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BDS2 BAMS Cardiovascular > 1. Epidemiology and Drugs > Flashcards

1. Epidemiology and Drugs Flashcards

1
Q

CVD risk factors may be (2)

A

Irreversible

Reversible

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2
Q

Irreversible CVD risk factors (3)

A

Age
Sex
Family history/genetics

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3
Q

Reversible CVD risk factors (4)

A

Smoking
Obesity
Diet
Exercise

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4
Q

Modifiable CVD risk factors (4)

A

Hypertension
Hyperlipidaemia
Diabetes
Stress

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5
Q

Types of CVD prevention (2)

A

Primary

Secondary

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6
Q

Examples of primary CVD prevention (3)

A

Exercise
Diet
Smoking cessation
Assess total risk - medical treatment if high risk

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7
Q

Difference between primary and secondary CVD prevention (2)

A

Secondary - primary with medical treatment to reduce risk

Secondary - undertaken after presenting with CVD

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8
Q

Primary prevention approach addresses (6)

A 
Family history
Diet
Smoking
Test cholesterol
Test blood pressure
Test for diabetes
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9
Q

Examples of CVD (4)

A

Angina
Myocardial infarction/heart attack (MI)
Stroke (CVA)
Claudication (leg/calf pains)

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10
Q

Approach to prevention involves (4)

A

Lifestyle changes
Control total cholesterol
Control hypertension
Anti-platelet drugs

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11
Q

Total cholesterol control involves (2)

A

Statin treatment

Reduce <5mmol/l or by 25%

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12
Q

Hypertension control is for (2) and aims to

A

Moderate hypertension
Mild hypertension with evidence of CVD
Reduce BP to < 140/85

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13
Q

Anti-platelets are used when (2)

A

CVD identified

When patient is at high risk of CVD (with no identified disease)

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14
Q

Drugs used in the CVS (2)

A

Prevent further disease

Reduce symptoms of current disease

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15
Q

Drugs which prevent further CVS disease include (4)

A

Anti-platelet drugs
Lipid lowering drugs
Anti-arrhythmic drugs
Anticoagulants

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16
Q

Drugs which reduce symptoms of current disease (5)

A 
Diuretics
Anti-arrhythmic drugs
Nitrates
Calcium channel blockers
ACE inhibitors
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17
Q

Anti-platelet drug aim

A

Significantly reduce chance of MI/CVA in at risk individuals

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18
Q

Anti-platelet drug side effects

A

Prolong bleeding (during extraction)

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19
Q

Types of anti-platelet drugs (3)

A

Platelet aggregation inhibitors (aspirin)
ADP-induced platelet aggregation inhibitors (clopidogrel)
Platelet phosphodiesterase inhibitors (dipyridamole)

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20
Q

Use of more than one anti-platelet drug in combination (3)

A

Decrease platelet aggregation
Decrease thrombosis risk
Increased effect

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21
Q

Anticoagulants used for

A

Those at risk of thrombosis/primary embolism in slow-moving blood areas (legs/ankles)

22
Q

Types of anticoagulants (5)

A 
Warfarin
Heparin
Apixiban
Dabigatran
Rivaroxiban
23
Q

Warfarin action

A

Inhibits synthesis of vitamin-K clotting factors (2, 7, 9, 10, protein C and protein S)

24
Q

Treatment for patient taking warfarin who begins to bleed excessively

A

Flood area with vitamin K

25
Q

Issues with warfarin and treatment (2)

A 
Initial hypercoagulation (anticoagulation takes 2-3 days)
Initially prescribe warfarin with heparin concurrently
26
Q

Warfarin monitoring test and value ranges

A

INR - standardised prothrombin time
1 - normal
2-4 - therapeutic range of patient taking warfarin

27
Q

Anticoagulant/warfarin drug interactions (3)

A

Amoxicillin
Metronidazole
NSAIDs

28
Q

New oral anticoagulants (NOACs) include (3)

A

Rivaroxiban - FX activation inhibitor
Apixiban - direct thrombin inhibitor
Dabigatran - direct thrombin inhibitor

29
Q

NOAC drug interactions (2)

A

Macrolides - erythromycin and clarithromycin

NSAIDs - prolong action and inhibit platelets

30
Q

Statins definition and types (3)

A

Lipid-lowering drugs

Simvastatin, atorvastatin, rosuvastatin

31
Q

Statin side effects

A

Possible myositis with some drug interactions - antifungals

32
Q

Beta-adrenergic blockers function (2)

A

Stop arrhythmias leading to cardiac arrest (VF)

Reduce heart muscle excitation

33
Q

Beta-blocker types (2)

A

Selective B1 only (atenolol) - reduce HR and heart electrical activity leading to prevention of arrhythmias

34
Q

Beta-blocker side effects and contraindications (3)

A

Prevent increase in HR, may lead to postural hypotension
Reduce heart efficiency, worsening HF
Block beta-receptors in lungs, exacerbating asthma

35
Q

Diuretics definition and function

A

Antihypertensive drugs

Used to treat HF

36
Q

Diuretic types (2)

A 
Thiazide diuretics (bendroflumethiazide)
Loop diuretics (frusemide)
37
Q

Diuretics action

A

Increase salt and water loss (reduce plasma volume and cardiac workload)

38
Q

Diuretics side effects (2)

A

Na/K imbalance if not monitored correctly

Xerostomia (in elderly)

39
Q

Nitrates can be (2)

A

Short-acting

Long-acting

40
Q

Use of short-acting diuretics and example

A

Emergency management of angina pectoris

41
Q

Use of long-acting diuretics and example

A

Prevention of angina pectoris - isosorbide mononitrate

42
Q

Action of nitrates (3)

A

Venodilation (dilate veins) - reduce preload to heart
Reduce peripheral resistance (dilate resistance arteries) - reduces cardiac workload and cardiac oxygen consumption
Dilate collateral coronary artery supply - reduces angina pain

43
Q

Method of nitrate administration and why

A

Sublingual, transdermal, IV

Inactivated by first-pass metabolism

44
Q

Nitrates side effects

A

Headaches

45
Q

Function and action of calcium channel blockers

A

Reduce hypertension

By blocking calcium channels in smooth muscle

46
Q

Different calcium channel blockers are more active in different places (2)

A

Peripheral blood vessels - relaxation and vasodilation of arterioles (nifedipine, amlodipine)
Heart muscles - slow conduction of pacing impulses (verapamil)

47
Q

Calcium-channel blockers side effects

A

Gingiva hyperplasia

48
Q

Function ACE inhibitors (2)

A

Reduce BP

Reduce excess salt and water retention (prevent aldosterone-dependent reabsorption of salt and water)

49
Q

Action of ACE inhibitors

A

Inhibit conversion of Angiotensin I into Angiotensin II

50
Q

Side effects of ACE inhibitors (2)

A

Cough

Hypotension

51
Q

Oral reactions to ACE inhibitors (2)

A

Angio-oedema

Lichenoid reactions

52
Q

Difference between Ang II blockers and ACE inhibitors

A

Ang II blockers inhibit the same system but by a different mechanism

BDS2 BAMS Cardiovascular (7 decks)

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