cardio drugs Flashcards

1
Q

ACEi EX

A

ramipril / lisinopril

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2
Q

ACEi IN

A

HTN
HF
MI 2nd prevention

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3
Q

ACEi MA

A

inhibit angiotensin converting enzyme (ACE)

(reduces sodium + water retention / arterial + venous dilation)

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4
Q

ACEi CC

A

afro-caribbeans
lowers glucose in diabetes
NO in pregnancy

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5
Q

ACEi SA

A

persistent dry cough
renal dys
angioedema

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6
Q

amiodarone IN

A

arrhythmias

(AFib / flutter
VFib / pulseless VTACH)

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7
Q

amiodarone MA

A

(CLASS 3) block K+ channels -> increase refrac period

(slows HR + AV conductions, prolongs QT)

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8
Q

amiodarone CC

A

heart block, brady, thyroid dys, hypokalaemia NO

avoid IV in cardiomyopathy, HF, sever resp failure

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9
Q

amiodarone SA

A

hypokalaemia
corneal microdeposits
hepatic disorders
hyperthyroidism
resp disorders
skin reactions (phototoxic)

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10
Q

atropine IN

A

bradycardia

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11
Q

atropine MA

A

inhibits M3 receptors -> anticholinergic effects

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12
Q

atropine CC

A

GI obstruction
acute MI
arrhythmias
tachycardia
HF
CAD
HTN
hyperthyroidism

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13
Q

atropine SA

A

dry mouth
dizziness
blurred vision
nausea

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14
Q

aspirin IN

A

antiplatelet agent

ACS
ischaemic stroke
thromboprophylaxis in CVD risk

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15
Q

aspirin MA

A

COX inhibitor

inhibits TXA2 synth (aggregates platelets) + prostaglandin production (activation)

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16
Q

aspirin CC

A

active peptic ulceration
bleeding disorders

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17
Q

aspirin SA

A

GI bleeding + ulceration

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18
Q

ARBs EX

A

losartan / valsartan

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19
Q

ARBs IN

A

HTN
post MI
HF

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20
Q

ARBs MA

A

inhibits binding of angiotensin-ll

(vasodilation + aldosterone blockage)

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21
Q

ARBs CC

A

pregnancy / planning to be

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22
Q

ARBs SA

A

dizziness
hyperkalaemia
localised angioedema

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23
Q

a blockers EX

A

doxazosin

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24
Q

a blockers IN

A

resistant HTN

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25
Q

a blockers MA

A

block a adrenoreceptors

(vasodilation)

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26
Q

a blockers CC

A

history of postural hypotension

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27
Q

a blockers SA

A

dizziness
hyperkalaemia
localised angioedema

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28
Q

B blockers EX

A

cardioselective -
atenolol / bisoprolol

non-selective -
propranolol / carvedilol

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29
Q

B blockers IN

A

cadioselective -
angina
ACS
HTN
HF

non-selective -
hyperthyroidism
migraine

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30
Q

B blockers MA

A

(CLASS 2) competitive inhibition of B1 / B2 adrenoreceptors

(lowers HR and BP)

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31
Q

B blockers CC

A

‘brittle’ asthma
worsen HF in short term

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32
Q

B blockers SA

A

tiredness
cold peripheries

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33
Q

CCBs EX

A

dihydropyridines -
amlodipine

rate limiting CCBs -
verapamil / diltiazem

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34
Q

CCBs IN

A

dihydropyridines -
HTN
angina

rate limiting CCBs -
HTN
angina
SVT (slows HR)

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35
Q

CCBs MA

A

(CLASS 4) block calcium channels

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36
Q

CCBs CC

A

on B blockers

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37
Q

CCBs SA

A

dizziness
flushing
headache
nausea
ankle oedema (dihydropyridines)

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38
Q

clopidogrel IN

A

thromboprophylaxis (aspirin intolerance)
ACS (+ aspirin)

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39
Q

clopidogrel MA

A

inhibits P2Y12 receptors (platelet aggregation)

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40
Q

clopidogrel CC

A

risk of bleeding

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41
Q

clopidogel SA

A

GI bleeding + ulceration

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42
Q

digoxin IN

A

HF
arrhythmias
HTN

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43
Q

digoxin MA

A

inhibits Na-K-ATPase pump -> increase in intracellular Ca2+

(decreases AVN conduction)

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44
Q

digoxin CC

A

narrow therapeutic index!

too much = AV delay -> brady / AVB
increases vent irritability = vent arrhythmias
overdose = toxicity (N+V, headache, yellow vision)

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45
Q

digoxin SA

A

AVB
arrhythmias
N+V
diarrhoea
colour vision disturbances

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46
Q

diuretics EX

A

thiazide -
bendrofluazide

loop -
furosemide

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47
Q

diuretics IN

A

thiazide -
HTN

loop -
HF

48
Q

diuretics MA

A

block Na+ reabsorption in kidneys

49
Q

diuretics CC

A

renal dys

50
Q

diuretics SA

A

hypokalaemia = tiredness, arrhythmias

hyperglycaemia = diabetes, increase in uric acid -> gout, impotence in men

51
Q

DOAC EX

A

dabigatran / rivaroxaban

52
Q

DOAC IN

A

venous thrombosis prevention (hip / knee replacements)
DVT or PE

53
Q

DOAC MA

A

directly inhibit thrombin (dabigatran) or factor Xa (rivaroxaban)

