cardiac

Question 1

what are examples of loop diuretics

Answer 1

frusemide
bumetanide

inhibit na/k/cl triple transporter in ascending loop of henle and increase NaCl excretion

Question 2

what are the side effects of loop diuretics?

Answer 2

hypokalaemia
hyponatramia,magnesia, calcaemia

postural hypotension
increased urate

Question 3

what are CI of loop diuretics

Answer 3

refractory hypokalamia

anuric renal failure

Question 4

what are interactions of loop diuretics?

Answer 4

increase toxicity of:
digoxin
NSAIDs
gentamicin
lithium

Question 5

what are examples of thiazide diuretics?

Answer 5

bendrofluazide, metolazone, chlortalidone

inhibit NaCl transporter in DCT and increase NaCl excretion

Question 6

what are are side effects of thiazide diuretics?

Answer 6

hypokalamia
hyponatraemia

hypercalcaemia, increased urate, glucose + DM
postural hypotension

Question 7

what are CI of thiazide diuretics?

Answer 7

refractory hypokalaemia
gout
severe renal failure

Question 8

what are interactions of thiazide diuretics?

Answer 8

increase toxicity of:
digoxin
lithium

Question 9

what are examples of aldosterone receptor antagonists?

Answer 9

spironolocatone
eplerenone
increase na excretion, decrease k + h excretion

Question 10

what re side effects of aldosterone receptor antagonists?

Answer 10

hyperkalaemia

gynaecomastia in spiro

Question 11

what are CI of aldosterone receptor antagonists?

Answer 11

hyperkalaemia
addisons
p?

Question 12

what are interactions of aldost. receptor antagonsits?

Answer 12

increase toxicity of dig + li

Question 13

what are the side effects of ACE-I?

Answer 13

hypotension- esp with diuretics, HF
RF
hyperkalaemia
dry cough

Question 14

what are the CI of ACE-i?

Answer 14

bilateral RAS

Question 15

what are interactions of ACE-i?

Answer 15

increase risk factors with NSAIDs

diuretics, TCAS + antipsychotics increase risk of hypotension

caution with drugs that increase K+ like spiro

Question 16

what are side effects of bb?

Answer 16

bronchospasm
decrease HR + BP

peripheral vasoconstriction- col extremities, worsen raynaud’s/PVD
lethargy/fatigue/nightmares
risk of new onset DM esp wtih thiazides

Question 17

what are CI of bb?

Answer 17

asthma/bronchospasm
PVD
severe bradycardia/HF
2-3rd degree AV block 
caution in DM 
decrease dose i renal impairment

Question 18

what are interactions of bb?

Answer 18

verapamil/diltiazem- risk of AV block and bradycardia

Question 19

what are side effects of dihydropyridines (amlodipine-CCB)?

Answer 19

flushing 
headache
ankle oedema
dizziness 
hypotension 
gingival hypertrophy with nifedipine

Question 20

what are CI to CCB dihydropyridines?

Answer 20

cardiogenic shock
unstable angina
significant AS
within 1month of MI

Question 21

what are interactions of CCB dihydropridines?

Answer 21

a/bb- risk of hypotension
grapefruit increases dose
rifampicin/phenytoin/CBZ decreases dose

nifedipine- increases digoxin

Question 22

what are side effects of non-dihydropyridines CCB (diltiazem, verapamil)

Answer 22

headache
flushing
AV block 
HF
hypotension 
ankle oeema
constipation 
gynaecomastia- verapamil

Question 23

what are CI of non-dihydropyridines CCB (dilt/verapamil)

Answer 23

2/3rd degree AV block

Question 24

what are interactions of non-dihydropyridines CCB?

Answer 24

bb- risk of AV block, HF, asystole
increases digoxin
verapamil increased by grapefruit and macrolides

simvastain- increased myopathy risk

Question 25

what are the side effects of amiodarone?

Answer 25

``` eye- corneal microdeposits thyroid- hyper+hypo lung- pulmonary fibrosis GI/LIVER- raised LFT, n+v neuro- peripheral neuropathy skin- photosensitivity, blue-grey disc, phlebitis ```

Question 26

what are CI of amiodarone?

Answer 26

thyroid disease sinus bradycardia elongated QTc -> TdP

Question 27

what interactions are there with amiodarone?

Answer 27

increases level sof- digoxin, warfarin, phenytoin increaes risk of vent arrythmias with TCAS, antypsychotics, erythromycin

Question 28

what are the side effects of digoxin?

Answer 28

toxicity: - any arrhytmia- SVT with AV block - nausea - xanthopsia - confusion - hyperkalaemia chronic - gynaecomastia

Question 29

what are CI to digoxin?

Answer 29

complete heart bock VF/VT HOCM SVTs secondary to WPW

Question 30

what are digoxin interactions?

Answer 30

increased by - CCB esp verapamil, amiodarone, diuretics (loop/thiazide due to hypokalaemia) decreases by- antacids, cholestyramine

Question 31

what are side effects of adenosine?

Answer 31

``` bronchospasm chest pain flushing nausea light headedness ```

Question 32

what are CI in adenosine?

Answer 32

asthma heart block 2/3 sick sinus syndrome

Question 33

what are interactions of adenosine?

Answer 33

increased by dipyridamole | decreased by theophylline

Question 34

what are the side effects of aspirin?

Answer 34

gastritis gastric ulceration bleeding bronchospasm renal failure gout ototoxic in OD- tinnitus

Question 35

what are CI in aspriin?

Answer 35

<16yo- reyes syndrome except in kawasakis active PUD bleeding disorders gout caution in asthma, uncontrolled HTN

Question 36

what are interactions of aspirin?

Answer 36

increases with sulfonylureas, methotrexate increased risk of bleeding with other anticoag/plat

Question 37

what are the side effects of clopidogrel?

Answer 37

bleeding- GI/intracranial GI puset dyspepsia/PU TTP- rare

Question 38

what are CI of clopidogrel?

Answer 38

severe liver disease | avoid with warfarin