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2 CVS > 13 Drugs and CVS > Flashcards

13 Drugs and CVS Flashcards

1
Q

What’s the difference between atrial fibrillation and atrial flutter?

A

Atrial fibrillation- atria beat irregularly

Atrial flutter- atria beat regularly but faster than usual and often more than the verticles (eg 4 atrial beats per 1 ventricular)

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2
Q

`What (in general terms) causes arrhythmias?

A
  1. Disturbance in impulse generation
  2. Disturbance in impulse conduction
  3. Both
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3
Q

Give some examples of causes of arrhythmias.

A
  1. Ectopic pacemaker activity (damaged area of myocardium
  2. Conduction problem- causing re-entry loop
  3. Mitral valve stenosis (extra pressure and stretch on atria)
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4
Q

Name 3 conditions which antiarrhythmic drugs can be used to treat?

A
  1. Supraventricular tachycardia
  2. Ventricular tachycardia
  3. Atrial fibrillation
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5
Q

Why must antiarrhythmic drugs be used with caution?

A

Have potential to cause arrhythmias

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6
Q

What are the 4 classes of antiarrhythmic drugs?

A
  1. Voltage-sensitive sodium channel blockers
  2. ß-adrenoreceptor antagonists
  3. Potassium channel blockers
  4. Calcium channel blockers
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7
Q

Name an anti-arrhythmic drug that acts of sodium, potassium and calcium channels as well as ß-adrenoreceptors.

A

Amiodarone

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8
Q

What do inotropic drugs do?

A

affect the force of contraction

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9
Q

Name 3 types of inotropic drugs and give an example of each.

A
  1. Cardiac glycosides (Increase contraction force)
    1. Digoxin
  2. Selective ß1 agonists (Increase contraction force)
    1. Adrenaline
    2. Dobutamine
  3. ß-adrenoblockers (Decrease contraction force)
    1. Propanolol
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10
Q

How do cardiac glycosides work to increase the force of heart contraction in a patient with heart failure with atrial fibrillation?

A
  • Increase cardiac output
    • Inhibit Sodium/Potassium ATPase
    • Increase intracellular Sodium
    • Lose Sodium gradient- NCX doesn’t work as well
    • Rise in intracellular Calcium
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11
Q

When would a cardiac glycoside be given to a patient?

A

If patient has heart failure w./ atrial fibrillation (not good in long term

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12
Q

When might a patient be given a selective beta-1 agonist?

A
  • Cardiogenic shock
  • Acute reversible heart failure
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13
Q

When and why might a patient be given a beta-adrenoreceptor blocker?

A
  • After MI- increase sympathetic response
    • Reduce HR and prevent arrhythmia
    • Treat angina
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14
Q

How do beta-adrenoreceptor blockers work?

A

Reduce contraction force

Lower workload

Prevent action of sympathetic noradrenaline

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15
Q

What are vasodilators used to treat? (2)

A
  1. Chronic heart failure
  2. Hypertension (to avoid CVD/stroke)
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16
Q

What are the 3 main categories of vasoldilators?

A
  1. Alpha 1-adrenoreceptor antagonists
    1. Hypertension
  2. Calcium channel blockers
    1. Hypertension
  3. ACE Inhibitors and Diuretics
    1. Chronic heart failure

ACE= Angiotensin converting enzyme

17
Q

How do ACE inhibitors work to decrease the workload of the heart to treat chronic heart failure? (2)

A
  • ACE= Inhibited- can’t form Angiotensin II​
    1. Promotes Vasodilation as angiotensin II= vasoconstrictor
      1. Decrease afterload and preload on heart
    2. Diuretic effect
      1. Angiotensin II- promotes aldosterone release from adrenal cortex
      2. Decrease blood volume
18
Q

What are organic nitrates used to treat?

A

Angina

19
Q

What do organic nitrates release and why are they effective?

A

Nitric oxide:

Powerful vasodilator (produced naturally- in the endothelial lining of blood vessels)

20
Q

What vessels does nitric oxide act on?

A
  1. Primarily Veins
    1. ​Decrease preload and work for heart
  2. May dilate collacteral coronary arteries
    1. ​NOT ARTERIOLES
    2. Improve blood supply to heart
21
Q

Antithrombotic drugs may be prescribed to patients with which conditions? (4)

A
  1. Atrial fibrillation
  2. Valve disease
  3. After MI
  4. Coronary artery disease
22
Q

Give examples of 3 antithrombotic drugs.

A
  • Warfarin
  • Dabigatran (direct thrombin inhibitor)
  • Aspirin (anti-platelet drug)
23
Q

What do you give a patient having an MI?

A

2 CVS (16 decks)

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