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Cardiovascular drugs Flashcards

(59 cards)

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1
Q

MOA antiplatelet drugs

A

aspirin irreversibly acetylates COX preventing formation of thromboxane A2 thus inhibiting platelet aggregation

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2
Q

when is aspirin used

A

in low dose (75 mg/24h) for secondary prevention following MI, TIA/stroke and patients with angina, peripheral vascular disease. sometimes primary

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3
Q

which drugs cause less gastric irritation aspirin (antiplatelet) or clopidogrel etc (ADP receptor antagonists)

A

clopidogrel

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4
Q

examples of ADP receptor antagonists

A

(antiplatelets)- clopidogrel, prasugrel- block platelet aggregation. used if intolerant to aspirin

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5
Q

what role do glycoprotein IIB/IIIa antagonists have

A

unstable angina/ MI

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6
Q

example glycoprotein IIb/IIIa

A

tirofiban

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7
Q

which anticoag is used in AF and name another instance where used

A

warfarin; in those patients with mechanical valves

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8
Q

what are the newer oral agents

A

Xa inhibitors- apixaban; direct thrombin inhibitors- dabigatran. don’t need therapeutic monitoring

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9
Q

when is LMWH used

A

in ACS

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10
Q

what are alternative anticoags (not newer therapies)

A

parenteral fondaparinux (Xa inhibitor) or bivalirudin (thrombin inhibitor)

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11
Q

MOA b blockers

A

blocks adrenaline and NA on B adrenoceptors thus antagonising sympathetic nervous system

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12
Q

what does b1 receptor blockers cause in inotropic and chronotropic of heart

A

decreases inotropic and chronotropic - pulse decreases due to the decreased firing of SA node.

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13
Q

what does b2 receptor blockers induce

A

peripheral vasoconstriction and bronchioconstriction

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14
Q

what is the action of b1 receptor

A

incr chronotropic effect (rate), incr ionotropic effect (strength contractibility), increase renin secretion, increase ghrelin secretion(stomach)

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15
Q

what is the action of b2 receptor

A

smooth muscle relaxation, dilation of arteries to skeletal muscle, relaxation bronchioles, inhibit histamine secretion etc

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16
Q

what is an adrenergic receptor

A

GPCR receptors activated by adrenaline and noradrenaline

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17
Q

B blockers vary in their selectivity true or false

A

true

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18
Q

is propranolol selective

A

no

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19
Q

is bisoprolol selective

A

relatively B1 selective

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20
Q

uses of B blockers

A

angina, hypertension, antidysrhythmic, post MI, heart failure

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21
Q

contraindications of b blockers

A

asthma, COPD, heart block

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22
Q

caution use of B blockers, which can be used

A

heart failure. carvediol (and bisoprolol) can be used

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23
Q

side effects of B blockers

A

lethargy, erectile dysfunction, nightmares, headache

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24
Q

which type of diuretic is used in heart failure give example and MOA

Study These Flashcards
A

loop diuretic- inhibits Na/2Cl/K co transporter eg furosemide

25
what type of diuretic is used in hypertension give example and MOA
thiazide, inhibit Na/Cl cotransporter. bendroflumethiazide
26
side effects of loop diuretics
dehydration, decr K, decr Ca, ototoxic
27
side effects of thiazides
decr K, incr Ca, decr Mg, incr urate (+- gout), impotence
28
example of K sparing diuretic
amiloride, spironolactone
29
side effect amiloride
incr K, GI upset
30
what are vasodilators used in
heart failure, IHD, hypertension
31
examples of vasodilators
nitrates, prazosin, hydralazine
32
MOA of nitrates
DECREASE PRE LOAD. dilates veins and large arteries so decreasing filling pressure
33
MOA of hydralazine
DECREASE AFTER LOAD. primarily dilates resistance vessels (used with nitrates), and decr BP
34
MOA prazosin
alpha blocker. dilates arteries and veins
35
MOA calcium channel blockers
reduce entry Ca2+- voltage sensitive channels in smooth muscle. this leads to coronary and peripheral vasodilatation, reducing coronary oxygen consumption
36
what receptors do the calcium channel blockers work on
L type Ca2+ channels
37
examples of dihydropyridines (Ca2+) and what is their principle action
nifedipine, amlodipine. peripheral vasodilators also dilate coronary arteries.
38
what do dihydropyridines cause and what are they used alongside, and what for
reflex tachycardia used alongside B blockers. angina and hypertension
39
examples of non dihydropyridines (ca2+) and action, what used for
verapamil, diltiazem. slow conduction at AV and SA. hyptertension, angina, dysrhythmias
40
what must you not give with B blockers
verapamil- risk severe bradycardia and LVF
41
side effects Ca channel blockers
flushes, headache, oedema, LV function decr, gingival hypertrophy
42
contraindications of Ca blockers
heart block
43
MOA digoxin
blocks Na/K pump. slows pulse in fast AF. weak+ve inotrope
44
who are at risk of incr toxicity with digoxin
elderly, use lower doses
45
side effects digoxin
any arrhythmia, nausea, decr appetite, yellow vision, confusion, gynaecomastia
46
in digoxin toxicity what needs to be checked
K+, treat arrhythmias, consider DigiFab by IVI
47
contraindications of use of digoxin
HCM (hypertrophic obstructive cardiomyopathy), WPW
48
what are dihydropyridines eg nifedipine used for
hypertension and angina
49
what are phenylalkalines eg verapamil used for
arrhythmias and angina
50
what are benzothiapenes eg diltiazem used for
hypertension, angina, arrhythmias
51
what is the basic MOA of a diuretic
traps ions in urine so H2O moves from blood into urine in osmotic shift
52
where does furosemide act
thick ascending loop of henle
53
where does bendroflumethiazide act
distal convoluted tubule
54
where does spironolactone act
collecting tubule
55
what can lead to decreased therapeutic index for drugs such as digoxin and amiodarone
hypokalaemia
56
how do K sparing diuretics work
usually Na is trapped in the loop or DCT which leads to a high conc of Na and so enhances K loss. in K sparing, the Na reabsorption is blocked in the collecting duct uncoupling the membrane which usually works in K secretion thus blocking the secretion of K into the urine
57
what receptor is responsible for Ca2+ release from sarcoplasmic reticulum in cardiomyocytes
ryanodine receptor
58
what enzyme is inhibited by statins
HMG-CoA reductase. de novo synthesis of cholesterol in the liver increasing LDL receptor expression by hepatocytes leading to decr circulating LDL cholesterol
59
side effects statin
muscle aches, abdo discomfort, incr transaminases

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