Coronary Heart Disease and Stroke Drugs Flashcards
(26 cards)
Which drugs are used to reduce oxygen demand in cardiovascular disease?
Beta-blockers (to reduce heart rate)
Nitrovasodilators (to reduce contraction strength)
Antihypertensives (to reduce arterial resistance)
Which drugs are used to increase oxygen supply in cardiovascular disease?
Antiplatelet drugs (decrease risk of clotting)
Cholesterol-lowering drugs (prevent atheroma formation, open up heart arteries)
During a myocardial infarction which drugs are used?
Major painkillers
Thrombolytics
Anti-arrhythmia drugs
Beta blockers
ACE inhibitors
What are the forms of glyceryl trinitrate?
Sublingual tablet
Nasal spray
Transdermal patch
Which of the clot-busting drugs must be administered within a few hours of onset of stroke in order to be effective?
Alteplase
What is the mechanism of action of nitrovasodilators?
Produce nitric oxide
Increases cGMP in muscle cells
Muscle relaxes
Vessels dilate
What are the side-effects associated with nitrovasodilators?
Throbbing headache (cerebral vasodilation)
Postural hypotension
Dizziness
Which drugs are cholesterol reducing?
Statins
Ezetimibe
Resins
Nicotinic acid
Which drugs are triglyceride reducing?
Statins
Fibrates
Omacor
Metformin
Nicotinic acid
Acipimox
What is the mechanism of action of statins?
Work as an HMG -CoA reductase inhibitor
HMG-CoA reductase is a rate-limiting step in cholesterol synthesis
What are the side-effects associated with statins?
GI upset
Abnormal liver tests
Myopathy (rare)
What are the two types of stroke?
Ischaemic stroke
Haemorrhagic stroke
In ischaemic stroke, what kind of lesion is produced?
A lesion with a central core surrounded by ischaemic penumbra
Due to necrosis and cerebral oedema and inflammation
What type of drugs are used to activate fibrinolysis?
Recombinant tissue plasminogen activators
eg. Alteplase
What are the mechanisms to inhibit platelet aggregation and thrombus formation?
Preventing GP11a/11b receptor expression
Preventing GP11a/11b receptor interaction
Which drugs are used to prevent GP11a/11b receptor expression?
Aspirin
Dipyridamole
Clopidogrel
How does aspirin preventGP11a/11b receptor expression?
By inhibiting the COX1 enzyme
How does dipyridamole preventGP11a/11b receptor expression?
By inhibiting thromoxane synthase and therefore preventing thromboxane formation
How does clopidogrel preventGP11a/11b receptor expression?
By antagonising the actions of ADP at the purinergic receptors
Which drug is used to prevent GP11a/11b receptor interaction and how does it work?
Abciximab
Binds to receptors to prevent linking of platelets to fibrinogen fibres
What are the mechanisms of action of anticoagulant drugs?
Activation of antithrombin
Inhibition of vitamin K reductase
Direct selective inhibition of steps in the clotting cascade
Which drugs work by activating antithrombin?
Heparins: Activate the body’s own antithrombin III
What are the different types of heparin?
Original unfractionated heparin
Low molecular weight heparin (fragments of heparin)
Which drugs work by inhibiting vitamin K reductase?
Warfarin
Acts on the liver to inhibit vitamin K reductase, which gradually diminishes the concentrations of clotting factors, so less fibrin can be made by the body
