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
Q

When is digoxin used?

A

Anti-arrhythmic drug - To slow the pulse in fast AF

26
Q

What are the side effects of digoxin?

A

Nausea, decreased appetite, yellow vision, confusion

27
Q

How does amiodarone work?

A

Prolongs the cardiac action potential, reducing the potential for tachyarrhythmicas

28
Q

When is amiodarone used?

A

Anti-Arrhythmic - tachycardias (including cardiac arrest)

29
Q

What are the side effects of amiodarone?

A

Thyroid disease, liver disease, pulmonary fibrosis, QT prolongation (polymorphic ventricular tachycardia)

30
Q

What medications may be given for acute coronary syndromes?

A

Pain relief - GTN spray, diamorphine
Dual anti platelet therapy - aspirin + clopidogrel
Antithrombin therapy - fondaparinux
Lipid lowering therapy - statins

31
Q

What medications may be given for chronic stable angina?

A

1st line - beta/calcium channel blocker
Antiplatelet therapy - aspirin or clopidogrel
Lipid lowering therapy - statins
Short acting nitrates - GTN spray

32
Q

Name 2 angiotensin receptor blockers

A

Valsartan, losartan

33
Q

When are angiotensin receptor blockers used?

A

Hypertension, diabetic nephropathy, heart failure (used when cannot have ACEi)

34
Q

What are the side effects of angiotensin receptor blockers?

A

Symptomatic hypotension, hyperkalaemia, rash, angio-oedema, renal dysfunction