Cardio drugs

Question 1

Drug regime in hypertension?

Answer 1

ACDB

Question 2

Role of Ca channel blockers in hypertension? Name 1

Answer 2

Amlodipine

Prevents cross bridge activity in smooth muscle as calmodulin and Ca binding is blocked –> vasodilation

Question 3

Name 2 thiazide like diuretics and describe their use in hypertension?

Answer 3

Indapamide
Bendroflumethiazide

Inhibits Na+/Cl- transporters at distale tubule

Question 4

Name 2 ACEIs?

Answer 4

Ramipril
Lisinopril

Inhibits RAAS by prevents Angiotensin I –> II conversion at the lungs.

Question 5

Example of ARB?

Answer 5

Losartan

Inhibits the AT1 receptors in RAAS

Question 6

Name 2 Beta blockers?

Answer 6

Bisoprisol

Atenolol

Question 7

Which diuretic is used in hypertension treatment?

Answer 7

K+ sparing

Spironolactone

Question 8

Regime for angina treatment to prolong survival?

Answer 8

SAAB

Statin, ACEI, Aspirin, Beta blocker

Question 9

Once survival drugs given for angina, what drugs relive symptoms?

Answer 9

BB
Calcium antagonists or Nitrates
Coronary angioplasty
Antianginals: Ivabradine and ranolzine

Question 10

Two type of calcium antagonists used in angina treatment?

Answer 10

DIhydropyridine derivatives e.g. amlodipine –> Vasodilation

Rate limiting e.g. verapamil and diltiazem –> Vasodilation + impairs AV conduction. Acts as antidysrhythmic in AF, SVTs

Question 11

Name 2 organic nitrates used in angina treatment?

Answer 11

GTN
Isosorbide mononitrate

–> Powerful vasodilators

Question 12

Use of organic nitrates in stable angina

Answer 12

• Stable angina: Prevention by sublingual glycerol trinitrate shortly before exertion or isosorbide mononitrate long before

Question 13

Use of organic nitrates in suntable angina

Answer 13

• Unstable angina: intravenous gylercol trinitrate

Question 14

Use of organic nitrates in heart failure

Answer 14

• Acute heart failure: Intravenous GTN

- Chronic heart failure (CHF): Isosorbide mononitrate with hydralazine

Question 15

Name the main K+ channel activator used in angina treatment?

Answer 15

Nicorandil

Hyperpolarises vascular smooth muscle

Question 16

Regime for chronic heart failure treatment?

Answer 16

DAB

Question 17

Side effect of furosemide?

Answer 17

Acute gout

Question 18

Class of drug of candesartan?

Answer 18

Angiotensin II receptor blocker

Question 19

Class and action of digoxin in CHF?

Answer 19

Cardiac glycoside

Increases vagal efferent to the heart (Decrease SAN firing, HR and conduction velocity in AVN)

Question 20

Initial and secondary treatment of acute HF?

Answer 20

Initial:

• IV loop diuretics
• IV opiates/opiods (reduce anxiety and preload)
• IV/buccal/SL nitrates

Secondary:

• Inotropes, beta agonists (E.g. Dobutamine, to increase heart ocntractility)
• Neurotransmitter e.g. dopamine to increase renal perfusion and bp
• Hormine e.g. adrenaline to increase myocardial contractility

Question 21

What is troponin

Answer 21

subtypes of troponin (cardiac I and T) are very sensitive and specific indicators of damage to the heart muscle (myocardium).

They are measured in the blood to differentiate between unstable angina and myocardial infarction (heart attack) in people with chest pain or acute coronary syndrome.

Question 22

What is D-dimer

Answer 22

D-dimer (or D dimer) is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.

Question 23

Treatment for AF?

Answer 23

Prevention of emboli formation: Warfarin, rivaroxoban

Control rate (crucia): Beta blocker, digoxin

Control rhythm (seldom done):	- DC cardioversion 
- Amiodarone if heart failure (K+ channel blocker)

Question 24

Emergency stroke requires..

Answer 24

Thrombolysis + aspirin –> Clopidogrel

Question 25

Use of adenosine?

Answer 25

SVTs

Hyperpolarises the AV node