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Cardiology Drugs Flashcards

1
Q

Loop Diuretic Examples

A

Furosemide, Bumetanide, Torsemide

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2
Q

How do Loop Diuretics work?

A

Act on ascending limp to inhibit Na+/K+/2CL- co-transporter

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3
Q

Loop Diuretic Indications

A

Acute Pulmonary Oedema, Heart Failure, Fluid overload due to other causes

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4
Q

Loop Diuretic Contra-indications

A

Hypovolaemia, Dehydration, Hypokalaemia/Hyponatraemia

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5
Q

What disease can Loop Diuretics worsen and why?

A

Gout - Loop Diuretics inhibit uric acid excretion

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6
Q

Loop Diuretic Side Effects

A

Dehydration, Hypotension, Hearing loss/Tinnitus

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7
Q

What drugs levels are increased by Loop Diuretics?

A

Lithium, Digoxin, Aminoglycosides

should be careful of this in all diuretics

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8
Q

Thiazide Diuretic Examples

A

Chlorthiazide, Indapamide, Metolazone

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9
Q

How do Thiazide Diuretics Work?

A

Inhibit the Na+/CL- co-transported in the Distal Tubule

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10
Q

Thiazide Diuretic Indications

A

Hypertension, First line if CCBs aren’t tolerated, Third line if ACE + CCB doesn’t work

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11
Q

Thiazide Diuretic Contra-indications

A

Hypokalaemia, Hyponatraemia, Gout

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12
Q

What drug class reduces the effectiveness of Thiazide Diuretics?

A

NSAIDs

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13
Q

Potassium Sparing Diuretics Examples

A

Spironolactone, Amiloride, Eplerenone

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14
Q

Potassium Sparing Diuretics Indications

A

Combination therapy with Loop/Thiazide diuretics to reduce potassium loss

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15
Q

Potassium Sparing Diuretics Contra-indications

A

Renal impairment, Hyperkalaemia and Hypokalaemia (unpredictable)

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16
Q

Beta-Blocker Examples

A

Bisoprolol, Atenolol, Propranolol

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17
Q

How do Beta-Blockers Work?

A

Block Beta1-adrenoreceptors (in heart) = reduced contraction and speed of conduction in heart

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18
Q

Beta-Blockers Indication

A

Angina/ACS, Heart failure, AF, SVT

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19
Q

Beta-Blockers Contra-indications

A

Asthma (bronchospasm), Heart block

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20
Q

Beta-Blockers Side-Effects

A

Fatigue, Cold Extremities, Sleep disturbance, Impotence

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21
Q

Beta-Blocker Interactions

A

Don’t use with non-dihydropyridine calcium channel blockers = heart failure / asystole

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22
Q

Non-dihydropyridine Calcium Channel Blocker Examples

A

Diltiazem, Verapamil

heart

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23
Q

Dihydropyridine Calcium Channel Blocker Examples

A

Amlodipine, Nifedipine

vasculature

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24
Q

How do Calcium Channel Blockers Work?

A

Decrease Ca2+ entry into cells = Relaxation, Vasodilation, Reduced contractility

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25
Q

Calcium Channel Blockers Indications

A

Hypertension, Stable Angina

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26
Q

Calcium Channel Blockers Contra-Indications

A

Heart failure, AV delay

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27
Q

Calcium Channel Blockers Side Effects

A

Ankle Swelling, Flushing, Palpitations, Bradycardia

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28
Q

What drugs shouldn’t you prescribe Non-dihydropyridine Calcium Channel Blockers with?

A

Beta-blockers

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29
Q

ACE Inhibitor Examples

A

Ramipril, Fosinopril, Enalapril

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30
Q

How do ACE Inhibitors Work?

A

Block conversion of angiotensin I to angiotensin II (which is a vasoconstrictor)

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31
Q

ACE Inhibitors Indications

A

Hypertension, Heart Failure, Angina/ACS, CKD

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32
Q

ACE Inhibitor Contra-Indications

A

Renal artery stenosis, AKI, Pregnancy

33
Q

ACE Inhibitor Side Effects

A

Dry Cough, Hypotension (after first dose)

34
Q

ACE Inhibitor Interactions

A

Potassium-Elevating drugs, NSAIDs (renal failure)

35
Q

Angiotensin Receptor Blockers Examples

A

Losartan, Candesartan

36
Q

Angiotensin Receptor Blockers Indications

A

Used as an alternative to ACE inhibitors

same contra-indications and side-effects

37
Q

How do Nitrates work?

