Cardio Flashcards
which part of the nephron does furosemide act in
ascending loop of henle
loop diuretics mechanism
prevents reabsorption of sodium, water, chloride and potassium in the ascending loop of henle
3 contraindications of furosemide
hyponatraemia, hypokalaemia
anuria
Side effect of furosemide, bendroflumethiazide, spironoactone
1 specific one in spirnolactone
postural hypotension in all
gynaecomastia in spirinolactone
which diuretic can cause gynaecomastia
spironolactone (potassium sparing)
4 contraindications of bendroflumethiazide
Addison’s
hyponatraemia
hypokalaemia
pregnancy
which diuretic is the least contraindicated in pregnancy
furosemide
which part of the nephron does bendroflumethiazide act on
distal convoluted tubule
mechanism of spirinolactone
potassium sparing diuretic
aldosterone antagonist
so promotes excretion of sodium but sparing of potassium
works in the collecting duct
which part of the nephron does spirinolactone act on
collecting duct
what are 2 unlicensed indications of spirinolactone
acne in women
hirtuism
(aldosterone antagonist)
3 contraindications of spirinolactone
Addison’s
hyperkalaemia
anuria
mechanism of atenolol
beta blocker
stops noradrenaline binding to beta 1 receptor (competitive inhibition)
causes negative ionotropic and chronotropic effects
decreased heart rate and strength of contraction
3 contraindications of atenolol
COPD/ asthma
bradycardia
pheochromocytoma
2 side effects of atenolol
cold peripheries
hypotensive symptoms
complication risk of atenolol
increases risk of T2DM
main side effect of ramipril
dry cough
2 contraindications of ramipril
angiodema
pregnancy
what drug do you not give ramipril with
renin inhibitor e.g. Aliskeren
mechanism of amlodipine
calcium channel blocker
relaxes vascular smooth muscle cells
no chrono/ionotropic action, just reduces blood pressure
3 contraindications of amlodipine
stenosis
cariogenic shock
unstable angina
what drug do you not give amlodipine with
other calcium channel blockers
3 side effects of amlodipine (one main one)
leg swelling/ oedema
drowsy
flushing
mechanism of losartan
angiotensin 2 receptor blocker (ARB)
acts on blood vessels directly to block angiotensin 2 receptor
decreases blood pressure
non cardiac indication of losartan
diabetic nephropathy
when do you give losartan in heart failure
when ramipril is contraindicated
2 side effects of losartan (one causes the other)
hyperkalaemia
leading to:
muscle cramps
mechanism of isosorbide mononitrate
donates Nitric Oxide (NO) to smooth muscle cells causing them to relax
which drug do you not give isosorbide mononitrate with
Viagra (Sildenafil)
mechanism of digoxin
cardiac glycoside
inhibits sodium absorption increasing intracellular calcium
decreases conduction, positively ionotropic
causes strong, slow heart beats
when do you give digoxin in heart failure
and other indication
sedentary old people
can give in AF
mechanism of amiodarone
class 3 antiarrythmic
potassium channel blocker
prevents depolarisation leading to a Lower heart rate
when is amiodarone given
in severe arrythmias
in hospital/ under close supervision by specialists
e.g. severe AF, Wolff-Parkinson-White Syndrome
5 contraindications of amiodarone
brachycardia
hypotension
heart failure
thyroid dysfunction (usually hypothyroid)
pregnancy
4 side effects of amiodarone
hypothyroidism (and actually hyperthyroid but less common)
prolonged QT interval
Photosensitivity
Vision changes
aspirin mechanism
antiplatelet
stops prostaglandin synthesis which stops platelet aggregation
2 side effects of aspirin
dyspepsia
bleeding
same as clopidogrel
mechanism of clopidogrel
antiplatelet
competitively inhibits ADP receptors on platelets leading to less aggregation
2 side effects of clopidogrel
dyspepsia
bleeding
same as aspirin
Enoxaparin mechanism
LMWH
inhibits factor 10a converting prothrombin into thrombin stopping the coagulation cascade
what drug anticoagulant do you give to pregnant women having a DVT
enoxaparin (LMWH)
2 side effects of enoxaparin
bleeding
increased liver enzymes
TPA mechanims
thrombolytic drug
binds directly to blood clot and breaks down the fibrin matrix
3 indications of TPA
acute MI (?)
massive PE with haemodynamic instability
stroke if given in 4 hours
3 side effects of TPA
bleeding
angina
hypotension
warfarin mechanism
anticoagulant
blocks vitamin K enzyme inhibiting factors 2,7,9,10
3 contraindications of warfarin
pregnancy (1st and 3rd trimesters)
bleeding
post-surgery with bleeding risk
3 side effects of warfarin
bleeding
mild rash
hair loss
rivaroxaban mechanism
DOAC
inhibits factor 10a converting prothrombin into thrombin
one contraindication of rivaroxaban
anti-phospholipid syndrome
3 side effects of rivaroxaban
iron deficiency anaemia
dizziness
GI upset
simvastatin mechanism
inhibits HMG COA reductase stopping cholesterol synthesis
contraindication of simvastatin
pregnancy/ lactation
3 side effects of simvastatin (one main one)
muscle weakness
constipation
sometimes causes increased liver enzymes so check LFTs beforehand
