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10 Cards in this Set
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Medications used in CVD |
•Diuretics •Beta blockers •Ca++Channel blockers •ACE inhibitors •ARBs •Alpha blockers •Nitrates •Antithrombotics |
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What are diuretics? |
•Forces increased urine production Main types = thiazide, loop and potassium sparing Thiazide diuretics inhibit reabsorptionof NaCl in proximal and early distal tubules of nephron (hydrochlorothiazide) •Drugnames tend to end in “ide” Loop diuretics = act on the ascendingloop of Henle (furosemide) Potassium sparing duiretics = donot promote secretion of potassium into the urine (aldosterone antagonistspironolactone) Side effects = electrolyte imbalances(hypokalaemia, hyponatraemia, hyperuricaemia), rash and hyperglycaemia |
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What are beta blockers? |
Used for arrhythmias, angina andhypertension (not first choice for HTN) Block receptor sites for adrenaline andnoradrenaline on adrenergic beta receptors Examples = ‘olol’such as metoprolol, atenolol Reduce heart rate, blood pressure andcardiac output Relative contraindications = Asthma,uncontrolled heart failure, bradycardia Side effects = Fatigue,lethargy, hypotension, cold peripheries, exacerbate bronchospasm and impotence |
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What are calcium channel blockers? |
Anti-hypertensive and anti-anginal drug Vasodilators = reduce systemic vasculartone and increase myocardial oxygen supply by dilating coronary arteries Lower myocardial oxygen demand byreducing blood pressure and myocardial contractility Side effects = General:oedema, flushing, headaches, dizziness, excerbation of heart failure (especially verapamiland diltiasem) Dental:Gingival hyperplasia Drug names tend to end in “-pine” |
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What are ACE inhibitors? |
Drugs used forHTN and congestive heart failure Inhibit the conversion of angiotensin I toangiotensin II Examples = Enalapril, lisinopril Relatively infrequent side effectsexcepts for dry cough Other side effects include = Hypotension, Rash, Hyperkalaemia, Renalfailure, Angioedema, Alteredliver function Need to monitor renal function and serum potassium Drug names tend to end in “-pril” |
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What are Angiotensin II receptor blockers (ARBs)? |
Used for the same indications as ACEinhibitors (hypertension, heart failure, post- myocardial infarction) Have similar effects but mode of actionis different =- ARBsare receptor antagonists that block type 1 angiotensin II (AT1) receptors on bloods vessels and othertissues -ARBsdo not inhibit ACE therefore they do not cause an increase in bradykinin, sothe side effects of a dry cough and angioedema are not produced Examples = ‘artan’ such as losartan, valsartan |
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What are alpha blockers? |
Group of vasodilators used to treathypertension Act as receptor antagonistsof α-adrenergic receptors Examples = ‘azosin’ such as Doxazosin,terazosin (Hytrin) Decrease peripheral vascular resistance –causing relaxation and decreased blood pressure Also relax the smooth muscle in thebladder neck and prostate gland, thus reducing bladder outlet obstruction souseful in men with prostate enlargement Side effects = postural hypotension,headache, tachycardia and oedema |
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What are nitrates? |
•nti-anginal drug Numerous preparations with oral,sublingual (GTN tablets, spray), buccal, transdermal and intravenous forms usedcommonly Examples = Isosorbide mononitrate (Imdur) Provide symptomatic relief of angina Produce NO at the endothelial surfaceleading to vascular smooth muscle relaxation and arteriolar and venousdilatation Reduce myocardial oxygen demand andincrease myocardial oxygen supply (coronary vasodilation) Side effects = headache, flushing,postural hypotension |
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What are anti-thrombics? |
Drugs that reduce thrombosis. Two types: platelet inhibitors and anticoagulants Platelet inhibitors-Inhibitplatelet aggregation and arterial thrombus formation, thus preventing heartattack, stroke and CV death -Aspirin= Blocksplatelet cyclo-oxygenase (COX1) and the production of thromboxane A2, aplatelet activating substance -Thienopyradine(clopidogrel) = PlateletADP receptor antagonist. Maybe used alone or in combination with aspirin -Dipyridamole= Mainlyused in combination with aspirin to prevent stroke All have prolongedaction Anticoagulants -Heparin -Lowmolecular weight heparin - Bindsto the enzyme inhibitor antithrombin III (AT) resulting in itsactivation which then inactivates thrombin and other proteasesinvolved in blood clotting, most notably factor Xa -Factor Xa inhibitor (Rivaroxaban) - Directinhibition of Factor Xa/ thrombin within the coagulation cascade -Warfarin(coumarin) - ½life of 5 d. Measuredby INR,Therapeuticrange 2-3 or 3.5 |
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Summary of uses for each |
Diuretics - HF, HTN B blocker - HTN, angina, arrythmia, HF a blocker - HTN and prostrate Ca blocker - HTN and angina ACE and ARBs - HTN, HF, heart attack (ARBs used when ACE don't work) Nitrates - angina Antithrombelics - prevent clotting disorders |
