Cardio Flashcards
Treatment APO in sulfur allergy
Ethacrynic acid
half lives beta blockers
Esmolol: 10m
Metoprolol: 3-4hrs
Propanolol: 3.5-6hrs
Labetalol: 5hrs
Atenolol: 6-9hrs
Bisoprolol: 10-12
Sotalol: 12h
Nadolol: 15h
heart failure meds
ACEi
Then thiazide
Then beta blocker
dig if AF
Antihypertensive with low risk reflex tachycardia
GTN
Metabolic derangement in diuretics
acetazolamide + spiro - hyperchloraemic metabolic acidosis
loop + thiazide - hypokalaemic metabolic alkalosis
Electrolyte causing digoxin induced arrhythmia
hypercalcaemia
Hypernatraemia
Hypokalaemia
Hypomagnasaemia
ACEi mechanism
decreased ATII
Inhibit breakdown bardykinin
LMWH monitoring
Anti factor Xa levels
Exogenous epo se
Htn, thrombosis, red cell aplasia
Oral onset time calcium channel blockers
Nifedipine- 5-20m.
Verapimil- is 30m.
Diltiazem- >30m.
Felodipine- 2-5hrs
Cause GTN tolerance
Decrease in sulfhydryl groups
Arterial dilation only
diazoxide
hydralazine
don’t cause postural hypotension as symp in tact
Bioavailability propanolol
30% dose dependant
Labetolol mechanism
competitive selective alpha 1 antagonist and a competitive non selective beta 1 (B1) and 2 (B2) antagonist
Drugs no effect AV nodal refractory period
Dofetilide
Ibutilide
Lignocaine
Mexiletine
Digoxin metabolism
less than 20% metabolised
T1/2 40h
25%pb
Dihydropyridines vs non
dihydro - pine drugs, smooth muscle - postural hypotension
non - verapamil, diltiezem, SA and AV nodes
Nimodipine and nifedipine bioavailability
Nimodipine 0.13
Nifedipine 0.5
Calcium channel blocker excreted in stool
diltiezem
Side effects quinidine
cinchonism, antimuscarinic, QTc, hepatitis
SE procainamide
QTc, antimusc, drug induced lupus, agranulocytosis
SE disopyramide
same as other 1a but v antimuscarinic
Contraindication amiodarone
porphyria
Cardiac drug causing constipation
calcium channel blockers
Captopril PK
not prodrug
A: rapid F0.95
D: vD 0.8 T1/2 2
E: 50% unchanged
Na nitroprusside PK
A: IV
M: T1/2 short, in RBC and plasma to cyanide, then in liver to thiocyanate
Diuretics causing hyperuricaemia
loop and thiazide and amiloride
Diuretics causing hypercalcaemia
thiazide
ACEi shortest and longest T1/2
short - captopril
long - ramipril
ACEi excreted unchanged in urine
lisinopril
Drugs causing lupus like syndrome
procainamide, hydralazine
Contra indication to acetazolamide
hepatic failure - risk hyperammonaemia
Verapamil bioavailability
25-35%
Atenolol bioavailability
50%
Diazoxide se
Inhibits insulin release
Fleicanide pK
F0.9
T1/2 13h
Renal metabolism and elimination
Methyldopa dose
250-500mg bd / tds
Max 3g/ day
Warfarin PK
A 100 bioavailability
D 99% plasma bound t1/2 36h
M hepatic
E nil unchanged
Fibrinolytics
Streptokinase - protein, combines plasminogen
Urokinase - made in kidney
TPA - activates plasminogen bound to fibrin
Heparin induced thrombocytopenia
1 - mild due to plt aggregation
2 - severe 5-14d post due to antibodies
Adenosine MOA
Binds GPCR
inc cAMP
Activation inward k channel
Supression calcium dependant action potential
ADP plt inhibitors
NON REVERSIBLE prodrugs
Clopidogrel
Prasugrel
Ticlodipine
ALLOSTERIC reversible not prodrug
Ticagrelor
Furosemide pk
F0.6-0.7
Onset 30-60m vs 5m
Duration 6-8h vs 2h
90-100%pb
Minimal hepatic metabolism
Aspirin pk
F0.68
Vd 0.1-0.2 (inc with acidosis) (11/70kg)
Pb 49%
1 -> 0 order kinetics
Aspirin pk
F0.68
Vd 0.1-0.2 (inc with acidosis) (11/70kg)
Pb 49%
1 -> 0 order kinetics
Amlodipine half life
30-50hours
Heparin induced electrolyte abnormality
Hyperkalaemia
Due to inhibition aldosterone
GPIIBIIIA inhibitor
Tirofiban
Abciximab
