Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > Cardio pharmacology > Flashcards

Cardio pharmacology Flashcards

1
Q

Why is it important to treat hypertension?

A

It is an important preventable cause of premature morbidity and mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name some conditions that hypertension is a risk factor for

A
  • Stroke (ischaemic and haemorrhagic)
  • MI
  • Heart failure
  • Chronic renal disease
  • Cognitive decline
  • Premature death
  • Increased risk of atrial fibrillation which is an independent risk for stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What level of clinical blood pressure is a diagnostic level for hypertension?

A

140/90mmHg or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What test can be used to confirm a diagnosis of hypertension?

A

Ambulatory blood pressure monitoring (ABPM) over 24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is RAAS involved in increasing blood pressure?

A
  • Angiotensin II is an extremely potent vasoconstrictor and increases peripheral resistance
  • Angiotensin II -> aldosterone -> increased Na+ -> increased water reabsorption -> increased blood volume and BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is the sympathetic nerverous system involved in increasing blood pressure?

A
  1. Causes renin release
  2. • Noradrenaline (NA) released in response to BP decrease
    • NA -> vasoconstriction and increased contractility of the heart -> increased peripheral resistance and cardiac output -> increased BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does ACE stand for in ACE inhibitors?

A

Angiotensin converting enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are ACE inhibitors indicated for?

A
  • Hypertension
  • Heart failure
  • Diabetic nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give some examples of ACE inhibitors

A
  • Ramipril
  • Enlarpril
  • Perindopril
  • Trandolapril
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the two different areas of ACE inhibitor side effects?

A
  • Related to angiotensin II formation

* Related to kinin production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the main adverse side effects of ACE inhibitors?

A
  • Hypotension, acute renal failure, hyperkalaemia, teratogenic effects
  • Chronic dry cough, rash, anaphylactoid reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does ARB stand for?

A

Angiotensin II receptor blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are ARBs inhibitors indicated for?

A

When ACE-i are contraindicated:
• Hypertension
• Diabetic neuropathy
• Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do ARBs act on

A

AT-1 receptor (angiotensin receptor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give some examples of ARBs

A
  • Candesartan
  • Losartan
  • Valsartan
  • Irbesartan
  • Telmisartan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the main adverse side effects of ARBs?

A
  • Symptomatic hypotension
  • Hyperkalaemia
  • Potential renal dysfunction
  • Rash
  • Angio-oedema
  • Contraindicated in pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does CCB stand for?

A

Calcium channel blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are CCBs inhibitors indicated for?

A
  • Hypertension

* IHD e.g. angina and arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 2 different types of CCBs based on their action?

A
  1. Vasodilators

2. Affecting electrical conductivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give some examples of CCBs

A
  • Vasodilator CCBs: amlodipine, nifedipine, felodipine, lacidipine
  • Electrical conductivity effectors: diltiazem, verapamil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the 4 different areas of CCB side effects?

A
  1. Due to peripheral vasodilation
  2. Due to negatively chronotropic effects (HR)
  3. Due to negatively inotropic effects (force of contractility)
  4. Miscellaneous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the main adverse peripheral side effects of CCBs?

A
  • Flushing
  • Headache
  • Oedema
  • Palpitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the main adverse chronotropic side effects of CCBs?

A
  • Bradycardia
  • AV block
  • Postural hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the main adverse inotropic side effect of CCBs?

A

Worsening of cardiac failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the main adverse miscellaneous side effect of CCBs?

A

Verapamil causes constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the main types of heart failure?

A
  • Due to impaired contractility of the heart – left ventricular systolic dysfunction (LVSD)
  • With preserved ejection fraction (HFPEF) aka diastolic failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How does oedema usually differ between acute and chronic heart failure?

A
  • Acute = pleural oedema

* Chronic = ankle oedema and abdominal ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common cause of heart failure?

A

Coronary artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In heart failure, what would you use for symptomatic treatment of congestion?

A

Diuretics, usually loop diuretics e.g. furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What drugs would you use to inhibit the RAAS in heart failure?

A

ACE inhibitors and ARBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What drugs would you use to inhibit the sympthetic nervous system in heart failure and why?

A

Beta blockers (e.g. bisoprolol) - they are effective at blocking reflex sympathetic responses which stress the failing heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the 1st line treatment in heart failure?

A

Low dose and slow uptitration ACE inhibitors (e.g. ramapril) and beta-blockers (e.g. bisoprolol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the 2nd line treatment in heart failure?

A

Aldosterone antagonists - ARBs (e.g. candesartan) if intolerant to ACE-i

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What could you give to treat heart failure if they were intolerant to ACE-i and ARBs?

A

Hydralazine/nitrate combination - peripheral vasodilators

35
Q

What are the 2 types of cardiac natriuretic peptides?

A
  • Atrial natriuretic peptide (ANP) – for the atria

* B-(brain) natriuretic peptide (BNP) – for the ventricles (found in the brain and heart)

36
Q

What causes the release of cardiac natriuretic peptides?

A
  • Stretching of atrial and ventricular muscle cells
  • Raised atrial or ventricular pressures
  • Volume overload
37
Q

What metabolises cardiac natriuretic peptides?

A

Neutral endopeptidase (NEP/neprilysin)

38
Q

What does NEP inhibition do?

A

Increases natriuretic peptide levels

39
Q

In heart failure, give 3 drugs which are based around influencing cardiac natriuretic peptide levels?

A
  • Sacubitril – neprilysin inhibitor
  • Valsartan – ARB
  • Entresto –combination of Sacubitril and Valsartan and it is very effective in heart failure
40
Q

What do nitrates do in cardiac disease?

A
  • They are atrial and venous dilators
  • Reduce preload and afterload
  • Lower BP
41
Q

What are nirates indicated for?