A

Converted to NO = Reduced Ca2+ in vascular smooth muscle cells

38
Q

Nitrate Indications

A

Acute angina/ACS Pain, Prophylaxis of angina (long acting)

39
Q

Nitrate Contra-indications

A

Aortic stenosis (=collapse), Hypotension

40
Q

Nitrate Side Effects

A

Flushing, Headache, Hyoptension

41
Q

How does Digoxin Work?

A

Negatively chronotropic + Positively inotropic

42
Q

Digoxin Indications

A

AF, Heart Failure

43
Q

Digoxin Contra-Indications

A

Heart block, Ventricular Arrhythmia, Renal failure

44
Q

Digoxin Side Effects

A

Visual disturbance, Dizziness, Bradycardia

45
Q

How does Amiodarone work?

A

Blocks sodium/calcium/potassium channels and Antagonism of a and b-adrenergic receptors

46
Q

Amiodarone Indications

A

Wide Range of Arrhythmias

47
Q

Why do you have to be careful with Amiodarone?

A

Many serious side-effects and possible interactions

48
Q

Anti-Platelet Examples

A

Aspirin, Clopidogrel, Ticagrelor

49
Q

How does Aspirin work?

A

Blocks COX = Reduces thromboxane

50
Q

Anti-Platelet Indications

A

ACS, Ischaemic stroke, Long term CVD/PVD

51
Q

Why shouldn’t aspirin be given to under 16yrs olds?

A

Reye’s Syndrome (liver and brain)

52
Q

Aspirin Contra-indications

A

Under 16yrs, Pregnancy, Peptic ulcer, Gout

53
Q

Main side-effect of Anti-platelets?

A

Increased risk of bleeding (especially when combined)

54
Q

Thrombolytic Examples

A

Streptokinae, tPA, Alteplase

55
Q

How do Thrombolytics work?

A

Catalyse the conversion of plasminogen to plasmin = Dissolves clot

56
Q

Thrombolytics Indications

A

Ischaemic stroke, STEMI, Massive PE

57
Q

Thrombolytics Side Effects

A

Hypotension, Cardiogenic shock, Serious Bleeding, Arrhythmia

58
Q

How does Heparin Work?

A

Inhibits Thrombin and Factor Xa = Prevents clots

59
Q

What does Low Molecular Weight Heparin specifically work on?

60
Q

Name a synthetic compound that is similar to Heparin?

A

Fondaparinux

61
Q

Heparin Indications

A

DVT, PE, ACS

62
Q

Heparin Side Effects

A

Bleeding, Heparin-Induced Thrombocytopenia

63
Q

Oral Anticoagulant Examples

A

Warfarin, Dabigatran, Rivaroxaban, Apixaban

64
Q

How does Warfarin work?

A

Inhibit Vitamin K cofactors: Factors II, VII, IX, X + Protein C, S, Z

65
Q

How do DOACs/NOACs work?

A

Inhibit just one Vitamin K cofactor unlike warfarin

66
Q

Oral Anticoagulants Indications

A

DVT, PE, AF, Valve replacements

67
Q

Oral Anticoagulant Contra-indications

A

Patients at risk of Bleeding, Pregnancy

68
Q

What system is Warfarin metabolised by?

A

CYP450 (many interactions)

69
Q

Why do Antibiotics increase anticoagulation with Warfarin?

A

They kill gut flora which normally make Vitamin K

70
Q

What is the main difference between Warfarin and NOACs?

A

NOACs are less influenced by diet and other medications

71
Q

Oral Direct Thrombin Inhibitor NOAC Example

A

Dabigatran

72
Q

Oral Direct Factor Xa Inhibitor NOAC Example

A

Rivaroxaban, Apixaban

73
Q

Statin Examples

A

Atorvastatin, Simvastatin, Lovastatin

74
Q

How do Statins Work?

A

Inhibit HMG Coa Reductase = Decreased cholesterol

Also increase LDL clearance from blood

75
Q

Statins Indications

A

Prevention of CVD, Hyperlipidaemia

76
Q

Statins Contra-indications

A

Hepatic or Renal impairment, Pregnancy

77
Q

What is the main Side Effect of Statins?

A

Muscle aches (can rarely = rhabdomyolisis)

78
Q

What system are Statins metabolised by?

Pharmacology (9 decks)

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