54
Q

DOAC CC

A

bleeding risk

55
Q

DOAC SA

A

bleeding (less than other meds)

56
Q

fibrates EX

A

bezafibrate

57
Q

fibrates IN

A

hypertriglyceridemia

58
Q

fibrates MA

A

agonist of nuclear receptor -> enhances gene transcription

(increased clearance of LDLs)

59
Q

fibrates CC

A

alcoholics

60
Q

fibrates SA

A

may cause myositis

61
Q

heparin IN

A

DVT or PE
unstable angina

62
Q

heparin MA

A

neutralises active clotting factors (serine proteases)
increases affinity for angiotensin-lll

63
Q

heparin CC

A

hepatic / renal impairment

64
Q

heparin SA

A

haemorrhage
heparin-induced thrombocytopenia
hyperkalaemia

65
Q

ivabradine IN

A

angina
HF

66
Q

ivabradine MA

A

If channel modulator

(only slows HR in SR)

67
Q

ivabradine CC

A

decompensation HF
low BP
conduction abnormalities

68
Q

ivabradine SA

A

visual disturbances

69
Q

mineralocorticoid antagonists EX

A

spironolactone / eplerenone

70
Q

mineralocorticoid antagonists IN

A

resistant HTN
HF

71
Q

mineralocorticoid antagonists MA

A

block aldosterone receptors

72
Q

mineralocorticoid antagonists CC

A

moderate / severe renal dys

73
Q

mineralocorticoid antagonists SA

A

gynaecomastia
hyperkalaemia
renal impairment

74
Q

ARNi / neprilysin inhibitors EX

A

sacubitril + valsartan

75
Q

ARNi / neprilysin inhibitors IN

A

HF

76
Q

ARNi / neprilysin inhibitors MA

A

stops neprilysin from binding down NPs

(vasodilation + decreases sympathetic tone)

77
Q

ARNi / neprilysin inhibitors CC

A

NOT alongside ACEi / ARBs

78
Q

ARNi / neprilysin inhibitors SA

A

hypotension
renal impairment
hyperkalaemia
angioneurotic oedema

79
Q

nicorandil IN

A

angina

80
Q

nicorandil MA

A

ATP-sensitive potassium channel activator

81
Q

nicorandil CC

A

acute pulmonary oedema
hypovolaemia
LV dys
severe hypotension
shock

82
Q

nicorandil SA

A

headache
mouth / GI ulcers

83
Q

nitrates EX

A

isosorbide mononitrate

84
Q

nitrates IN

A

angina (GTN)
acute HF

85
Q

nitrates MA

A

relax all types of SM via metabolism to NO

86
Q

nitrates CC

A

can develop a tolerance

87
Q

nitrates SA

A

headache
hypotension

88
Q

PCSK9 inhibitors EX

A

alirocumab / evolocumab

89
Q

PCSK9 inhibitors IN

A

familial hypercholesterolaemia

90
Q

PCSK9 inhibitors MA

A

inhibits binding of PCSK9 to LDL receptors

(increases clearance of LDLs)

91
Q

PCSK9 inhibitors SA

A

flu-like symptoms
myalgia

92
Q

ranolazine IN

A

refractory angina

93
Q

ranolazine MA

A

late sodium channel modulator (decreases Ca2+ load on heart)

94
Q

ranolazine CC

A

moderate / severe hepatic impairment

caution - weight <60kg, elderly, moderate / severe HF, QT prolongation, mild renal / hepatic impairment

95
Q

ranolazine SA

A

asthenia
constipation
headache
vomiting

96
Q

statins EX

A

simvastatin / atorvastatin

97
Q

statins IN

A

hypercholesterolaemia
diabetes
angina

98
Q

statins MA

A

inhibit HMG-CoA reductase -> RDS in cholesterol synth

(increased clearance of LDLs)

99
Q

statins CC

A

elderly
alcoholics
Hx of liver disease
hyperthyroidism
pregnancy

100
Q

statins SA

A

myopathy
rhabdomyolysis

101
Q

fibrinolytics EX

A

streptokinase / tPA

102
Q

fibrinolytics IN

A

ACS (STEMI)
PE
stroke

103
Q

fibrinolytics CC

A

trauma
bleeding tendencies
peptic ulcer

104
Q

fibrinolytics SA

A

haemorrhage

105
Q

warfarin IN

A

DVT
PE
AFib

106
Q

warfarin MA

A

inhibits vitamin K reductase -> inhibits post-translational y-carboxylation of clotting factors

slow onset

107
Q

warfarin CC

A

bleeding risk (monitor w/ INR)

reversed by vitamin K

108
Q

warfarin SA

A

bleeding

109
Q

class 1 arrhythmic MA

A

block Na+ channels

prolong action potential duration + refractory period

110
Q

(NE) class 1 arrhythmic EX

A

quinidine / lidocaine

111
Q

class 2 arrhythmic MA

A

B blockers

decrease rate of depolarisation on SA / AV nodes

112
Q

class 3 arrhythmic MA

A

block K+ channels

prolong action potential, increase refractory period

113
Q

class 3 arrhythmic EX

A

amiodarone

114
Q

class 4 arrhythmic MA

A

CCBs

slow conduction in SA / AV nodes, decrease force of contraction

115
Q

SGLT2 inhibitors EX

A

dapagliflozin (-liflozin)

116
Q

SGLT2 inhibitors IN

A

lowers blood glucose
can lower BP (osmotic diuresis)