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Fire Through Finals > Cardiology: The Drugs that make it possible > Flashcards

Cardiology: The Drugs that make it possible Flashcards

1
Q

What are the 3 types of diuretic and how does their MOA differ?

A

Loop: Blocks Na/2Cl/K co-transporter in ascending loop
Thiazide: Blocks Na/Cl symporter in DCT
Potassium sparing: Block Na channels in DCT

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2
Q

Spironolactone, eplerenone and amiloride are all types of?

A

K+ sparing diuretics

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3
Q

Furosemide and bumetanide are what drugs?

A

Loop diuretics

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4
Q

What drug is metolozone? name another member of this class

A

Thiazide diuretic

indapamide

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5
Q

Which of the following drugs will not cause hypokalaemia?

Amiloride

Metolazone

Indapamide

Eplernone

furosemide

A

Eplernone

K+ Sparing only block Na+ reabsorption

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6
Q

Amenorrhea, gynaecomastia, decreased libido are features of which diuretic?

A

K+ sparing diuretics

Spares your potassium but not your sex life

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7
Q

What are the side effects of thiazide diuretics?

A

Gout, Glucose tolerance impaired, Getting it up

(making you pee costs you the 3 Gs)

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8
Q

Which diuretic causes your electrolytes to leave and not hear them go?

A

Loop diuretics

also remember hearing by induction LOOP

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9
Q

Ramipril and lisinopril are what class of drugs?

A

ACE inhibitor

Blocks conversion of AT1–>2 which:

Prevents vasoDILATION

Secretes aldosterone .’. retain sodium (water)

BOTH OF WHICH RAISE BP

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10
Q

Which of the following is NOT a contraindication to ramipril?

Pregnancy

Angioedema

Previous MI

Renal artery stenosis

Stroke

A

Previous MI

Stroke

SEs of ramipril: RAS, pregnancy, angioedema

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11
Q

How does the effect of -sartans differ from ACEIs?

A

Blocks AT1 receptor rather than conversion to AT2

Does not deactivate bradykinin so no less vasodilation

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12
Q

Compare the contraindications of losartan and lisinopril

A

Both RAS and pregnancy

Only losartan allowed in angioedema

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13
Q

What is the action of GTN/Isorboside mononitrate and how do they differ?

A

Vasodilation

NO causes downstream reduction in Ca2+ influx

GTN shorter acting while ISMN longer acting

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14
Q

What are the side effects of nitrate use?

A

Think of everything vasodilation would do

Hypotension

Tachycardia

Headaches

Flushing

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15
Q

Amlodipine and verapamil are what kind of drug?

A

Calcium channel blockers

-dipines are dihydropyridines

verapamil and diltiazem are not

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16
Q

Outline the action of nifedipine and verapamil

A

Both are CCBs so reduce contractile force

Verapamil, like diltiazem, is a ND-CCB so reduces AVN conduction to slow rate

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17
Q

What drug should NEVER be given with verapamil or diltiazem?

A

B-blockers

Bradycardia

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18
Q

How do the prolols work? why is propanolol special?

A

Block B receptors

Propanolol non selective

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19
Q

What are the side effects of B-blockers?

A

Bronchospasm

Cold peripheries

Fatigue

Sleep disturbances

ED

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20
Q

In which circumstances are B-blockers contraindicated?

A

Where bradycardia is BADycardia (HF, Sick sinus, + verapamil)

Asthma

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21
Q

Aspirin, tirofiban, clopidogrel, ticagrelor are all what?

A

Antiplatelets

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22
Q

Which of the following is not an antiplatelet?

Tirofiban

Ifetroban

Apixiban

A

Apixiban

Its an anticoagulant

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23
Q

If a patient with PMHx of gastric ulcers is found to have aspirin, what should be changed?

A

Aspirin to clopidogrel

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24
Q

If a patient has a thrombus, what blood altering medication should you give?

