Improved cardiovascular drugs

Goal of antihypertensives?

Lower BP → prevent stroke, MI, Kidney damage

Cause of angina pain

O2 Supply is lower than body needs → myocardial ischemia

Main issue in heart failure

Heart can’t pump enough blood

What causes thromboembolism?

Clot formation → travels → blocks vessel

ACE inhibitor suffix?

-pril

ARB suffix?

-sartan

Beta blocker suffix?

-olol

DHP calcium channel blocker suffix?

-Dipine

Factor Xa inhibitor suffix

-xaban

Statin suffix?

-statin

ACE inhibitors mechanism?

↓ Ang II → vasodilation → ↓BP

ACE inhibitors effect on bradykinin?

↑ bradykinin → vasodilation

ACE inhibitors main uses?

HTN, HF, MI, Diabetic nephropathy

ACE inhibitors key side effects?

• cough

• hyperkalaemia

• angioedema

ACE inhibitors contraindication?

Pregnancy, renal artery stenosis

ARB’s mechanism

Block AT1 receptor → ↓ Ang II effects of inc BP, blood flow etc.

ARB’S effect on BP?

↓ vasoconstriction and ↓ aldosterone → ↓BP

ARB’s key side effect?

Hyperkalaemia

ARB’s advantages over ACE inhibitors?

No cough (no bradykinin effect)

ARBS contraindication?

Pregnancy

Beta blockers mechanism

Block B1 to lower HR and contractility

Beta blockers uses?

HTN, angina, HF, dysrhythmias

Beta blockers key side effects?

• Bradycardia, fatigue

Beta blockers danger in asthma?

Bronchoconstriction

CCB mechanism?

Block Ca2+ channels → ↓contraction

CCB effect?

Vasodilation + ↓HR

Non-DHP CCB effect on heart?

↓HR

DHP CCB main effect?

Vasodilation

CCB key side effects?

Hypotension, oedema, bradycardia

Loop diuretics mechanism?

Block NA-K-2Cl in loop → ↑ urine volume

Loop diuretics effect?

↓ volume → ↓ BP

Loop diuretics key side effect?

Electrolyte loss

Thiazide mechanism?

Block Na/Cl in distal tubule

Thiazide unique effect?

↑ calcium reabsorption

Aldosterone antagonists mechanism?

Block aldosterone —> ↑ Na + water retention

Aldosterone antagonists key side effect?

Hyperkalaemia

Amiodarone mechanism?

K+ channel blocker → prolong repolarisation

Amiodarone key side effects?

Thyroid, lung, skin issues

Flecainide mechanism?

Na+ channel blocker

Digoxin mechanism?

Inhibit Na+/K+ ATPase → ↑ Ca2+

Digoxin effect?

↑ contractility, ↓ HR

Digoxin toxicity signs?

Nausea, vision changes, arrhythmias

ARNI

Angiotensin receptor-neprilysin inhibitors

ARNI example/common names?

Sacubitril = neprilysin inhibitor

Valsartan = angiotensin receptor blocker (ARB)

ARNI mechanism?

block Ang II, neprilysin inhibition

Nitrates mechanism?

• They are direct vasodilators

• ↑ NO → vasodilation

Nitrates effect?

↓ preload → ↓ cardiac workload

Nitrates main use?

Angina relief

Nitrates key side effect?

Headache

Warfarin mechanism?

Inhibits vitamin K needed for clotting → ↓ clotting factors

Warfarin major risk?

• Is an anticoagulant

• Bleeding

Xa inhibitors mechanism?

• Is an anticoagulant

• Block factor Xa → ↓ thrombin

Dabigatran mechanism?

• is an anticoagulant

• Direct thrombin inhibitor

Aspirin Mechanism?

• Is an antiplatelet

• COX inhibition to ↓ platelets

P2Y12 inhibitors mechanism?

• antiplatelet

• Block ADP receptor → ↓ platelet aggregation

Statins mechanism?

Inhibit HMG-CoA reductase

Statins effect?

↓ cholesterol

Statins key side effect?

Muscle pain (myopathy)