Cardio Pharmacology Flashcards

1
Q

How does aspirin inhibit platelet aggregation?

A

Irreversibly acetylenes cyclo-oxygenase, preventing production of thromboxane A2, inhibiting platelet aggregation

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2
Q

When are anti-platelets used?

A

Used in low dose for secondary prevention following MI, TIA/ stroke, and for patients with angina or peripheral vascular disease
Have a role in primary prevention

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3
Q

Name some anticoagulants

A

Low molecular weight heparin, warfarin, fondaparinux (Xa inhibitor), and bivalirudin (thrombin inhibitor)

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4
Q

What is warfarin the anticoagulant of choice for?

A

Mechanical valves

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5
Q

Which drugs are used to treat AF and clots?

A

Direct oral coagulants (DOACs) e.g. Xa inhibitors and direct thrombin inhibitors

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6
Q

When are beta blockers used?

A

Angina, hypertension, arrhythmia, post MI, heart failure

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7
Q

What are some side effects of beta blockers?

A

Lethargy, ED, headache, sleep disturbance, hypotension

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8
Q

Give 2 examples of beta blockers

A

Bisoprolol, propranolol

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9
Q

When are ACE inhibitors used?

A

Hypertension, heart failure, post MI, diabetic nephropathy

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10
Q

What are some side effects of ACE inhibitors?

A

Dry cough, urticaria, hypotension, acute renal failure (reduced angiotensin II formation), rash

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11
Q

Give 2 examples of ACE inhibitors

A

Ramipril, captopril

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12
Q

When are loop diuretics used?

A

Heart failure - inhibit the Na/2Cl/K co-transporter

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13
Q

What are the side effects of loop diuretics?

A

Dehydration, low Na+, K+, Ca2+, hypovolaemia

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14
Q

When are thiazides and thiazide-like diuretics used?

A

Hypertension and heart failure

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15
Q

What are the side effects of thiazides and thiazide-like diuretics?

A

Low K+, raised Ca2+, low Mg2+, increased urate, impotence, impaired glucose tolerance

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16
Q

When are vasodilators used?

A

Heart failure, IHD, hypertension

17
Q

Which vasodilators lower pre-load and how?

A

Nitrates dilate veins and the larger arteries, lowering filling pressure

18
Q

Which vasodilators lower after-load and how?

A

Hydralazine dilates the resistance vessels, lowering blood pressure

19
Q

How do calcium antagonists work?

A

Decrease cell entry of Ca2+ via voltage-sensitive channels in smooth muscle, thereby promoting coronary and peripheral vasodilation and reducing myocardial oxygen consumption

20
Q

What are the side effects of calcium antagonists?

A

Flushes, headaches, ankle oedema, lowered LV function, palpitations

21
Q

Give an example of a dihydropyridine and when it would be used

A

Amlodipine - used in hypertension and angina

Mainly peripheral vasodilators and cause a reflex tachycardia, so are often used with a beta blocker

22
Q

Give an example of a non-dihydropyridine and when it would be used

A

Verapamil - hypertension and angina and dysrhythmias

Slow conduction at the AV and SA nodes

23
Q

Give 2 examples of calcium channel blockers

A

Amlodipine, nifedipine, verapamil (unusual ending)

24
Q

How does Digoxin work?

A

Blocks the Na+/K+ pump

25
When is digoxin used?
Anti-arrhythmic drug - To slow the pulse in fast AF
26
What are the side effects of digoxin?
Nausea, decreased appetite, yellow vision, confusion
27
How does amiodarone work?
Prolongs the cardiac action potential, reducing the potential for tachyarrhythmicas
28
When is amiodarone used?
Anti-Arrhythmic - tachycardias (including cardiac arrest)
29
What are the side effects of amiodarone?
Thyroid disease, liver disease, pulmonary fibrosis, QT prolongation (polymorphic ventricular tachycardia)
30
What medications may be given for acute coronary syndromes?
Pain relief - GTN spray, diamorphine Dual anti platelet therapy - aspirin + clopidogrel Antithrombin therapy - fondaparinux Lipid lowering therapy - statins
31
What medications may be given for chronic stable angina?
1st line - beta/calcium channel blocker Antiplatelet therapy - aspirin or clopidogrel Lipid lowering therapy - statins Short acting nitrates - GTN spray
32
Name 2 angiotensin receptor blockers
Valsartan, losartan
33
When are angiotensin receptor blockers used?
Hypertension, diabetic nephropathy, heart failure (used when cannot have ACEi)
34
What are the side effects of angiotensin receptor blockers?
Symptomatic hypotension, hyperkalaemia, rash, angio-oedema, renal dysfunction