A

IHD – angina and heart failure

42
Q

Give 3 examples of nitrate treatment

A
  • Isosorbide mononitrate
  • GTN spray
  • GTN infusion
43
Q

What are the main adverse effects of nitrate treatment?

A
  • Headache
  • GTN spray syncope
  • Potential tolerance to the drug
44
Q

What does GTN stand for?

A

Glyceryl trinitrate

45
Q

What are the 1st line treatments for chronic stable angina?

A
  • Beta blocker
  • Calcium channel blocker
  • Combine if angina persists on just one
46
Q

What are the antiplatelet treatments for chronic stable angina?

A

Aspirin or clopidogrel (if aspirin intolerant)

47
Q

What are the lipid lowering therapy treatments for chronic stable angina?

48
Q

What is the short acting nitrate treatment for chronic stable angina?

A

GTN spray for acute attack

49
Q

How should chronic stable angina be treated if the patient is intolerant to the usual therapies or the angina remains uncontrolled?

A

Consider a monotherapy or combination with a long acting nitrate e.g. ivabradine, nicorandil, ranolazine

50
Q

What pain relief can be given in acute coronary syndromes?

A
  • GTN spray

* Opiates e.g. diamorphine

51
Q

What types of therapy would you usually give to manage acute coronary syndromes?

A
  • Pain relief
  • Dual antiplatelet therapy
  • Anti-thrombin therapy
  • Background angina therapy
  • Lipid lowering therapy
  • Therapy for LVSD/heart failure as required
52
Q

What would you give in high risk cases of acute coronary syndromes?

A

IV glycoprotein IIb/IIIa inhibitor e.g. tirofiban, eptifbatide, abciximab

53
Q

What is dual antiplatelet therapy for acute coronary syndromes?

A

Aspirin + oral P2Y12 inhibitor e.g. ticagrelor, clopidogrel

54
Q

What is an anti-thrombin therapy and give an example of a drug?

A

Low molecular weight heparin e.g. fondaparinux (injection)

55
Q

How do beta blockers relieve angina pain?

A
  • They reduce oxygen demand by slowing hear rate and reducing myocardial contractility
  • They improve oxygen distribution by slowing heart rate
56
Q

What is the classification for anti-arrhythmic drugs?

A

Vaughan Williams classification

57
Q

What do the classes of anti-arrhythmic drugs do?

A
  • Class 1 & 3 = rhythm control

* Class 2 & 4 = rate control

58
Q

What are Class 1 anti-arrhythmic drugs and what are some examples?

A

• Sodium channel blockers
 1a: disopyramide, quinidine, procainamide
 1b: lidocaine, mexiletine
 1c: flecainide, propafenone

59
Q

What is the most commonly used Class 1 anti-arrthythmic drug?

A

Flecainide

60
Q

What are Class 2 anti-arrhythmic drugs and what are some examples?

A

• Beta adrenoceptor antagonists
 Non-selective: propranolol, nadolol, carvedilol
 β-1 selective: bisoprolol, metoprolol

61
Q

How do Class 3 anti-arrhythmic drugs work and what are some examples?

A
  • Prolong the action potential – increase QT interval

* e.g. amiodarone, sotalol

62
Q

What are Class 4 anti-arrhythmic drugs and what are some examples?

A
  • Calcium channel blockers

* e.g. verapamil, diltiazem

63
Q

Give an example of an α-blocker

64
Q

Give examples of an ACE inhibitor

A
  • Ramipril
  • Enlarpril
  • Perindopril
  • Trandolapril
65
Q

Give examples of an ARB

A
  • Candesartan
  • Losartan
  • Valsartan
  • Irbesartan
  • Telmisartan
66
Q

Give examples of antiplatelet therapies

A
  • COX-1 inhibitor: aspirin

* P2Y12 inhibitor: Ticagrelor, Clopidogrel

67
Q

Give an example of an anti-thrombin therapy

A

Low molecular weight heparin e.g. fondaparinux

68
Q

Give examples of beta blockers

A
  • Propranolol
  • Bisoprolol
  • Atenolol
69
Q

Give examples of a calcium channel blocker

A
  • Amlodipine
  • Felodipine
  • Diltiazem
  • Verapamil
70
Q

Give examples of centrally acting anti-hypertensives

A
  • Moxonidine

* Methyldopa

71
Q

Give examples of a Class 1a Na channel blocker

A
  • Disopyramide
  • Quinidine
  • Procainamide
72
Q

Give examples of a Class 1b Na channel blocker

A
  • Lidocaine

* Mexiletine

73
Q

Give examples of a Class 1c Na channel blocker

A
  • Flecainide (most commonly used)

* Propafenone

74
Q

Give examples of a Class 3 anti-arrhythmic drug

A
  • Amiodarone

* Sotalol

75
Q

Give an example of a direct renin inhibitor

76
Q

Give examples of a thiazide diuretic

A
  • Bendroflumethiazide
  • Hydrochlorothiazide
  • Chlorthalidone
77
Q

Give examples of a loop diuretic

A
  • Furosemide

* Bumetanide

78
Q

Give examples of a potassium-sparing diuretic

A
  • Spironolactone

* Eplerenone

79
Q

Give examples of a glycoprotein IIb/IIIa inhibitor

A
  • Tirofiban
  • Eptifbatide
  • Abciximab
80
Q

Give an example of a neprilysin inhibitor

A

Sacubitril

81
Q

Give an example of an opiate

A

Diamorphine

82
Q

Give examples of a long-acting nitrate

A
  • Isosorbide mononitrate
  • Ivabradine
  • Nicorandil
  • Ranolazine
83
Q

Give an example of a short-acting nitrate

A

Glyceryl trinitrate (GTN)

84
Q

Give an example of a statin

A

Simvastatin

Cardiovascular (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions