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Pharmacology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

How do ACE inhibitors work?

A

Inhibit ACE and prevent the formation of angiotensin II

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2
Q

What are ACE inhibitors used for?

A

Hypertension, heart failure, diabetic nephropathy

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3
Q

Give examples of ACE inhibitors.

A

Rampipril, perindopril, enalapril, trandolapril.

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4
Q

What are the main adverse effects of ACE inhibitors - due to reduced angiotensin II formation?

A

Hypotension, acute renal failure, hyperkalaemia, teratogenic effects in pregnancy (deformity)

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5
Q

Main adverse effects of ACE inhibitors due to increased kinin production?

A

Cough, rash, anaphylactoid reactions (allergic reactions)

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6
Q

Why do ACE inhibitors cause an increase in kinin?

A

Bradykinin gets broken down by ACE in to inactive proteins, when ACE is inhibited bradykinin/ kinin levels increase.

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7
Q

Give some contraindications of ACE inhibitors.

A

Pregnancy, renal failure, hyperkalaemia, hyponatraemia, hypotension

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8
Q

How do Angiotensin II receptor blockers work?

A

By binding to AT-1 receptors on angiotensin II

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9
Q

When would ARBs be used?

A

Hypertension, diabetic nephropathy, heart failure (if ACE inhibitor intollerant)

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10
Q

Give some examples of ARBs

A

Candesartan, valstratan, losartan, irbesartan, telmisartan

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11
Q

What are the main adverse effects of ARBs?

A

hypotension, hyperkalaemia, rash, angio-oedema, potential renal dysfunction

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12
Q

How do Ca2+ channel blockers work?

A

Decrease cell entry of Ca2+ by blocking L-type Ca2+ channels, increasing vasodilation and reducing myocardial O2 demand.

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13
Q

What are type 1 calcium channel blockers?

A

Dihydropyridines -nifedipine, amlodipine

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14
Q

What are the effects of type 1 calcium channel blockers?

A

Mainly peripheral vasodilators (also coronary arteries) - can cause reflex tachycardia so used with a beta blcoker.

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15
Q

What are type 2 calcium channel blockers?

A

Phenylalkylamines - verapamil
mainly effects the heart (decreased heart rate and force of contraction)
DO NOT GIVE WITH BETA BLOCKERS - bradycardia!

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16
Q

What are type 3 calcium channel blockers?

A

Benzothiazepines - diltiazem

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17
Q

What are the main adverse effects of Ca2+ channel blockers?

A 
Due to peripheral vasodilation:
flushing, headache, oedema, palpitations
Due to decreased heart rate(-ve chronotropic):
Bradycardia, atrioventricular block
Due to decreased contraction force -
worsening cardiac failure
verapamil causes constipation.
18
Q

How do beta blockers work?

A

block beta- adrenoreceptors, antagonise sympathetic NS.
beta 1 : -ve ionotrophic & chronotrophic effects
beta 2 : decrease vaso/bronchoconstriction.

19
Q

Give an example of a Beta1/cardio selective drug.

A

Bisoprosol, metoprolol

20
Q

Give an example of a non-slective beta-blocker.

A

propranolol,

21
Q

Uses of betablockers.

A

Angina, hypertension, antidysrhythmias, IHD, heart failure

22
Q

Contraindications of beta-blockers?

A

Asthma/COPD, heart block

23
Q

Main adverse effects of beta-blockers?

A

Fatigue, headache, sleep disturbance/nightmares, bradycardia, hypotension, cold peripheries, erectile dysfunction.

24
Q

How do loop diuretics work?

A

Inhibit Na/2Cl/K cotransporter in the loop of Henle. Cause dehydration, decreased K+ and Ca2+

25
Q

When are loop diuretics used?

A

Heart failure.

26
Q

How does thiazide work?

A

Inhibit Na/Cl cotransporter. Decrease K+ and Mg2+, increase Ca2+

27
Q

When are thiazides used?

A

Hypertension.

28
Q

What are the main adverse effects of loop diuretics?

A

Hypovolaemia, hypotension, hypokaaemia, hyponatraemia, raised uric acid - gout

29
Q

What are the main adverse effects of thiazides?

A

erectile dysfunction, impared glucose tolerance.

30
Q

How do nitrates work?

A

Cause vasodilation, reduce preload and afterload, lower BP.

31
Q

What are the main uses of nitrates?

A

IHD and heart failure

32
Q

Give examples of nitrates.

A

Isosorbide mononitrate, GTN spray, GTN infusion

33
Q

How do class 1 antiarrhythmis drugs work?

A

they are Na+ channel blockers.

34
Q

Give examples of 1a, 1b and 1c anitarrhythmic drugs.

A

1a. disopyramide
1b. lidocaine
1c. flecainide

35
Q

What are class 2 antiarrhythmic drugs

A

Beta blockers

36
Q

How do class 3 antiarrhythmic drugs work?

A

prolong the action potential - amiodarone

37
Q

How do class 4 antiarrhythmic drugs work?

A

They’re calcium channel blockers - verapamil.

38
Q

How does digoxin work?

A

Blocks the Na+/k+ pump.

39
Q

What are the main effects of digoxin?

A

bradycardia, slowing atrioventricular conduction, increased force of contraction.

40
Q

What are the main adverse effects of digoxin?

A

Nausea, vomiting, diarrhoea, confusion.

41
Q

when is digoxin used?

A

AF - to reduce ventricular rate response

Sever heart failure - positive ionotropic effect

42
Q

What are the side effects of amiodorone?

A

due to iodine:
prolongues QT intervals, interstitial pneumitis, abnormal liver function, hyper/hypothyroidism, increased sun sensitivity,, skin decolouration, microdeposites in cornea, optic neuropathy.

Pharmacology (2 decks)

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