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308 Clinical pharmacology > Cardiovascular drugs 1 > Flashcards

Cardiovascular drugs 1 Flashcards

1
Q

What are the risk factors for atrial fibrillation?

A 
Hypertension
Valvular heart disease
Coronary artery disease
Cardiomyopathy
Congenital heart disease
Previous cardiac surgery
Pericarditis
Lung disease - PE, pneumonia, COPD
Hyperthyroidism
Alcohol
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2
Q

How is AF classified?

A

Lone AF
Paroxysmal
Persistent
Permanent

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3
Q

What are the clinical features of AF?

A 
Asymptomatic
Palpitations
SOB
Chest pain
Syncope
Pre-syncope
Heart failure
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4
Q

What are the 3 broad ways of treating AF?

A

Rate control
Rhythm control
Anticoagulation

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5
Q

When is rhythm controlled preferred over rate control?

A

Symptom improved
Younger patient
Heart failure related to AF
Adequacy of rate control

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6
Q

What are the rate control drugs for acute AF without heart failure?

A

1st line: Beta blocker or Calcium channel blocker

2nd line: add digoxin

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7
Q

What are the rate control drugs for acute AF with heart failure?

A

1st line: digoxin and amiodarone

2nd line: add amiodarone

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8
Q

What are the rate control drugs for permanent or paroxysmal AF?

A

1st line: beta blocker or CCB

2nd line: add digoxin

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9
Q

What are the rhythm control drugs for acute cardio version and a normal heart?

A

Flecainide

Sotalol

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10
Q

What are the rhythm control drugs for acute cardio version with an abnormal heart?

A

Amiodarone

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11
Q

What are the rhythm control drugs to maintain sinus rhythm in a normal heart?

A

Flecainide

Sotalol

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12
Q

What are the rhyththm control drugs to maintain sinus rhythm in an abnormal heart?

A

Amiodarone

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13
Q

What are the 3 types of beta blockers?

A

Non-cardioselective
Cardioselective
Vasodilatory

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14
Q

Give examples of non cardioselective beta blockers

A

Propanolol
Carvedilol
Sotalol

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15
Q

Give examples of cardioselective beta blockers

A 
Atenolol
Bisoprolol
Esmolol
Metoprolol
Nebivolol
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16
Q

Give examples of vasodilatory beta blockers

A

Labetalol

Carvedilol

17
Q

Give examples of rate limiting calcium channel blockers

A

Verapamil

Diltiazem

18
Q

Give examples of dihydropyridine calcium Chanel blockers

A 
Amlodipine
Nifedipine
Felodipine
Lercanidipine
Nimodipine
19
Q

What risk factors are included in the ChadsVaSc score?

A 
Congestive HF = 1
Hypertension = 1
Age >75 = 2
Diabetes = 1
Stroke = 2
Vascular disease = 1
Age 65-74 = 1
Sex (female) = 1
20
Q

What is included in the HAS-BLED score?

A 
Hypertension = 1
Abnormal renal / liver function = 1 point for each
Stroke = 1
Bleeding = 1
Labile INRs = 1
Elderly = 1
Drugs / alcohol = 1 point each
21
Q

What is the HAS-BLED score?

A

1 year risk of bleeding with AF and anticoagulation

22
Q

What are some non-pharmaceutical treatments of AF?

A

Radiofrequency catheter or cryo-ablation

Left atrial appendage occlusion

23
Q

What drug treatments are given for stroke?

A 
Fibrinolysis
Antithrombotics
Aspirin
Clopidogrel
Warfarin or DOACs
Lipid modification
Treat hypertension
24
Q

Give examples of secondary causes of raised lipids

A 
Excess alcohol
Uncontrolled diabetes
Hypothyroidism
Liver disease
Nephrotic syndrome
25
Q

When should patients be referred to lipid specialist?

A

Total serum cholesterol > 7.5mmol/l + family history of premature CAD
Total serum cholesterol >9mmol/l

26
Q

How do PCSK9i work?

A

PRALUENT binds to PCSK9 which inhibits binding of PCSK9 to LDLR. This increases number of LDLRs available to clear LDL which lowers LDL-C levels

27
Q

Give examples of PCSK9i drugs

A

Alirocumab

Evolocumab

28
Q

What drug classes are used to treat heart failure?

A 
Diuretics
ACE inhibitors
Beta blockers
Aldosterone antagonists
ARBs
Hydralazine / nitrates
Digoxin
29
Q

Give an example of a loop diuretic

A

Furosemide

30
Q

Give an example of a thiazide diuretic

A

Bendroflumethiazide

31
Q

What type of diuretic is metolazone?

A

Thiazide like

32
Q

Give examples of K+ sparing diuretics

A

Spironolactone

Amiloride

33
Q

Give examples of ACE inhibitors

A 
Ramipril
Lisinopril
Enalapril
Perindopril
Captopril
34
Q

Give examples of ARBs

A

Losartan
Candersartan
Valsartan

35
Q

When is ivabradine recommended?

A

With / instead of beta blocker if HR is too high

36
Q

When is hydralazine + nitrate recommended?

A

If ACEi / ARB are not tolerated or contraindicated or in those of African origin

37
Q

When is sacubitril recommended?

A

NYHA II-III symptoms and LVEF ≤35% and already taking stable dose of ACEi or ARB

38
Q

What are some alternative therapies for HF?

A

Coronary revascularisation
Cardiac resynchronisation therapy
Cardiac transplantation

308 Clinical pharmacology (10 decks)

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