Cardiovascular Pharmacology Flashcards
(33 cards)
Ramipril
ACE inhibitor, reduction in production of angiotensin II and decreasing the breakdown of bradykinin, used to treat hypertension and congestive heart failure.
Adverse effects include:
- Shakiness
- Dry cough
- Dizziness and light-headedness due to low blood pressure
- Fatigue, especially in the early stages
- Mouth dryness in the early stages
- Nausea
- Fainting
- Signs of infection (e.g., fever, chills, persistent sore throat)
- Chest pain
- Neutropenia
- Impotence
T1/2 = 2-4 hours
Lisinopril
ACE inhibitor, reduction in production of angiotensin II and decreasing the breakdown of bradykinin, used to treat hypertension and congestive heart failure.
Adverse effects include:
- Chills, signs of infection
- Dark urine (melanuria)
- Decreased urination (oliguria)
- Difficulty swallowing or breathing (signs of angioedema)
- allergic reaction (anaphylaxis)
- Hoarseness
- Itching
- Yellowing of skin or eyes (jaundice)
- Abdominal pain
- bloating
- vomiting
- Chest pain or tightness
- lightheadedness
- fainting
- Dry cough
- Fever
- Joint pain
- Rash
- Diarrhea
- nausea
- Drowsiness
- headache
- tiredness
- Muscle cramps
- Dry mouth
- Serious (possibly fatal) liver problems
- Impotence
- Dizziness
- Faintness
T1/2 = 12 hours
Enalapril
ACE inhibitor used in the treatment of hypertension, diabetic nephropathy and some types of chronic heart failure.
Adverse effects include:
- raised serum creatinine
- dizziness
- hypotension
- syncope
- dry cough
- angioedema
T1/2 = 11 hours
Adrenaline
Hormone and neurotransmitter used in cardiac arrest, anaphylaxis, asthma and croup.
Adverse effects include:
- palpitations
- tachycardia
- arryhthmias
- anxiety
- panic attack
- headache
- tremor
- hypertension
- acute pulmonary oedema
T1/2 = 2 minutes
Amiodarone
Amiodarone is a class III antiarrhythmic agent used for various types of cardiac dysrhythmias, both ventricular and atrial (shock-refractory VF, haemodynamically stable VT, AF). Still used to treat arrhythmias that are otherwise difficult to treat with other medications.
It prolongs phase 3 of the cardiac action potential. Additionally, shows beta blocker and potassium channel blocker like actions on the SA and AV nodes. Chemically resembles thyroxine.
Adverse effects include:
- ILD
- thyroid dysfunction
- corneal deposits
- abnormal liver enzyme results
- jaundice, hepatomegaly and hepatitis (rare)
- light-sensitive blue/grey discolouration of the skin
- peripheral neuropathies
- gynecomastia
- epidiymitis
T1/2 = 58 days
Candesartan
angiotensin 2 inhibitor
irbesartan
angiontensin 2 inhibitor
losartan
angiontensin 2 inhibitor
aspirin
Analgaesic, antipyretic, antiplatelet and anti-inflammatory medication. Antiplatelet effect by inhibition of thromboxane A2. Irreversible inhibition of COX 1 and 2 has downstream effects on production of prostaglandins and thromboxanes.
Used at low doses to prevent heart attacks, strokes and thrombus formation in those at risk.
Adverse effects include:
- GI bleed
- Reye’s syndrome (encephalopathy and fatty liver)
T1/2 is dose dependent
- low dose = 2-3 hours
- high dose = 15-30 hours
Bendroflumethiazide
Bendroflumethiazide (bendrofluazide) is a thiazide diuretic which works by inhibiting sodium absorption at the beginning of the distal convoluted tubule (DCT). Potassium is lost as a result of more sodium reaching the collecting ducts. Bendroflumethiazide has a role in the treatment of mild heart failure although loop diuretics are better for reducing overload. The main use of bendroflumethiazide was in the management of hypertension but recent NICE guidelines now recommend other thiazide-like diuretics such as indapamide and chlortalidone.
Common adverse effects
- dehydration
- postural hypotension
- hyponatraemia, hypokalaemia, hypercalcaemia
- gout
- impaired glucose tolerance
- impotence
Rare adverse effects
- thrombocytopaenia
- agranulocytosis
- photosensitivity rash
- pancreatitis
Amlodipine
Dihydropyridine-type Ca2+ channel blocker used in the treatment of hypertension and angina.
Adverse effects include:
- peripheral oedema and fatigue
- gynaecomastia
- impotence
- depression
- insomnia
- tachycardia
- gingival enlargement
- erratic behaviour
- hepatitis and jaundice (rare)
T1/2 = 30-50 hours
Diltiazem
Ca2+ channel blocker
Nifedipine
Ca2+ channel blocker
Verapamil
Ca2+ channel blocker
Clopidogrel
Oral thienopyridine-class antiplatelet agent used to inhibit clot formation in coronary heart disease, peripheral vascular disease and cerebrovascular disease, as well as prevent myocardial infarction.
Irreversibly binds the P2Y12 adenosine diphosphate (ADP) chemoreceptor on platelet cell membranes leading to inhibition of platelet aggregation.
Adverse effects include:
- bleeding
- severe neurtropaenia
- thrombotic thrombocytopaenia purpura
T1/2 = 7-8 hours
Digoxin
Cardiac glycoside derived from Digitalis lanata used in the treatment of AF, atrial flutter and sometimes heart failure.
Inhibition of Na+/K+ ATPase, mainly in the myocardium. Causes an increase in intracellular sodium levels resulting in a reversal of the action of the sodium-calcium exchanger which normally imports three extracellular sodium ions into the cell and transports one intracellular calcium ion out of the cell. This leads to a decrease in heart rate with the addition of increased contractility without any additional energy expenditure.
T1/2 = 36-48 hours in patients with normal renal function
Dipyridamole
inhibits phosphodiesterase enzymes that normally break down cAMP (increasing cellular cAMP levels and blocking the platelet aggregation response to ADP).
Used in peripheral artery disease, coronary artery disease and pulmonary hypertension.
Adverse effects include:
- bleeding
Overdose can be treated with aminophylline
T1/2 = 40 minutes (alpha) and 10 hours (beta)
Bumetanide
loop diuretic
Furosemide
loop diuretic
Nicorandil
Vasodilatory drug used to treate angina.
Adverse effects include:
- palpitations
- weakness
- vomiting
Dual properties of nitrate (large coronary arteries) and K+ATP channel (coronary vascular resistance) agonist.
T1/2 = 1 hour
Isosorbide mononitrate
nitrate
GTN
nitrate
Prothrombin complex
A combination of:
- clotting factor II
- clotting factor VII
- clotting factor IX
- clotting factor X
- protein C
- protein S
Used to reverse the effects of anticoagulation therapy when bleeding occurs.
Spironolactone
A potassium sparing diuretic used primarily as a diuretic and antihypertensive in the treatment of heart failure and hypertension.
A competitive aldosterone receptor antagonist.
Adverse effects include:
- urinary frequency
- ataxia
- drowsiness
- dry skin
- rashes
- gynaecomastia
- femisation
- impotence
- hyperkalaemia
- GI upset
- immunosuppression
T1/2 = 1.3-2 hours
