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Pharmacology > Cardiology: Vasculature > Flashcards

Cardiology: Vasculature Flashcards

1
Q

What is your central venous pressure?

A

The pressure in your right atrium

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2
Q

What g protein acts in smooth muscle?

A

Gq

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3
Q

What does activation of the CPCR in smooth muscle cause?

A 
Opening of L type calcium channels
Increased calcium into cell
Calcium binds to calmodulin
Activates MLCK
Phosphorylates myosin LC
CONTRACTION
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4
Q

How does vascular smooth muscle relax?

A

Increased cGMP
Activates Myosin LC phosphatase
Dephosphorylates myosin LC
RELAXATION

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5
Q

Describe the formation of NO in endothelial cells.

A

Vasodilating substances act on CPCR which open calcium channels
Increase in calcium
Binds to calmodulin
Forms eNOS
Catalyses the formation of NO from Larginine and oxygen

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6
Q

What happens when NO diffuses into the smooth muscle?

A

NO activates Calcium dependant activated K channels
Efflux of potassium–>relaxation
NO also activates guanylate cyclase which concerts GTP to cGMP
cGMP acts of protein kinase G
RELAXATION

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7
Q

What is the effect of organic nitrates?

A

Metabolise to form nitric oxide- relaxes all types of smooth muscle

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8
Q

What effect does organic nitrates have on the vasculature?

A

Venorelaxation
Arteriolar dilation
Increased coronary blood flow

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9
Q

How are organic nitrates beneficial in angina?

A

Decrease preload and afterload

Improve perfusion to the ischaemic areas ( by opening collaterals)

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10
Q

Name two organic nitrates used to treat angina.

A 
GTN (short acting)
Isosorbide Mononitrate (longer acting)
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11
Q

Name two unwanted effects of organic nitrates.

A

Tolerance

Headaches (initially)

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12
Q

What substances will switch on genes for endothelin production?

A

Adrenaline A
Andgiotensine II
ADH

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13
Q

What substances will switch off genes for endothelin production?

A

Nitric oxide

Shear stress

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14
Q

What receptor does endothelin activate?

A

ETa receptorq

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15
Q

What g protein is activated by endothelin?

A

Gq

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16
Q

What does the activation of g proteins by endothelin cause?

A

Intracellular calcium increases- contraction

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17
Q

What are antagonists of the ETa receptor used to treat?

A

PULMONARY hypertension

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18
Q

Name two ETa antagonists

A

Bosentan

Ambrisentan

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19
Q

What do ACE inhibitors do?

A

Block ACE- an endothelial enzyme which catalyses the formation of angiotensin II from angiotensin I

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20
Q

Name an ACE inhibitor.

A

Lisinopril

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21
Q

What do AT1 receptor antagonists do?

A

Block the action of angiotensin II on the AT1 receptors

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22
Q

Name an ARB

A

Losartan

23
Q

What drug should not be used in conjunction with ACE inhibitors or ARBs?

A

Rennin inhibitors eg aliskiren

24
Q

Give the adverse affects of ACE inhibitors.

A

Hypotension

Dry cough

25
Q

What is the main difference between ACEI and ARBs

A

ARBS do not inhibit the metabolism of bradykinin

Do not get a dry cough

26
Q

Are ACEI and ARBs safe in pregnancy?

A

NO

27
Q

Name three uses of ACEI and ARBS

A

hypertension
cardiac failure
following an MI

28
Q

Why do ACEI give you a dry cough?

A

They do not allow the break down of bradykinin which irritates sensory nerve fibres triggering the cough reflex

29
Q

What effect do beta blockers have on the kidney?

A

Decrease renin release

30
Q

What happens to RAAS during heart failure?

A

It is inappropriately activated

31
Q

What do calcium antagonists do?

A

Prevent the opening of L-type channels and decrease calcium concentration of result in relaxation

32
Q

Where can calcium antagonists act?

A

The Heart

Smooth muscel

33
Q

Name a calcium antagonist the works solely of the heart.

A

Verapamil

34
Q

Name a calcium antagonist that works manly on the smooth muscle?

A

Amlodipine

35
Q

Name a calcium antagonist that works with intermediate selectivity?

A

Diltiazem

36
Q

How can calcium antagonists be used to treat hypertension?

A

Arteriolar dilation- reduces MAP
Coronary vasodilation
Indicated for patients soley with systolic hypertension

37
Q

Give the adverse effects of calcium antagonists

A

Hypotension
Dizziness
Flushing
Swollen ankles

38
Q

How can calcium blockers be used in angina?

A

Arteriolar dilation decreases preload

Coronary vasodilation

39
Q

When should verapamil not be used?

A

In heart failure

With a beta blocker

40
Q

How do potassium channel openers work?

A

Antagoniste intracellular ATP redulting in opening of K channels and hyperpolarisation which switches of Ca channels
RELAXATION

41
Q

Name two potassium channel openers.

A

Minoxidil

Nicorandil

42
Q

When is minozidil used?

A

Last resort hypertension

Can cause reflex tachycardia and water retention

43
Q

WHen is nicorandil used>

A

Last resort angina

44
Q

Name two alpha adrenoceptor antagonsits

A

Prazosin
Doxazosin
can cause postural hypertension

45
Q

How do diuretics work?

A

They act on the kidney to increase the excretion of Na, Cl and water

46
Q

Name the two types of diuretic

A

Thiazide

Loop

47
Q

Where do thiazide diuretics limit absoprtion

A

In the distal tubules

Moderate diuresis

48
Q

Where so loop diuretics limit absorption

A

Loop of henle

Strong diuresis

49
Q

What is the adverse affect of diuretics?

A

Hypokalaemia

50
Q

Name a thiazide

A

Bendroflumethiazide

51
Q

When is bendroflumethiazed used?

A

Mild hear failure
Hypertension
Severe resistan oedema (combined with Loop)

52
Q

Name a loop diuretic

A

Furosemide

53
Q

When is furosemide used?

A

Acute pulmonary oedema

chronic heart failure

Pharmacology (13 decks)

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