Cardiovascular Flashcards
(20 cards)
Mechanism of action for blood pressure
- Blood volume (plasma)
- Heart rate (stress, calcium)
- Stroke volume
- Blood viscosity
- Peripheral resistance (blood vessel constriction)
Cardiovascular drugs glossary
Lipids
1. Statin - production
2. Bile acid resin - excretion
3. Fibric acid
4. Ezetimibe - absorption
5. Ezetimibe/Statin fixed etc. Vytorin
6. CETPi (Cerivastatin, did not pass QC) - transport
Hypertension
1. Diuretics
2. Calcium channel blockers
3. ACEi / angiotensin-receptor blockers (etc. Vasotec)
4. Alpha & beta-andrenergic blockers
5. vasodilators
Angina Pectoris
1. Glyceryl titrate spray
Myocardial Infarction
1. Thrombolytics - restore blood supply
2. Beta blockers or calcium channel blockers - reduce myocardial O2 demand
3. Aspirin, beta-blockers or ACEi - reduce BP and stress
4. Antiplatelet/ anticoagulant
Dysarrythmia
1. Channel blockers (Sodium, beta-adrenergic, potassium, calcium)
Cardiovascular diseases glossary
- Atherosclerosis
- Coronary heart disease (CHD)
- Chest pain (angina pectoris)
- Irregular heartbeat (arrhythmia)
- Congestive heart failure (CHF)
- Congenital and rheumatic heart disease
- Stroke
Types of Lipid disorders
- Atherosclerosis: plaque buildup
- Hyperlipidemia: high lipid level in blood
- Hypercholesterolemia: elevated blood cholestrol
Types of lipoproteins (water soluble, free-moving in blood)
- low-density lipoprotein (plauqe buildup & atherosclerosis)
- high-density lipoprotein (reverse lipid transport; beneficial)
- very low-density lipoprotein (primary triglyceride carrier; unideal)
reduce blood lipid levels
Statin; inhibit cholestrol levels (reduce LDL, VLDL, increase HDL)
Mechanism of Statin
Aim: to reduce LDL levels
acts as competitive inhibitor of HMG-CoA reductase (enzyme that converts HMG-CoA to mevalonate; precurosor of cholestrol)
By inhibiting HMG-CoA, cholestrol production is reduced, and increased expression of LDL receptor is triggered and LDL uptake increases, hence reducing LDL levels.
Examples of Statin
- Atorvastatin (Liptor)
- Simvastatin (Zocor)
Statin to be administered enteral in the evening (after meal digestion -> LDL increase)
- Cerivastatin (Baycol, Lipobay) withdrawal due to rhabdomyolysis
Other drugs to lower blood cholestrol
- Bile acid resin
- aid in fat digestion, reduce LDL - Fibric acid (etc. Tricor)
- treat high triglycerides - Combination approach (ezetimibe + statin; etc Vytorin, Advicor)
- ezetimibe blocks absorption of dietary cholestrol -> reduce LDL & triglycerides
- lower dose, increased compliance benefits
CETPi
stands for CholesterylEster Transfer Protein Inhibitor
- to prevent transfer of cholestrol from HDL to VLDL or LDL
Did not pass QC
Hypertension
can lead to stroke, heart failure or myocardial infarction
primary factors responsible for blood pressure are cardiac output,
resistance of the small arteries & blood volume
Anti-hypertensive therapy
Vasodilation:
Calcium channel blockers (CCBs) → relax vascular smooth muscle
Vasodilators → direct smooth muscle relaxation (e.g. hydralazine)
Angiotensin receptor blockers (ARBs) → block angiotensin II = vasodilation
[blocks stress response]
ACE inhibitors (ACEi) → ↓ angiotensin II = vasodilation ✅
[blocks hormonal activity]
Reduce cardiac output:
Alpha & Beta blockers → ↓ heart rate, ↓ myocardial contractility
Some CCBs (like verapamil/diltiazem) also ↓ HR and contractility
Increase urine output & reduce blood volume:
Diuretics (1st choice) → e.g. thiazide diuretics (hydrochlorothiazide), loop diuretics
→ ↓ blood volume → ↓ preload → ↓ BP
Angina Pectoris
Acute chest pain due to insufficient oxygen to heart muscles, commonly caused by atherosclerosis
Drug mechanism to for angina pectoris treatment
- Beta blockers → prevent angina pain
- Organic nitrates (etc. Glyceryl trinitrate spray) → terminating angina pain
- Calcium channel blockers → substitue for beta blockers
Myocardial Infarction
heart attack; blood flow to the heart is suddenly cut off
Usually caused by blood clot from rupture at pre-existing atherosclerosic site
Myocardial infarction treatment
- Thrombolytics → restore blood supply by dissolving clot
- Beta blockers → reduce myocardial oxygen demands
- Calcium channel blockers → prevent another MI
- Asprin & ACEi (or beta blockers) → reduce post MI mortality
- Analgesis → manage severe chest pains
- Antiplatelets or anticoagulants → prevent new clot
Disarthymias
Arrhythmias; abnormal heartbeat, can be harmless (palpitations) or life-threatening (asystole lol)
types of disarthymias
- SVT (Supraventricular tachycardia): arrythmia, sudden burst of rapid heartbeats
- A-Fib (Atrial fibrilliation): heart palpitations
- V-Tach (Ventricular tachycardia): >100bpm, indicate pre-existing heart disease
- V-Fib (Ventricular fibrillation): due to untreated V-Tach, usually becomes heart attack
Disarthymia treatment
1-3 slows HR
1. Sodium channel blockers: slow the rate of impulse conduction through the
heart
- Beta-adrenergic blockers: reduce automatically and slow conduction velocity in the heart
- Potassium blockers: prolong the refractory period of the heart
- Calcium channel blockers: treats SVT
生脉散（Generate the Pulse Powder)
- Increases myocardial contractility
- Prevents arrythmia, improves blood perfusion to coronary artery and body peripherals
- Cardio protective effect against post-ischemic myocardial dysfunction
- Immune stimulant: increases white blood cells and T-lymphocytes
- Mild sedative effect on CNS
- Anti-inflammatory