A

Depends if venous or arterial

Venous: Anticoagulant

Arterial: Antiplatelet

25
Compare the MOA of warfarin vs LMWH/OACs
Both anticoagulants Warfarin is a vit K reductase inhibitor Others either inhibit thrombin or Factor Xa
26
A patient has a major haemorrhage, what meds would help reverse: Warfarin LMWH OACs
Warfarin: Vitamin K Heparins: Protamine DOAC: idarucizamab (dabigitran), andexanet alfa
27
Streptokinase, alteplase and duteplase are all what drugs?
Fibrinolytics Break down fibrin via plasminogen activation
28
What are the main concerns with fibrinolytics?
Haemorrhage Streptokinase allergy --\> dont give following recent strep infection
29
How do simvastatin and atorvostatin work?
Statins Reduce cholestrol formation through HMG-CoA reductase inhibition increased LDL receptor expression causing LDL clearance
30
What are the side effects of atorvostatin, simvastatin
Myopathies Liver impairment so check 3 months the yearly
31
What 3 patient groups should a statin be avoided in?
Pregnancy Macrolide users Previous IC bleed
32
What do bezafibrate and gemfibrozil do?
Fibrates Reduce cholestrol By upregulating PPARa related genes
33
Put the following drugs into their correct class Quinidine Lidocaine Procainamide Disopyramide Flecanide
All sodium channel blockers Flecainide: Slow acting Lidocaine: Fast acting Others: Medium acting
34
What drugs are class II antiarrhythmics?
B-blockers
35
What is amiodarone and what are its side effects?
Potassium channel blocker Side effects: Pulmonary fibrosis Photosensitivity Peripheral neuropathy Thyroid problems
36
What is the effect of digoxin?
Reduces rate Increases force
37
What are the side effects of digoxin and how do you look out for them?
Heart block, arrhythmias Not routinely monitored but measure 8-12 hours after last dose
38
What does atropine do?
Speeds up the heart Blocks muscarnic inhibition of heart rate
39
Ivabradine: How?
Reduces cardiac rate Through blocking 'funny' current in SA node
40
Altered light vision, headache and bradys are caused by what cardiac drug?
Ivabradine
41
How does the INR for warfarin differ between A-fib and VTE/
2. 5 for both 3. 5 if VTE recurrent
42
Which of the following does not reduce warfarin's effect? Amiodarone NSAIDS Cranberry juice Ciprofloxacin Clindamycin Clopidogrel
Clopidogrel P450 inhibition: Amiodarone, cipro (ALSO LIVER DISEASE) NSAIDS: Inhibit platelet function and displace warfarin
43
What tests should be performed prior to amiodarone therapy?
TFTs, CXR, U+Es, LFTs
44
Breathlessness with fever and a new murmur points towards what cardiac condition?
Infective endocarditis
45
For endocarditis, what pathogen is most assoicated with Being the most common Poor dental hygiene People with IVs Colorectal cancer
S. aureus S. Viridans S. Epidermidis S. bovis
46
What are the major Duke Criteria and how many do you need for IE diagnosis?
Postiive blood cultures x 2 Positive Echo for regurg/oscillating structures/abscess formation 2 major (or 1 major, 3 minor)
47
What are the minor criteria for IE and how many are needed for diagnosis?
Positive cultures x1 Prior heart condition or IVDU Fever \>38 degrees Vasuclar changes (eg emboli) Immunoligical history Need 5 minor
48
What is the blind and targeted therapy for native endocarditis
B: Amox +/- gent T: Flucloxicillin
49
What is the blind and targeted therapy for prosthetic valve endocarditis?
B: Vanc + Gent + rifampicin T: Swap vanc to fluclox
50
Who gets prophylactic therapy for endocarditis?
At risk populations taking antimicrobials for GI/GU stuff
51
What investigations are performed in suspected endocarditis?
Blood cultures TT echo \<24hrs, TOE if -ve + US abdo for splenic infarcts
52
How can you tell aortic stenosis and mitral regurgitation apart?
AS: Ejection systolic, crescendo-decrescendo murmur, slow rising pulse MR: Pan-systolic murmur, high pitched, mid-systolic click worse on squatting
53
Differentiate mitral stenosis and aortic regurgitation
MS: Mid-diastolic, low-rumbling. Malar flush and A-fib AR: Early diastolic, soft murmur, collapsing pulse
54
Match the pulse to its murmur Collapsing wide pulse pressure narrow pulse pressure
Aortic regurgitation Aortic regurgitation Aortic stenosis
55
What does raised JVP, hypotension and muffled heart sounds indicate?
Beck's triad Cardiac tamponade
56
What does this show and what condition is it seen in?
Electrica alternans Cardiac tamponade
57
How can you differentiate chronic pericarditis from cardiac tamponade using JVP waveform Raised JVP on inspiration (Kussmaul's) Inspiratory fall in pulse pressure (pulsus paradoxus) Pericardial calcification on CXR
CT // CP X // X+Y Rare // present Present // Absent No // Yes
58
How do you treat a cardiac tamponade?
Pericardiocentesis
59
Breathlessness, raised JVP, pansystolic murmur and hepatosplenomegaly in a chronic lung disease patient indicates what and how is it treated
Cor pulmonale Manage underlying cause

Fire Through Finals (32 decks)

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