Cardiac Drugs Flashcards

1
Q

Name some examples of beta blockers

A
  • Atenolol

- Propranolol

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2
Q

What are the side effects f beta blockers

A
  • bronchospasm
  • cold peripheries
  • fatigue
  • sleep disturbances
  • erectile dysfunciton
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3
Q

What are the contraindications of beta blockers

A
  • Uncontrolled heart failure
  • asthma
  • sick sinus syndrome
  • concurrent verapamil use
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4
Q

What happens when beta blockers and verapamil are used together

A
  • Can cause complete heart block
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5
Q

What happens if you have a beta blocker overdose

A
  • bradycardia
  • hypotension
  • heart failure
  • syncope
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6
Q

What is the management of beta blocker overdose

A
  • atropine

- in resistant cases glucagon may be used

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7
Q

What does a negative inotrope do

A

these slow the hearts contraction and slows the heart rate down

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8
Q

name examples of negative inotropes

A
  • beta blockers

- calcium channel blockers

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9
Q

What are the two types of calcium channel blockers

A
  • non dihydropyridines

- Dihydropyridines

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10
Q

Name some examples of non dihydropyridine calcium channel blockers

A
  • Dilitizem

- Verapamil

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11
Q

Name some examples of dihydropyridine calcium channel blockers

A
  • Nifedipine

- Amlodipine

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12
Q

What are the side effects of verapamil

A
  • heart failure
  • constipation
  • hypotension
  • bradycardia
  • flushing
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13
Q

What are the side effects of diltiazem

A
  • hypotension
  • bradycardia
  • heart failure
  • ankle swelling
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14
Q

What are the side effects of nifedipine, amlodipine, felodipine

A
  • flushing
  • headache
  • ankle swelling
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15
Q

What are the side effects of ACE inhibitors

A
  • cough
  • angioedema
  • hyperkalamia
  • first dose hypotension
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16
Q

what are the contraindications for ACE inhibitors

A
  • pregnancy and breastfeeding
  • renovascular disease
  • aortic stenosis
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17
Q

Name an example of an aldosterone inhibitor

A

Spironolactone

Eplerenone

18
Q

What are the adverse effects of spironolactone

A
  • hyperkalaemia

- gynaecomastia less common with eplerenone

19
Q

What are the side effects of thiazide diuretics

A
  • dehydration
  • postural hypotension
  • hyponatraemia
  • hypokalaemia
  • hypercalcaemia
  • gout
  • impaired glucose tolerance
  • impotence
20
Q

How do thiazide diuretics work

A
  • Work by inhibiting sodium reabsorption at the beginning of the distal convoluted tubule by blocking the thiazide sensitive Na+Cl- symporter
21
Q

Name some thiazide like diuretics

A
  • Indapamide

- chloratalidone

22
Q

Name a thiazide diuretic

A

bendroflumethiazide

23
Q

What are the two types of potassium-sparing diuretics

A
  • aldosterone antagonists e.g. spironolactone

- Amiloride - blocks the epithelial sodium channel in the distal convoluted tubule

24
Q

what does amiloride do

A
  • blocks epithelial sodium channel in the distal convoluted tubule
25
Q

Name some loop diuretics

A
  • furosemide and bumetanide
26
Q

what are the adverse effects of loop diuretics

A
  • hypotension
  • hyponatraemia
  • hypokalamiea
  • hypomagensaemia -
  • ototoxicity
  • hypocalcaemia
  • hypercholraemic alkossi
  • renal impairment
27
Q

What are the classes of anitarrhytmics

A

Class I
- sodium channel blockers e.g. flecainide, procainamide, quinidine
Class II
- Beta blockers e.g. propranolol and metoprolol
Class III
- Potassium channel inhibitors e.g. Amiodarone, Sotalol
Class IV
- Calcium channel blockers e.g. verapamil, dilimiazem

28
Q

How does amiodarone work

A
  • Works by blocking potassium channels which inhibits depolarisation and therefore prolongs the action potential
29
Q

What are the adverse effects of amiodarone

A
  • thyroid dysfunction = both hypothyroidism and hyperthyroidism
  • corneal deposits
  • pulmonary fibrosis
  • liver fibrosis/hepatits
  • peripheral neuropathy - photosensitivity
  • slate-gray apperance
  • bradycardia
  • lengths QT interval
30
Q

What drug interactions does amiodarone have

A
  • decreases the metabolism of warfarin therefore results in an increase in INR
  • increases digoxin levels
31
Q

What is adenosine used for

A
  • It is used to terminate supra ventricular tachycardias
32
Q

How does adenosine work

A
  • causes transient heart block in the AV node
  • agonists of the A1 receptor in the atrioventricular node which inhibits adenylyl cyclase thus reducing cAMP and causing hyperpolarization by increasing outward potassium flux
33
Q

what is the half life of adenosine

A

half life of about 8-10 seconds

34
Q

What are the adverse effects of adenosine

A
  • chest pain
  • bronchospasm - avoided in asthmatics
  • transient flushing
35
Q

What is digoxin used in

A
  • used in rate control in the management of atrial fibrillation
36
Q

Name a positive inotrope

A

digoxin

37
Q

How does digoxin work

A
  • decreases conduction through the atrioventricular node which slows the ventricular rate in atrial fibrillation and flutter
  • increases the force of cardiac muscle contraction due to inhibition of the sodium/potassium ATPase pump
38
Q

What are the symptoms of digoxin toxicity

A
  • generally unwell
  • lethargy
  • nausea and vomiting
  • anorexia
  • confusion
  • yellow-green vision
  • Arrhythmias
  • gynaecomastia
39
Q

What is the precipitating factors of digoxin toxicity

A
  • hypokalaemia
  • increasing age
  • renal failure
  • MI
  • hypomagensaemia
  • hypoalbuminaemia
  • hypothermia
  • hypothyroidism
40
Q

How does atropine work

A
  • anticholinergic medicine that increases firing of the SA node
41
Q

What are the ECG features of digoxin toxicity

A
  • down-sloping ST depression
  • flattended/inverted T waves
  • short QT interval
  • Arrhythmias