CARDIOVASCULAR

Question 1

What type of antiplatelet therapy are MI patients on?

Answer 1

Dual anti platelet therapy.

Aspirin + P2Y12 inhibitor e.g. clopidogrel, ticagrelor or prasugrel.

Question 2

What is the immediate management of a STEMI?

Answer 2

MONA:
Use of GTN spray, administer O2 (only if hypoxaemic, pulmonary oedema or continuing myocardial ischaemia) analgesia- (e.g morphine and a co-prescribed antiemetic), dual antiplatelet therapy (aspirin and clopidogrel/ticagrelor), restore patency to occluded artery (PCI or thrombolytic drug).

Question 3

What is the mechanism of action of aspirin?

Answer 3

Inhibition of cyclooxygenase enzymes in proximal tubules.

Question 4

What is the mechanism of action of a calcium channel blocker e.g Amlodipine?

Answer 4

Inhibition of L-type voltage gated calcium channel in the nephron.

Question 5

What is the action of a thiazide-like diuretic e.g Bendroflumethiazide?

Answer 5

Inhibition of the sodium chloride transporter in the distal convoluted tubule.

Question 6

What is the mechanism of action of loop diuretics e.g furosemide?

Answer 6

Inhibition of the sodium/potassium/chloride symporter in the loop of Henle.

Question 7

What is the mechanism of action of spironolactone?

Answer 7

Inhibition of aldosterone receptor in the distal tubule.