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Phase II Drugs List > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

Class Ia
Sodium Channel Blockers

(Anti-arrhythmic Drugs)

A

Disopyramide, Quinidine

MoA:
Voltage-sensitive sodium channel blockade
Prolong QT interval, increase QRS duration.

Indication:
Ventricular and supraventricular arrhythmias

Adverse Effects/Interaction:
Oedema

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2
Q

Class Ib
Sodium Channel Blockers

(Anti-arrhythmic Drugs)

A

Lidocaine

MoA:
Voltage-sensitive sodium channel blockade
Prolong QT interval, increase QRS duration.

Indication:
CPR (used IV)

Adverse Effects/Interaction:
Oedema

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3
Q

Class Ic
Sodium Channel Blockers

(Anti-arrhythmic Drugs)

A

Flecainide, Propafenone

MoA:
Voltage-sensitive sodium channel blockade
Prolong QT interval, increase QRS duration.

Indication:
Paroxysmal atrial fibrillation and ventricular ectopic beats “pill in pocket”

Adverse Effects/Interaction:
Oedema

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4
Q

Class II
Beta blockers
(Beta-adrenergic antagonists)

(Anti-arrhythmic Drugs)

A

Bisoprolol, Atenolol (Beta-1 selective); Propranolol (Beta-1 & Beta-2 selective)

MoA:
Beta-adrenergic receptor blockade – reduction in adrenergic effects on rate and inotropy

Indication:
Prophylaxis of paroxysmal atrial tachycardia or fibrillation

Adverse Effects/Interaction:
Hypotension

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5
Q

Class III
Potassium Channel Blockers

(Anti-arrhythmic Drugs)

A

Amiodarone, Dronedarone, Sotalol (Sotalol also has some beta blocker activity)

MoA:
Potassium channel blockade, also evidence of beta blocker and calcium channel blocker properties – prolong QT interval

Indication:
Supraventricular, nodal and ventricular tachyarrhythmias, atrial fibrillation
(CPR - used IV)

Adverse Effects/Interaction:
Nausea, vomiting

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6
Q

Class IV
Calcium Channel Blockers (phenylalkylamine & benzothiazepine subclasses

(Anti-arrhythmic Drugs)

A

Verapamil, Diltiazem (for arrhythmia)

MoA:
Cardiac calcium channel blockade – reduction of action potential & cardiac output

Indication:
Supraventricular tachycardia (especially paroxysmal SVT)

Adverse Effects/Interaction:
Hypotension (verapamil)
Constipation (diltiazem)

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7
Q

Cardiac Glycosides

Anti-arrhythmic Drugs

A

Digoxin

MoA:
Reduces conductivity of atrioventricular node

Indication:
Arrhythmias – atrial fibrillation, congestive heart failure

Adverse Effects/Interaction:
Fatigue, nausea

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8
Q

Adenosine

Anti-arrhythmic Drugs

A

Adenosine

MoA:
Activates adenosine receptors – causes hyperpolarization
Slows conduction through AV Node

Indication:
Supraventricular tachycardia

Adverse Effects/Interaction:
Nausea
*contraindicated in obstructive airway disease

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9
Q

Antimuscarinic

Anti-arrhythmic Drugs

A

Atropine

MoA:
Blockade of vagal muscarinic acetylcholine receptors

Indication:
Emergency bradycardia

Adverse Effects/Interaction:
Urinary retention

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10
Q

Magnesium

Anti-arrhythmic Drugs

A

Magnesium sulfate (intravenous)

MoA:
Unclear – possible alteration of Na+, K+ and Ca2+ ion balance via ion channels and transporters

Indication:
Emergency arrhythmia
(Also used IV for emergency asthma)

Adverse Effects/Interaction:
Electrolyte irregularities

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11
Q

Loop Diuretics

Diuretics

A

Furosemide

MoA:
Inhibits Na+/K+/2Cl- transporter in loop of Henle

Indication:
Left ventricular heart failure, oedema

Adverse Effects/Interaction:
Nausea, dizziness
NSAIDs, ACE inhibitors

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12
Q

Thiazides

Diuretics

A

Indapamide
Bendroflumethiazide
Chlorthalidone
Hydrochlorothiazide

MoA:
Decreases sodium and chloride reabsorption

Indication:
Hypertension

Adverse Effects/Interaction:
Electrolyte imbalance, exacerbation or precipitation of gout
NSAIDs, digoxin

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13
Q

Potassium Sparing Diuretics

Diuretics

A

Spironolactone, Epleronone
Amiloride

MoA:

Mineralocorticoid receptor blockade (spironolactone, epleronone)
Blockade of sodium reabsorption via ENaC channel (amiloride)

Indication:
Oedema, congestive heart failure

Adverse Effects/Interaction:
Gastrointestinal
NSAIDs, ACE inhibitors

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14
Q

Osmotic Diuretics

Diuretics

A

Mannitol

MoA:
Elevates plasma osmolarity

Indication:
Cerebral oedema, intra-ocular pressure

Adverse Effects/Interaction:
Hypotension

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15
Q

Carbonic Anhydrase Inhibitors

Diuretics

A

Acetazolamide

MoA:
Reduces aqueous humour volume

Indication:
Intra-ocular pressure – open & acute closed angle glaucoma

Adverse Effects/Interaction:
Paraesthesia

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16
Q

Carbonic Anhydrase Inhibitors

Diuretics

A

Acetazolamide

MoA:
Reduces aqueous humour volume

Indication:
Intra-ocular pressure – open & acute closed angle glaucoma

Adverse Effects/Interaction:
Paraesthesia

17
Q

Angiotensin-converting enzyme (ACE) inhibitors

Drugs acting on heart and circulation

A

Ramipril
Captopril
Lisinopril

MoA:
Inhibits conversion of angiotensin I to II. Blocks vasoconstriction

Indication:
Hypertension, diabetic nephropathy, heart failure

Adverse Effects/Interaction:
Cough, hyperkalemia
Lithium, NSAIDs

18
Q

Angiotensin II receptor blockers (ARBs)

