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MODA > Cardiac Drugs > Flashcards

Cardiac Drugs Flashcards

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
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1
Q

Dobutamine

A
  • Selective β1 agonist

- Used in acute cardiogenic shock

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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
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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
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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.
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5
Q

Clopidogrel

A

-inhibits platelet aggregation by inhibiting binding of ADP to it’s receptor on platelets.

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6
Q

Aspirin

A

-oral low dose prevents thrombosis.

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7
Q

Amiodarone

A
  • class III antidysrhythmic

- prolongs AP and refractory period

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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)
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9
Q

Digitoxin

A
  • Cardiac glycoside

- blocks Na+/K+ ATPase

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10
Q

Digoxin

A
  • cardiac glycoside
  • inhibits Na+/K+ ATPase thus inhibiting Na+/Ca2+ exchanger, causing increased intracellular Ca2+ causing increased force of contraction
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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)
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12
Q

Carvedilol

A
  • β1 antagonist (β-blocker) used in treatment of stable heart failure.
  • reduces effects of damage by chronic overstimulation by catecholamines
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13
Q

Alteplase

A
  • Single chain recombinant human tissue plasminogen activator
  • specific for plasminogen bound to fibrin- localised action
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14
Q

Duteplase

A
  • double chain recombinant human tissue plasminogen activator
  • specific for plasminogen bound to fibrin- localised action
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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
Q

Procainamide

A
  • class IA antidysrhythmic

- increase AP duration

25
Q

Ouabain

A

-cardiac glycoside- only used experimentally. Inhibits Na+/k+ ATPase too much.

26
Q

Atenolol

A
  • β1 receptor blocker
  • used to treat hypertension, cardiac dysrhythmias and angina
  • can be used in heart failure
  • class II antidysrhythmic
27
Q

Pimobendan

A
  • 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
Q

Theophylline

A
  • 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
Q

Caffeine

A
  • 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
Q

Milrinone

A
  • 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
Q

Tranexamic acid

A
  • analogue of aminocaproic acid

- competitively inhibits plasminogen activator, preventing excessive clot lysis.

32
Q

Warfarin

A
  • 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
Q

Aminocaproic acid

A
  • chemically similar to lysine, competitively inhibits plasminogen activator.
  • prevents excessive clot lysis.
34
Q

Rivaroxaban

A
  • factor Xa inhibitor
  • similar uses to dabigatran
  • quite new
35
Q

Flecainide

A
  • blocks VGNCs- class IC antidysrhythmic

- no effect on AP

MODA (2 decks)

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