Cardiac Drugs Flashcards
(36 cards)
0
Q
Heparin
A
- produced by basophils and mast cells
- binds to enzyme inhibitor antithrombin III (ATIII) causing inactivation of thrombin and factor Xa
- used in unstable angina and DVT. Also as a prophylactic during and after surgery
1
Q
Dobutamine
A
- Selective β1 agonist
- Used in acute cardiogenic shock
2
Q
Eptifibatide
A
- cyclic peptide inhibitor of glycoprotein IIb/IIIa receptor. Prevents platelet aggregation.
- used for prevention of MI in angina patients or previous MI sufferers
3
Q
Tirofiban
A
- non-peptide inhibitor of glycoprotein IIb/IIIa receptor. Prevents platelet aggregation.
- used for prevention of MI in angina patients or previous MI sufferers
4
Q
Abciximab
A
- Monoclonal antibody against glycoprotein IIb/IIIa receptor and vitronectin receptor. Prevents platelet aggregation and cell adhesion.
- used in coronary angioplasty for coronary artery thrombosis.
5
Q
Clopidogrel
A
-inhibits platelet aggregation by inhibiting binding of ADP to it’s receptor on platelets.
6
Q
Aspirin
A
-oral low dose prevents thrombosis.
7
Q
Amiodarone
A
- class III antidysrhythmic
- prolongs AP and refractory period
8
Q
Dabigatran
A
- thrombin inhibitor
- used in patients with atrial fibrillation and prophylactic ally in knee and hip replacements
- recently approved by NICE (2012)
9
Q
Digitoxin
A
- Cardiac glycoside
- blocks Na+/K+ ATPase
10
Q
Digoxin
A
- cardiac glycoside
- inhibits Na+/K+ ATPase thus inhibiting Na+/Ca2+ exchanger, causing increased intracellular Ca2+ causing increased force of contraction
11
Q
Levosimendan
A
- indilator and calcium sensitiser- blocks PDE3 causing peripheral vasodilator ions and increased binding efficiency of Ca2+ to troponin
- used in hospitals to treat heart failure (not licensed in UK)
12
Q
Carvedilol
A
- β1 antagonist (β-blocker) used in treatment of stable heart failure.
- reduces effects of damage by chronic overstimulation by catecholamines
13
Q
Alteplase
A
- Single chain recombinant human tissue plasminogen activator
- specific for plasminogen bound to fibrin- localised action
14
Q
Duteplase
A
- double chain recombinant human tissue plasminogen activator
- specific for plasminogen bound to fibrin- localised action
15
Q
Anistreplase
A
-plasminogen anisoylated streptokinase. Slow acting as streptokinase needs to have anisoyl group removed- prolonged effect
16
Q
Streptokinase
A
- 47kDa, formed by haemolytic streptococci
- binds to plasminogen activator, promoting plasminogen formation and therefore breakdown of fibrin and clotting factors II, V and VII
17
Q
Bisoprolol
A
- β1 antagonist (β blocker) used in treatment of stable heart failure.
- reduces effects of damage by chronic overstimulation by catecholamines
18
Q
Sildenafil
A
- selective inhibitor of PDE5 (which breaks down cGMP)
- used to treat impotence
19
Q
Dipyridamole
A
- potentiates responses mediated by adenosine by blocking it’s uptake into the cell
- also blocks PDE5, preventing breakdown of cGMP
20
Q
Lidocaine
A
- charged LA which blocks VGNCs via hydrophilic route.
- show use dependence at high stim
- class IB antidysrhythmic. Fast in, fast out.
21
Q
Verapamil
A
- L type calcium channel blocker- binding site distinct from DHP site but reduces DHP binding.
- shows use dependence
- causes peripheral and coronary vasodilatation but preferentially affects cardiac muscle.
- class IV antidysrhythmic
22
Q
Quinidine
A
- charged LA
- shows use dependence at low stim (slow in slow out)
- class IA antidysrhythmic, increases AP duration
23
Q
Propranolol
A
- non selective β antagonist
- used to be used in hypertension, but caused bronchoconstriction
- class II antidysrhythmic
24
Procainamide
- class IA antidysrhythmic
| - increase AP duration
25
Ouabain
-cardiac glycoside- only used experimentally. Inhibits Na+/k+ ATPase too much.
26
Atenolol
- β1 receptor blocker
- used to treat hypertension, cardiac dysrhythmias and angina
- can be used in heart failure
- class II antidysrhythmic
27
Pimobendan
- calcium sensitiser- increases cardiac Ca2+ binding efficiency to troponin, causes peripheral vasodilatation by inhibiting PDE3 (inodilator)
- used in canine dilated cardiomyopathy and canine mitral valve regurgitation
28
Theophylline
- methylxanthine (like caffeine)
- non selective PDE inhibitor causing increased cAMP
- A2 receptor antagonist- causes increased rate and force of contraction, the latter due to release of Ca2+ from intracellular stores.
- induces wakefulness
29
Caffeine
- A1 receptor antagonist
- promotes wakefulness- most prominent after prolonged wakefulness
- increases rate and force of contraction, at high conc causes Ca2+ release from intracellular stores.
- also inhibits PDE (non selective)
30
Milrinone
- PDE3 inhibitor, used in heart failure. Use confined to short term treatment of severe heart failure.
- caused vasodilatation in smooth muscle, decreasing after-load and therefore stress on heart
31
Tranexamic acid
- analogue of aminocaproic acid
| - competitively inhibits plasminogen activator, preventing excessive clot lysis.
32
Warfarin
- oral clot-inhibiting drug.
- inhibits synthesis of factors II, VII, IX and X and proteins C, S and Z.
- narrow therapeutic window, many things affect bioavailability (needs regular blood tests)
- reversed by vitamin K
33
Aminocaproic acid
- chemically similar to lysine, competitively inhibits plasminogen activator.
- prevents excessive clot lysis.
34
Rivaroxaban
- factor Xa inhibitor
- similar uses to dabigatran
- quite new
35
Flecainide
- blocks VGNCs- class IC antidysrhythmic
| - no effect on AP
