Common CV Drugs Flashcards
(90 cards)
1
Q
describe the cardiovascular continuum
A
risk factors endothelial dysfunction atherosclerosis coronary artery disease plaque rupture (can lead to stroke) myocardial infarction dilatation/remodelling heart failure end stage heart disease
2
Q
name anti cholesterol drugs
A
statins
fibrates
PCSK 9 inhibitors
3
Q
name anti hypertensive drugs
A
thiazide diuretics
beta blockers
vasodilators
4
Q
name statins
A
simvastatin
atorvastatin
5
Q
name PCSK 9 inhibitors
A
evolocumab
alirocumab
6
Q
name vasodilators
A
calcium antagonists
alpha blockers
ACE inhibitors (ACEI)
angiotensin receptor blockers (ARB)
7
Q
describe statins mechanism of action
A
blocks HMG CoA reductase
8
Q
use of statins
A
hypercholeterolaemia diabetes angina/MI CVA/TIA high risk of MI and CVA
9
Q
side effects of statins
A
myopathy rhabdomyolysis (renal failure)
10
Q
use of fibrates
A
hypertriglyceridaemia
low HDL cholesterol
11
Q
mechanism of PCSK 9 inhibitors
A
by inhibiting the binding of PCSK9 to LDLR, they increase the number of LDLRs available to clear LDL, thereby lowering LDL-C levels
12
Q
use of PCSK 9 inhibitors
A
for familial hypercholesterolaemia
13
Q
results of hypertension
A
stroke blindness heart attack and heart failure kidney failure arteriosclerosis
14
Q
name anti hypertensive drugs
A
thiazide diuretics
beta blockers
vasodilators
15
Q
mechanism of action of diuretics
A
block Na reabsorption in kidneys
16
Q
describe thiazide diuretics
A
mild
eg bendrofluazide
used in hypertension
17
Q
describe loop diuretics
A
stronger
eg furosemide
used in heart failure
18
Q
diuretic side effects
A
hypokalaemia- tired arrhythmias hyperglycaemia- diabetes increase in uric acid- gout impotence
19
Q
mechanism of action of beta blockers
A
block B1 and sometimes B2 adrenoreceptors
20
Q
describe cardioselective B blockers
A
only block B1 receptors
21
Q
name cardioselective B blockers
A
atenolol
bisoprolol
22
Q
use of cardioselective B blockers
A
angina acute coronary syndrome myocardial infarction hypertension heart failure
23
Q
mechanism of action of non selective B blockers
A
block B1 and B2 receptors
24
Q
name non selective beta blockers
A
propranolol
carvedilol
25
use of non selective beta blockers
thyrotoxicosis
| migraine
26
beta blocker side effects
asthma- contraindicated in brittle/severe asthma
tired
heart failure (can worsen it in short term)
cold peripheries
27
name the two types of calcium antagonists
dihydropyridines
| rate limiting calcium antagonists
28
name dihydopyridines
amlodipine
29
use of dihydropyridines
hypertension
| angina
30
side effect of dihydropyridines
ankle oedema
31
name rate limiting calcium antagonists
verapamil
diltiazem
(avoid use with beta blockers)
32
use of rate limiting calcium antagonists
hypertension
angina
supracalvicular arrhythmias
33
describe mechanism of action of ACE inhibitors
block angiotensin I becoming angiotensin II
34
name an ACE inhibitor
lisinopril
| never use in pregnancy induced hypertension
35
describe the effect of ACE inhibitors and angiotensin receptor blockers on kidneys
good for kidneys in diabetic nephropathy
| bad for kidneys in renal artery stenosis
36
side effects of ACE inhibitors
cough
renal dysfunction
angioneurmtic oedema
37
describe the mechanism of action of angiotensin receptor blockers
block angiotensin II receptors
38
name an angiotensin receptor blocker
losartan
| never use in pregnancy induced hypertension
39
use of angiotensin receptor blockers
hypertension
| heart failure
40
side effects of angiotensin receptor blockers
```
renal dysfunction
(no cough)
```
41
mechanism of action of alpha blockers
block alpha adrenoreceptors to cause vasodilation
42
use of alpha blockers
hypertension
| prostatic hypertrophy
43
name an alpha blocker
doxazosin
44
side effect of alpha blockers
postural hypotension
45
mechanism of action of mineralocorticoid antagonists
block aldosterone receptors
46
use of mineralocorticoid antagonists
heart failure
| resistant hypertension
47
name mineralocorticoid antagonists
spironolactone
| eplerenone
48
side effects of mineralocorticoid antagonists
gynaecomastia
hyperkalaemia
renal impairment
49
name anti anginal drugs
vasodilators
slow heart rate
metabolic modulators
50
name vasodilators used in angina
nitrates
nicorandil
calcium antagonisti
51
name drugs used to slow heart rate
beta blockers
calcium antagonists
ivabradine
52
name the metabolic modulator used in angina
ranolazine
53
describe the mechanism of action of nitrates
ventilators
54
name a nitrate
isosorbide mononitrate
55
use of nitrates
angina
| acute heart failure
56
side effects of nitrates
headaches
| hypotension/collapse
57
treatment of tolerance of nitrates
leave 8hr/day nitrate free
58
mechanism of action of nicorandil
K ATP channel activator
59
side effects of nicorandil
headache
| mouth/ GI ulcers
60
describe ivabradine
If channel modulator in the sinus node
slows HR only in sinus rhythm
does not work in atrial fibrillation
altered visual disturbance
61
describe ranolazine
late sodium channel modulator
decrease calcium load on heart
effective in refractory angina
62
what is acute coronary syndrome
unstable angina
NSTEMI
STEMI
63
name anti thrombotic drugs
```
anti platelet drugs
anticoagulants
warfarin
rivaroxaban
dabigatran
edoxaban
fibrinolytic
```
64
name antiplatelets
aspirin
clopidogrel
prasugrel
ticagrelor
65
name anticoagulants
heparin
| fondaparinux
66
name fibrinolytics
streptokinase
| tPA
67
role of antiplatelet agents
all prevent new thrombosis
68
use of antiplatelet agents
angina
acute MI
CVA/TIA
patients at high risk of MI and CVA
69
side effects of antiplatelet agents
haemorrhage anywhere
peptic ulcer which can lead to a haemorrhage
aspirin sensitivity which results in asthma
70
role of anticoagulants
prevent new thrombosis
71
mechanism of action of warfarin
block clotting factors 2,7,9,10
72
use of warfarin
deep vein thrombosis
pulmonary embolism
NSTEMI
atrial fibrillation
73
side effects of warfarin
haemorrhage anywhere
74
heparin use
IV only
75
warfarin use
oral only
control dose carefully by INR
reversed by vitamin K
76
rivaroxaban
anticoagulant
| factor X a inhibitor
77
dabigatran
anticoagulant
thrombin factor Ica inhibitor
Xa converts prothrombin (II) to thrombin (IIa)
78
role of fibrinolytic drugs
dissolve formed clot
79
use of fibrinolytic drugs
```
STEMI
PE (selected cases only)
CVA (selected cases only)
```
80
side effects of fibrinolytics
haemorrhage serious risk
81
when to avoid fibrinolytics
```
recent haemorrhage (some CVAs)
trauma
bleeding tendencies
severe diabetic retinopathy
peptic ulcer
```
82
name atrial fibrillation drugs
rate control with BB, digoxin or rate limiting calcium channel blockers
or chemically cardiovert with amiodarone
83
name heart failure drugs
```
ACE inhibitors
ARBs
BBs
mineralocorticoid antagonists
neprilusin inhibitor
diuretics
digoxin
```
84
name a neprilysin inhibitor
salcubitril valsartan
85
describe the 2 effects of digoxin
blocks atrial-ventiruclar conduction
| increases ventricular irritability which produces ventricular arrhythmias
86
effect of blocking AV conduction by digoxin
produces a degree of AV conduction delay
good in AF
if excessive, bad because HR falls too much giving bradycardia and heart block
87
effect of increasing ventricular irritability by digoxin
always bad
| -ve therapeutic index
88
digoxin toxicity
nausea, vomiting
yellow vision
bradycardia, heart block
ventricular arrhythmias
89
mechanism of action of a neprilysin inhibitor
ARB and endopeptidase inhibitor
| superior to ACEI or ARB
90
side effects of neprilysin inhibitor
hypotension
renal impairment
hyperkalaemia
angioneutoritc oedema