Drugs acting on heart and circulation

A

Losartan, Valsartan

MoA:
Blocks angiotensin-renin system

Indication:
Hypertension, diabetic nephropathy, heart failure

Adverse Effects/Interaction:
Hypotension, fatigue
Diuretics

19
Q

Neprilysin inhibitors (used in combination with an ARB)

Drugs acting on heart and circulation

A

Sacubitril (in combination with the ARB Valsartan)

MoA:
Inhibition of natriuretic peptide breakdown

Indication:
Heart failure (with reduced ejection fraction)

Adverse Effects/Interaction:
Hypokalaemia, hypoglycaemia (from BNF)

20
Q

Beta adrenergic receptor antagonists (beta blockers)

Drugs acting on heart and circulation

A

Bisoprolol, Atenolol (Beta-1 selective); Propranolol (Beta-1 & Beta-2 selective)

MoA:
Negative inotropic/
chronotropic agent

Indication:
Hypertension, stable angina

Adverse Effects/Interaction:
Bradycardia, bronchospasm
NSAIDs, digoxin

21
Q

Alpha adrenergic receptor antagonists (Alpha blockers)

Drugs acting on heart and circulation

A

Doxazosin

MoA:
Vasodilator, decreases total peripheral resistance

Indication:
Hypertension, (see also BPH)

Adverse Effects/Interaction:
Dizziness, headache
Hypotensive drugs

22
Q

Calcium channel antagonists
(Calcium channel blockers)

(Drugs acting on heart and circulation)

A

Amlodipine
Nifedipine
Diltiazem

MoA:
Blockade of vascular smooth muscle contraction

Indication:
Hypertension, stable angina

Adverse Effects/Interaction:
Ankle swelling, oedema
Beta blockers, digoxin

23
Q

Nitrates

Drugs acting on heart and circulation

A 
Glyceryl trinitrate (GTN),
Isosorbide mononitrate (ISMN)

MoA:
Nitric oxide release, leading to smooth muscle relaxation & vasodilation

Indication:
Acute angina pectoris (GTN), heart failure

Adverse Effects/Interaction:
Hypotension, headache
Antihypertensives

24
Q

Sympathomimetics

Drugs acting on heart and circulation

A

Adrenaline
Dobutamine
Noradrenaline

MoA:
Adrenergic stimulation, increased inotropy

Indication:
Cardiac arrest, cardiogenic shock

Adverse Effects/Interaction:
Arrhythmia

25
Q

Antiplatelet drugs

Drugs acting on heart and circulation

A

Aspirin,
Clopidogrel

MoA:
Inhibition of thromboxane synthesis (aspirin).
Inhibition of platelet activation by ADP (clopidogrel).

Indication:
Primary and secondary relief for CVD, anticoagulant prophylaxis

Adverse Effects/Interaction:
Gastrointestinal irritation & bleeding
Anticoagulants

26
Q

Anticoagulants - coumarin

Drugs acting on heart and circulation

A

Warfarin

MoA:
Inhibition of Vitamin K epoxide reductase complex 1 (VKORC1) enzyme

Indication:
Deep vein thrombosis, prophylaxis of stroke from atrial fibrillation

Adverse Effects/Interaction:
Abnormal bleeding,
Multiple drug interactions, notably NSAIDs, diuretics

27
Q

Anticoagulants - coumarin

Drugs acting on heart and circulation

A

Warfarin

MoA:
Inhibition of Vitamin K epoxide reductase complex 1 (VKORC1) enzyme

Indication:
Deep vein thrombosis, prophylaxis of stroke from atrial fibrillation

Adverse Effects/Interaction:
Abnormal bleeding,
Multiple drug interactions, notably NSAIDs, diuretics

28
Q

Anticoagulants – direct thrombin inhibitor

Drugs acting on heart and circulation

A

Dabigatran

MoA:
Inhibition of thrombin (also called Factor IIa)

Indication:
Prophylaxis of venous thromboembolism post-surgery

Adverse Effects/Interaction:
Abnormal bleeding

29
Q

Anticoagulants – direct Factor Xa inhibitors

Drugs acting on heart and circulation

A

Apixaban, Edoxaban, Rivaroxaban

MoA:
Inhibition of Factor Xa in coagulation cascade

Indication:
Prophylaxis of stroke from atrial fibrillation; DVT

Adverse Effects/Interaction:
Abnormal bleeding

30
Q

Anticoagulants - heparins

Drugs acting on heart and circulation

A

Dalteparin, Tinzaparin, Enoxaparin (low molecular weight); unfractionated heparins

MoA:
Inactivation of thrombin and Factor Xa via complexing antithrombin III

Indication:
Prophylaxis of venous thrombosis and pulmonary embolism

Adverse Effects/Interaction:
Abnormal bleeding

31
Q

Thrombolytics/Fibrinolytics

Drugs acting on heart and circulation

A

Alteplase, Streptokinase, Urokinase

MoA:
Activation of plasminogen for proteolytic breakdown of thrombus fibrin

Indication:
Myocardial infarction, ischaemic stroke

32
Q

HMG-CoA Reductase inhibitors

Drugs acting on heart and circulation

A

Simvastatin, Atorvastatin (statins)

MoA:

Inhibition of mavelonate pathway required for cholesterol synthesis

Indication:
Hypercholesterolaemia, risk of CVD and stroke

Adverse Effects/Interaction:
Myalgia
Verapamil, macrolides

Phase II Drugs List (10 decks)

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