Cardiovascular

Question 1

Maximum daily doses of 8 ACE inhibitors?

Answer 1

Capt. won fifty trains for ten pairs of rams.
An owl keen for sin lies forty times.

Captopril 150mg
Trandolapril 4mg
Perindopril, ramipril 10mg
Enalapril, quinapril, fosinopril, lisinopril 40mg

Question 2

Maximum daily doses of 7 sartans?

Answer 2

COT LIVE

Candesartan 32mg
Olmesartan 40mg
Telmisartan 80mg
Losartan 100mg
Irbesartan 300mg
Valsartan 320mg
Eprosartan 600mg

Question 3

Maximum daily doses of 8 calcium channel blockers?

Answer 3

I am tentative. 20yo Luke fell on a knife 120 times.
A nimble dill, he did a 360. Very clever.

Amlodipine 10mg
Lercanidipine, felodipine 20mg
Nifedipine 120mg
Nimodipine, diltiazem 360mg
Verapamil 480mg
Clevidipine 500mg/24h infusion

Question 4

Calcium channel blockers also indicated for angina?

Answer 4

Dihydropyridines: amlodipine, nifedipine

Non-dihydropyridines: verapamil, diltiazem

Question 5

Nimodipine: indication and formulation(s)?

Answer 5

Subarachnoid haemorrhage.

Tablets and infusion.

Question 6

Cardioselective beta blockers?

Answer 6

B-MAN has a lot of heart.

Bisoprolol
Metoprolol
Atenolol
Nebivolol

Question 7

Maximum daily doses for 10 beta blockers?

Answer 7

10 busy nebbishes want 30 pins for 100% caring attention.
At 3:20 sought proper oxen 400 meat. 2400hrs lab.

Nebivolol, Bisoprolol 10mg
Pindolol 30mg
Carvedilol, Atenolol 100mg
Sotalol, Propranolol, Oxprenolol 320mg
Metoprolol 400mg
Labetalol 2.4g

Question 8

Renally eliminated beta blockers?

Answer 8

ABN

Atenolol
Bisoprolol
Nebivolol

Question 9

Clonidine indications?

MOA?

Answer 9

A MAP HOP clone

Anaesthesia (adjunct)
Menopausal flushing
ADHD
Phaeochromocytoma diagnosis
Hypertension
Opioid withdrawal
Pain (adjunct)

Centrally-acting alpha-2/imidazoline receptor agonist.

Stimulates alpha-adrenoceptors in the brain stem to decrease activity of the sympathetic NS: decreases in peripheral resistance, renal vascular resistance, heart rate, and blood pressure.

Question 10

Hydralazine indications?

MOA?

Answer 10

Hypertensive emergency
Refractory hypertension (+beta-blocker and diuretic)
Heart failure (with a nitrate)

Direct-acting arterial dilator.
Via hyperpolarisation of vascular smooth muscle (opens potassium channels).

Often used in conjunction with a beta-blocker and diuretic to attenuate the baroreceptor-mediated reflex tachycardia and renal sodium retention, respectively.

Question 11

Methyldopa indications?

MOA?

Answer 11

Hypertension (including gestational and pre-eclampsia)

Centrally-acting alpha-2 adrenergic agonist (active metabolite alpha-methylnorepinephrine).

Stimulates alpha-adrenoceptors in the brain stem to decrease activity of the sympathetic NS.

Question 12

Minoxidil MOA?

Answer 12

Direct-acting arterial dilator (active metabolite minoxidil sulfate).
Via hyperpolarisation of smooth muscle (opens potassium channels).

Question 13

Moxonidine indications?
MOA?

Formulations & brands?

Answer 13

Sounds like clonidine.

Hypertension

Centrally-acting alpha-2/imidazoline receptor agonist.
(Much greater affinity for imidazoline receptor.)

Decreases activity of the sympathetic NS.

200mcg & 400mcg tabs “Physiotens”

Question 14

Sodium nitroprusside in-depth MOA?

Answer 14

Peripheral venous & arterial vasodilator.

Binds oxyhaemoglobin to release nitric oxide, cyanide and methaemoglobin (side effects).
NO activates guanylate cyclase in vascular smooth muscle and increases intracellular production of cGMP.
cGMP activates protein kinase G, which activates phosphatases that inactivate myosin light chains.
Myosin light chains are involved in muscle contraction. The end result is vascular smooth muscle relaxation, which allow vessels to dilate.
Mechanism is similar to PDE5 inhibitors, which increase cGMP by inhibiting its degradation by PDE5.