ACC drugs Flashcards
What does chlorphenamine treat?
Symptomatic relief of allergies - hay fever, food allergy, drug reactions, urticaria, relief of itch associated with chicken pox
Common side effects associated with chlorphenamine?
Drowsiness, fatigue, dry mouth, headache, nausea, impaired concentration
When is the use of glyceryl trinitrate indicated? (4)
- Treatment/prophylaxis for angina
- Control of hypertension/ischaemia during cardiac surgery
- Congestive heart failure (with caution)
- Unstable angina
What are the contraindications for glyceryl trinitrates/GTN? (5)
- Aortic stenosis
- Cardiac tamponade
- Pericarditis
- Hypotensive conditions
- Raised intracranial pressure
What is ticagrelor and why is it thought to be better than clopidogrel?
Ticagrelor is a P2Y12 receptor antagonist that prevents ADP-mediated P2Y12 dependent platelet activation and aggregation. Ticagrelor therapy overcomes nonresponsiveness to clopidogrel, and its antiplatelet effect is the same in responders and nonresponders. In addition to it being a more rapid and more potent platelet inhibitor than clopidogrel, after drug discontinuation the offset of platelet inhibition is faster for ticagrelor than for clopidogrel
What is the indication for use of ticagrelor? (2)
- Prevention of atherothrombotic events in patients with acute coronary syndrome [in combination with aspirin]
- Prevention of atherothrombotic events in patients with a history of myocardial infarction and a high risk of an atherothrombotic event [in combination with aspirin]
What is the basic mechanism of action of anti platelets?
Anti platelets act by preventing the production of thromboxane which is released by platelets and is involved in the clotting process. Antiplatelet drugs decrease platelet aggregation and inhibit thrombus formation in the arterial circulation, because in faster-flowing vessels, thrombi are composed mainly of platelets with little fibrin.
Name some anti platelets? (4)
- Aspirin
- Clopidogrel
- Ticagrelor
- Cangrelor
Why are anti platelets useful for treating thrombi in the arterial circulation?
Because fast-flowing vessels such as arteries mean the thrombi that normally form contain mainly platelets and very little fibrin, meaning the anti platelet will work, but anticoagulants work on the clotting cascade that results in fibrinogen forming - but if no fibrinogen present, no point in using?!
When is tranexaminc acid given?
To stop haemorrhage, epistaxis, menorrhagia, hereditary angioedema, general fibrinolysis
When are anticoagulants given/indicated?
The main use of anticoagulants is to prevent thrombus formation or extension of an existing thrombus in the slower-moving venous side of the circulation, where the thrombus consists of a fibrin web enmeshed with platelets and red cells.
Anticoagulants are of less use in preventing thrombus formation in arteries, for in faster-flowing vessels thrombi are composed mainly of platelets with little fibrin.
Name some anticoagulants? (6)
- Warfarin
- Heparin
- Rivaroxaban
- Dabigatran
- Apixaban
- Fondaparinux
What is adenosine indicated for and by which route is it given?
Rapid reversion to sinus rhythm of paroxysmal supraventricular tachycardias, including those associated with accessory conducting pathways (e.g. Wolff-Parkinson-White syndrome),
Used to aid to diagnosis of broad or narrow complex supra ventricular tachycardias
- rapid intravenous injection
What drug is given in patients who have deficiency in clotting factors and are at risk of/are bleeding?
Dried prothrombin complex AKA octaplex
(Treatment and peri-operative prophylaxis of haemorrhage in patients with congenital deficiency of factors II, VII, IX, or X if purified specific coagulation factors not available)
What is entonox also known as?
Nitrous oxide
