of muscles and reducing conduction of AV node. given IV

43
Q

contraindications of digoxin

A

narrow therapeutic index- too much can cause AV delay to be too long and cause bradycardia and heart block, increases ventricular irritability which produces ventricular arrhythmias

44
Q

side effects of digoxin

A

heart block, arrhythmias, diarrhoea, overdose- yellow vision, headache, nausea, vomiting

45
Q

diuretics main indications

A

used to treat hypertension (thiazide like diuretics) and heart failure (loop diuretics)

46
Q

examples of loop diuretics

A

furosemide, bumetanide, ethacrynic acid, torasemide (PO or IV)

47
Q

examples of thiazide like diuretics

A

furosemide, bendrofluazide, chlorothiazide (PO)

48
Q

mechanism of action of diuretics

A

block sodium reabsorption in kidneys

49
Q

contraindications of diuretics

A

use with caution in renal dysfunction

50
Q

side effects of diuretics

A

hypokalaemia- tiredness and arrythmia, hyperglycaemia- diabetes, increased uric acid, gout, impotence in men

51
Q

direct oral anticoagulants (DOACs) main indications

A

prevention of DVT in hip or knee replacements, DVT and PE

52
Q

direct oral anticoagulants (DOACs) mechanism of action

A

direct inhibitors of thrombin or factor Xa (PO)

53
Q

examples of DOACs

A

dabigatran, rivaroxaban, apixaban, edoxaban

54
Q

spironolactone

A

potassium sparing diuretic that prevents reabsorption of sodium and keeps potassium levels from getting too low, side effects- dizziness and light headedness

55
Q

contraindications of DOACs

A

no specific agent available to reduce haemorrhage in overdose but predictable degree of anticoagulation so minimal risk

56
Q

adverse effects of DOACs

A

bleeding (less common than in warfarin or heparin)

57
Q

heparin main indications

A

DVT, PE, unstable angina

58
Q

heparin mechanism of action

A

neutralises active clotting factors (IV or subcutaneous)

59
Q

heparin side effects

A

haemorrhage, heparin induced thrombocytopenia, hyperkalaemia

60
Q

ivabradine

A

used in angina and heart failure. slowing heart rate in sinus rhythm (doesnt work in AF), can cause visual disturbances, PO, channel modulator

61
Q

low molecular weight heparins main indications

A

generally preferred ovr heparins. used in DVT, PE, unstable angina (SC)

62
Q

contraindications of LMWHs

A

renal failure- use heparin instead as it is not excreted via the kidneys

63
Q

Neprilysin inhibitors examples

A

sacubitril/valsartan

64
Q

main indications of neprilysin inhibitors

A

heart failure (PO)

65
Q

mechanism of action of neprilysin inhibitors

A

stop neprilysin from breaking down natriuretic peptides,. NPs cause vasodilation and decrease sympathetic tone so more NPs mean more vasodilation

66
Q

contraindications of neprilysin inhibitors

A

do not use alongside ACEi or ARBs

67
Q

side effects of neprilysin inhibitors

A

hypotension, renal impairment, hyperkalaemia, angioneurotic oedema

68
Q

nitrates examples

A

isosorbide mononitrate

69
Q

main indications for nitrates

A

angina- GTN, acute HF. (sublingual, IV)

70
Q

mechanism of action of nitrates

A

relax all types of smooth muscle via metabolism to nitric oxide

71
Q

adverse effects of nitrates

A

headaches, hypotension, collapse

72
Q

statins examples

A

simvastatin, atorvastatin

73
Q

main indications of statins

A

drug of choice to reduce LDLs. hypercholesterolaemia- prevention of heart attack and stroke, diabetes, angina (PO)

74
Q

mechanism of action of statins

A

act as competitive inhibitors of HMG-CoA reductase. decreases inflammation, reversal of endothelial dysfunction, decreased thrombosis, stabilisation of atherosclerotic plaques

75
Q

contraindications of statins

A

elderly, high alcohol intake, history of liver disease, hypothyroidism, avoid in pregnancy

76
Q

adverse effects of statins

A

myopathy, rhadbomyolysis

77
Q

streptokinase used for

A

reduces mortality on acute MI (IV)

78
Q

warfarin

A

prevents blood clots. used for people with mechanical heart valves

Cardiovascular System (47 decks)

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