Name drug classes which are used to treat hypertension?
Thiazide Diuretics Beta Blockers Calcium Antagonists Alpha Blockers ACE Inhibitors (ACEI) Angiotensin Receptor Blockers (ARB)
Name drug classes used in the treatment of angina?
Beta Blockers
Calcium Antagonists
Nitrates
Name 4 anti platelet drugs
Aspirin, Clopidogrel, Prasugrel, Ticagrelor
Name 3 anticoagulant drugs
Warfarin, Rivaroxaban, Dabigatran
Name two fibrinolystics
Streptokinase
tPa
Name two classes of anti cholesterol drugs?
Statins
Fibrates
What is the rough mechanism of diuretics?
Block Na reabsorption in the kidneys
Name a thiazide diuretic? When is it used?
bendroflumethiazide
used in hypertension
Name a loop diuretic? When is it used?
furosemide
used in heart failure
Which is the stronger from of diuretic?
Loop diuretics
What are some side effects of diuretics?
hypokalaemia- tired arrhythmias hyperglycaemia- diabetes increased uric acid= gout impotence
Name a cardioselective B blocker
atenolol
When are cardioselective b blockers used?
angina
hypertension
heart failure
name a non-selective b blocker
propanolol
When are non-selective b blockers used?
thyrotoxicosis
What are the side effects of b blockers?
NEVER use in asthma
tiredness
heart failure-short term worsening
cold peripheries
What are the two classes of calcium antagonists?
Dihydropiridines
Rate limiting calcium antagonists
When are Dihydropiridines used?
hypertension
anina
not in hf
name a Dihydropiridine
amlodipine
Name two rate limiting calcium antagonists
verapamil
diltiazem
What is a side effect of Dihydropiridines?
ankle oedema
When are rate limiting calcium antagonists used?
hypertension and angina (not common due to AV node block)
supraventricular arrhythmias (AF, SVT)
when should rate limiting calcium antagonists be avoided?
if patient is on a b blocker
What is the primary effect of alpha-blockers?
Vasodilatation
When are alpha-blockers used?
hypertension
prostatic hypertrophy (doxazosin)
What is a side effect of alpha blockers?
Postural hypotension
What is the primary function of ACE inhibitors?
block angiotensin I becoming angiotensin II
Name an ACE inhibitor.
lisinopril
When are ACE inhibitors used?
hypertension
HF
What potential adverse effects can ACE inhibitors cause?
Good for kidneys in diabetic nephropathy
Bad for kidneys in renal artery stenosis
What are common side effects of ACE inhibitors?
cough
renal dysfunction
angioneurotic oedema
life threatening- allergic response where there is blotch and swollen tissue- including the larynx, causing asphyxiation (commoner in black people due to genetics)
when should ACE inhibitors not be used?
pregnancy induced hypertension
What is the primary function of angiotensin receptor blockers?
Block angiotensin II receptors
Name an angiotensin II receptor blocker
losartan
When are angiotensin II receptor blockers used?
Hypertension
heart failure
What alternative effects to angiotensin II receptor blockers have?
good in diabetic neuropathy
bad in a renal artery stenosis
What are common side effects of
Angiotensin receptor blockers?
renal dysfunction
no cough
When should
Angiotensin receptor blockers not be used?
When pregnant
What is the primary function of nitrates?
venodilators
Name a nitrate
isosorbide mononitrate
When are nitrates used?
Angina
acute heart failure
What are common side effects of nitrates?
headaches
hypotension/collapse
What is the problem with nitrates?
Tolerance
What are anti platelet drugs used for?
To prevent a new thrombosis
When are anti platelets prescribed?
angina
acute MI
CVA/TIA
What are the side effects of anti platelet medications?
haemorrhage anywhere
What other conditions should be considered when prescribing anti platelet agents?
Peptic ulcers
Aspirin sensitivity –> asthma
What do anticoagulants do?
Prevent a new thrombus
How is heparin administered?
IV only
How is warfarin administered
Oral use
What does warfarin do?
block clotting factors (2, 7, 9, 10)
When is warfarin used?
DVT
PE
NSTEMI
AF
what is the side effects of warfarin?
Haemorrhage risk
What can be do if too much warfarin is administered?
Vitamin K
What is rivaroxiban?
Factor X a inhibitor
What is dabigatran?
Thrombin factor IIa inhibitor
What does Xa do?
Converts prothrombin II to prothrombin IIa
What do fibrinolytic drugs do?
Dissolve a formed clot
When are fibrinolytic used?
STEMI
PE
CVA
What are the side effects of fibrinolyticd
haemorrhage
When should fibrinolytic be avoided?
recent haemorrhage trauma bleeding tendencies severe diabetic retinopathy peptic ulcer
What are the two classes of anti-cholesterol drugs?
Statins
Fibrates
Name a statin
Simvastatin
What do statins do?
Block HMG CoA reductase
When are statins used?
hypercholesterolaemia
diabetes
angina/MI
CVA/TIA
What are the side effects of statins?
myopathy
rhabdomyolisis
renal failure
Name a fibrate
Benzafibrate
When are fibrates used?
hypertriglyceridaemia
low HDL cholesterol
What antiarrhythmic drug would be used in a supra ventricular arrhythmia e.g. SVT?
Adenosine in acute phase
What would be used in “ ventricular and supraventricular arrhythmias?
Amiodarone
B-blockers
Flecainide
What are the issues with amiodarone?
takes a long time to accumulate and therefore to clear
phototoxicity (sun-sensitivity)
pulmonary fibrosis
thyroid abnormalities
What are the two effects of digoxin?
- blocks AV conduction
2. increases ventricular irritability which produces ventricular arrhythmias
What can digoxin be useful for?
AF
What can digoxin toxicity manifest as?
nausea vomiting yellow vision bradycardia, heart block ventricular arrhythmias