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cardioresp drugs > ischemic heart disease > Flashcards

ischemic heart disease Flashcards

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1
Q

cardioselective BB

A

Atenolol, Metoprolol, Nebivolol

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2
Q

non cardioselective BB

A

Carvedilol, Propranolol

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3
Q

cardioselective receptor

A

β1

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4
Q

Bisoprolol target

A

Beta adrenoceptors

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5
Q

Bisoprolol moa

A

Inhibits binding of normal ligand noradrenaline released from sympathetic adrenergic neurones. This inhibits activation of adenylyl cyclase enzymes leading to reduced cyclic AMP. This in turn leads to reduced intracellular calcium levels.

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6
Q

Bisoprolol common side effects

A

Dizziness; Headache, fatigue, cold hands, impotence

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7
Q

Bisoprolol important side effects

A 
Hypotension 
Bronchoconstriction
Bradycardia and heart block 
Hypoglycaemia 
Peripheral vasoconstriction
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8
Q

Bisoprolol and Peripheral vasoconstriction issue

A

intermittent claudication and Raynaud’s phenomenon

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9
Q

Calcium channel blockers

A

Amlodipine
Diltiazem
Verapamil

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10
Q

amlodipine drug class

A

Dihydropyridine calcium channel blockers

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11
Q

amlodipine target

A

L-type calcium channels

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12
Q

amlodipine moa

A

Inhibit influx of calcium ions into vascular smooth muscle cells through L-type calcium channels

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13
Q

amlodipine affect overall

A

ecreased arterial smooth muscle contratility leading to vasodilatation

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14
Q

amlodipine common side effects

A

Flushing; Headache; Tachycardia; Peripheral oedema

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15
Q

amlodipine bad side effects

A

Heart failure in patients with poor left ventricular function

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16
Q

diltiazem target

A

L-type calcium channels

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17
Q

diltiazem drug class

A

Rate-limiting calcium channel blocker

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18
Q

diltiazem action

A

Inhibit influx of calcium ions into cardiomyocytes through L-type calcium channels

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19
Q

diltiazem common side effects

A 
Headache 
Flushing 
Tachycardia 
Peripheral oedema 
Constipation
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20
Q

diltiazem bad side effect

A

Sino-atrial and AV block

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21
Q

verapamil drug class

A

Class IV anti-arrhythmia agent CCB

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22
Q

verapamil inhibits

A

voltage-dependent calcium channels

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23
Q

GTN target

A

Nitrate membrane receptor

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24
Q

GTN moa

A

Inhibits the entry of calcium ions into the cell leading to reduced intracellular calcium levels

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25
GTN effect
Vascular smooth muscle relaxation and vasodilatation
26
bad thing about long term GTN
tolerance
27
what are nitrites metabolised to
NO
28
what does NO do
stimulates guanylate cyclase enzymes to increase production of the second messenger cyclic GMP
29
name a potassium channel opener
Nicorandil
30
nicorandil drug class
Potassium channel activator
31
nicorandil two moas
Potassium channel activator | Nitrate like effect
32
how does nicorandil work as a k+ channel activator
Opens ATP-dependent potassium channels, causing K+ to leave the cell. This results in hyperpolarisation of the cell membrane, closure of voltage-gated Ca2+ channels and a reduction in intracellular calcium.
33
nicorandil nitrate moa
Stimulates guanylate cyclase enzymes to increase production of the second messenger cyclic GMP (cGMP). This inhibits the entry of calcium ions into the cell leading to reduced intracellular calcium levels.
34
Anti-platelet agents
``` Aspirin Clopidogrel Ticagrelor Dipyridamole Tirofiban ```
35
aspirin target
COX
36
aspirin moa
Impairs synthesis of thromboxane A2 and prostacyclin = platelets cant aggregate
37
aspirin bad side effect
GI irritation, ulceration and bleeding | Bronchospasm
38
what can be co prescribed with aspirin to avoid GI upset
PPI
39
dipyridamole drug class
antiplatelet
40
dipyridamole 3 moas
1. Inhibitor of platelet phosphodiesterase 2. Blocks adenosine uptake into RBCs, 3. Potentiation of PGI2 anti-aggregatory activity and enhancement of PGI2 biosynthesis
41
dipyridamole bad adverse effects
Haemorrhage; Hypotension; Worsening symptoms of coronary artery disease
42
what happens if adenosine cant get into RBCs
increases plasma adenosine levels which has a vasodilatory and anti-platelet effect
43
what happens if platelet phosphodiesterase is inhibited
cyclic AMP concentration is increased and platelet activity reduced
44
Isosorbide dinitrate is used to treat what
angina
45
what is Isosorbide dinitrate converted to
NO
46
Isosorbide dinitrate moa
converted to NO which activates the enzyme guanylate cyclase stimulates synthesis of cGMP which activates a series of protein kinase-dependent phosphorylations in the smooth muscle cells, eventually resulting in the dephosphorylation of the myosin light chain of the smooth muscle fiber. The subsequent release of calcium ions results in the relaxation of the smooth muscle cells and vasodilation.
47
ivabradine aim
lower heart rate
48
what is guanylate cyclase
atrial natriuretic peptide receptor A
49
what does ivabradine inhibits
if channels
50
ivabradine moa
disrupts If ion current flow, which prolongs diastolic depolarization, lowering heart rate
51
Ranolazine inhibits
peak and late sodium channels | delayed rectifier potassium currents
52
clopidogrel class
P2Y12 antagonist
53
clopidogrel blocks
P2Y12 receptor
54
clopidogrel blocks the binding of what to P2Y12 receptor
ADP
55
clopidogrel reduces activation of what receptor
GPIIb/IIIa receptor
56
clopidogrel overall aim
reduction in fibrinogen binding and thrombus formation
57
what is ADP
platelet agonist | platelet activation
58
ticagrelor blocks what receptors
adenosine diphosphate (ADP) receptors
59
whats good about ticagrelor compared with the others
dosent need liver activion
60
Tirofiban binds to
GP IIb/IIIa receptor
61
Tirofiban antogonises
fibrinogen
62
what is GP IIb/IIIa receptor
the major platelet surface receptor involved in platelet aggregation
63
Alteplase drug class
Tissue plasminogen activator.
64
Alteplase binds to
fibrin rich clots via the fibronectin finger-like domain and the Kringle 2 domain
65
Alteplase moa
protease domain then cleaves the Arg/Val bond in plasminogen to form plasmin
66
what does plasmin do
degrades the fibrin matrix of the thrombus
67
Tenecteplase class
Tissue plasminogen activator
68
Tenecteplase binds to
fibrin rich clots via the fibronectin finger-like domain and the Kringle 2 domain
69
Tenecteplase moa
protease domain then cleaves the Arg/Val bond in plasminogen to form plasmin

cardioresp drugs (13 decks)

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