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Angina And Acs Notes

Pharmacology Notes > Drug Development (BIOL10822) Notes

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e-learning VI - Angina and ACS#
Atorvastatin - A statin. Used to treat high cholesterol levels. Targets HMG-CoA
reductase.
Ezetimibe - Inhibits uptake of dietary cholesterol by blocking a transport protein.
Often given with statins.
Nicotinic acid - Vitamin B3 (niacin). Used to lower cholesterol levels. The mechanism is unclear: much higher doses are needed than for its actions as a vitamin. Causes vasodilation, impaired glucose tolerance and gout.
Fish oils - Used to lower plasma lipids but raises cholesterol levels. Mechanism unclear. Maybe that you have to eat the fish, not just the oil to get the benefits.
Statins - Lipid lowering drugs. Cause muscle inflammation, damage.
Fibrates - Lipid lowering drugs. Cause muscle inflammation, damage and potentially (as a consequence) renal damage. They have a higher risk of muscle problems than do the statins.
Heparin - A naturally occurring sulphated mucopolysaccharide, used to prevent blood clotting. Binds to antithrombin III, and increases its binding of components of the clotting cascade (factors Xa and IIa). Can only be given by injection. Comes in unfractionated an low MW forms. Can cause haemorrhage in overdose.
Warfarin - Analogue of vitamin K. Inhibits vitamin K reductase and reduces plasma levels of vitamin K. Vit K needed to make clotting factors. Can be given orally.
Causes haemorrhage in overdose. Causes birth defects. Lots of interactions with other drugs. Interaction with diet. Difficult to get plasma levels right.
Aspirin - Used to prevent thrombus formation. Inhibits cyclooxygenase I irreversibly.
Platelets use this enzyme to produce thromboxane A2, a signalling molecule that triggers aggregation and activation of other platelets. Platelets are more strongly affected than other cell types because they have no nucleus.
Clopidogrel - An irreversible antagonist at ADP receptors. Acts as an inhibitor of platelet aggregation and is used to prevent thrombosis. Clopidogrel is a second line drug. It is sometimes given in combination with aspirin.

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