Cardiovascular drugs

Question 1

How does aspirin work?

Answer 1

Blocks cyclo-oxygenase, preventing production of thromboxane A2, thereby inhibiting platelet aggregation..

Question 2

How does aspirin work?

Answer 2

Blocks cyclo-oxygenase, preventing production of thromboxane A2, thereby inhibiting platelet aggregation..

Question 3

How does clopidogrel work?

Answer 3

Antagonizes the ADP receptor on platelets, preventing platelet aggregation

Question 4

When are aspirin and clopidogrel used?

Answer 4

Acute coronary syndrome (treatment and prevention)

Question 5

How do B-blockers work?

Answer 5

Block B-adrenoceptors:
B1- blocking causes a negative inotropic and chronotropic effect
B2- peripheral vasoconstriction and bronchoconstriction

Question 6

Describe the selectivity of propanolol and bisoprolol.

Answer 6

Propanolol- non selective

Bisoprolol- B1 selective

Question 7

When should beta-blockers be used with caution?

Answer 7

Peripheral vascular disease, heart failure

Question 8

What are the indications for beta blockers?

Answer 8

Angina, hypertension, anti-dysrhythmic, post MI, heart failure (start low go slow)

Question 9

What are the indications for beta blockers?

Answer 9

Angina, hypertension, anti-dysrhythmic, post MI, heart failure (start low go slow)

Question 10

How do a) thiazide and b) loop diuretics work?

Answer 10

a) block the Na/Cl co-transporter b) block the triple co-transporter

Question 11

What side-effect do thiazide and loop diuretics share?

Answer 11

Hypokalaemia

Question 12

Gout is a side-effect of which diuretic?

Answer 12

Thiazides

Question 13

What is the mechanism of action of nitrates in ischaemic heart disease?

Answer 13

Reduces preload and oxygen requirements of the myocardium

Question 14

What is the mechanism of action of nitrates in ischaemic heart disease?

Answer 14

Reduces preload and oxygen requirements of the myocardium

Question 15

How do calcium blockers work?

Answer 15

Inhibit the entry of calcium via voltage-sensitive L-type channels

Question 16

Give examples of dihydropyridine calcium blockers, and explain their mechanism of action/indications.

Answer 16

Amlodopine, nifedipine. Mainly peripheral vasodilators- used in angina and hypertension

Question 17

What are verapamil and diltiazem used to treat and why?

Answer 17

Hypertension, angina and dysrhythmias. Slow down transmission at SA and AV nodes

Question 18

Which drug should verapamil never be used with?

Answer 18

Beta-blocker- risks severe bradycardia and left ventricular failure

Question 19

How does digoxin work?

Answer 19

Blocks the Na/K pump, thereby slowing the pulse

Question 20

What is digoxin used for? (2)

Answer 20

Rate control in fast AF

Option in heart failure

Question 21

Which abnormality of electrolyte balance enhances the toxicity of digoxin?

Answer 21

Hypokalaemia

Question 22

How do statins work?

Answer 22

Block HMG-COA reductase, hence blocking synthesis of cholesterol in the liver

Question 23

Which class of drug is amiodarone?

Answer 23

Class III antiarrythmic

Question 24

Monitoring of patients taking amiodarone:

a) prior to starting treatment
b) every 6/12

Answer 24

a) TFT, LFT, U&Es, CXR

b) TFT, LFT

Question 25

Adverse effects of amiodarone? (5)

Answer 25

Many; important ones:

Thyroid dysfunction
Pulmonary fibrosis/pneumonitis
Liver fibrosis/hepatitis
Neuropathy
Thrombophlebitis

Question 26

Which antihypertensives can cause hyperkalaemia? (4)

Answer 26

Spironolactone, potassium-sparing (co-amiloride), ACE inhibitors/ARBs

Question 27

Which calcium channel blocker is most likely to precipitate acute pulmonary oedema in a patient with heart failure, and why?

Answer 27

Verapamil

Is the most negatively inotropic of the calcium blockers