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MD3001 > cardiovascular drugs > Flashcards

cardiovascular drugs Flashcards

1
Q

what treatment would you give for a hypertensive patient under 55

A

A
then A + C
then A + C + D
Then ABCD or alpha blocker or extra diuretic

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2
Q

how do you treat someone over 55 with hypertension

A

C
then A + C
then A + C + D
( D = thiazide like diuretic)

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3
Q

ramipril

A

ACE inhibitor

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4
Q

lisonopril

A

ACE inhibitor

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5
Q

losartan

A

Angiotensin receptor agonist - ARB

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6
Q

aliskiren

A

Renin inhibitor

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7
Q

amlodipine

A

Calcium channel blocker(dihydropyridine like)

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8
Q

lercanidipine

A

Calcium channel blocker (dihydropyridine like)

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9
Q

indapamide

A

thiazide like diuretic

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10
Q

bendroflumethiazide

A

thiazide like diuretic

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11
Q

bisoprolol

A

B blocker

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12
Q

atenolol

A

B blocker

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13
Q

doxazosin

A

alpha blocker

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14
Q

Potassium sparing diuretic/ aldosterone antagonist

A

spironolactone

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15
Q

dry cough, dizziness, headaches, tiredness

A

ACE inhibitor

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16
Q

dizziness, headaches, leg pain

A

ARBs

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17
Q

flushes, headaches, ankle oedema, dizziness

A

Calcium blocker

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18
Q

raised potassium and blood sugar levels

A

thiazide like diuretic

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19
Q

furosemide

A

loop diuretic

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20
Q

candesartan

A

ARB

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21
Q

carvedilol

A

B blocker

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22
Q

side effect of loop diuretics

A

gout

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23
Q

digoxin

A

AF

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24
Q

opiates

A

reduce anxiety and preload

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25
Q

nitrates

A

preload and afterload

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26
Q

dobutamine

A

beta 1 agonist
increases myocardial contractility
acute reversible heart failure

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27
Q

dopamine

A

increases renal perfusion and BP, improves contractility

acute heart failure and cardiogenic shock

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28
Q

adrenaline

A

increases contractility

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29
Q

ivabradine

A

anti angina

reduces heart rate by blocking funny channels

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30
Q

ranolazine

A

anti angina
inhibits Na
thereby reducing heart workload

last resort

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31
Q

Nirocandil

A

vasodilator for angina

activation of K channels
hyperpolarises smooth muscle

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32
Q

what type of angina is demand ischaemia

A

chronic stable

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33
Q

which drugs are vasodilators

A

organic nitrates
nicorandil
Ca antagonists

they reduce preload and afterload

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34
Q

which drugs slow down the heart

A

ivabradine

B blockers

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35
Q

what are the two types of Ca blocker

A

dihydropyridine derivatives

rate limiting

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36
Q

verapamil and diltiazem

A

rate limiting ca blocker

can impair AV conduction

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37
Q

amlodipine and lercanidipine

A

dihydropyradine derivatives ca blocker

use in variant angina or alongside beta blocker

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38
Q

head aches, constipation, ankle oedema

A

ca antagonist

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39
Q

which ca antag is used as an antidysrhythmic

A

verapamil

used in SVTs

40
Q

what ca antag are used in hypertension

A

amlodipine or lercanidipine

41
Q

how do organic nitrates work

A 
metabolised to NO and relaxes vascular smooth muscle
reduces preload
dilates coronary vessels 
esp in variant angina
may dilate collaterals
42
Q

isosorbide mononitrate

A

used long before exertion
angina pectoris
dilates blood vessels

43
Q

intravenous GTN

A

unstable angina

acute heart failure

44
Q

headaches and postural hypotension

A

organic nitrates

45
Q

sublinguinal GTN

A

just before exercise

46
Q

isosorbide mononitrate with hydralazine

A

chronic heart failure

47
Q

headaches, flushing, dizziness

A

nicorandil

48
Q

what is a class 1 antidysrhythmic

A

blocks fast sodium channels

49
Q

what is a class 2 antidysrhythmic

A

blocks Beta adrenergic receptors

50
Q

what is a class 3 antidysrhythmic

A

potassium channel blocker

prolongs the duration of action potential repolarisation

51
Q

what is a class 4 antidysrhythmic

A

blocks Ca channels

52
Q

what other two drugs are used to treat dysrhythmia but don’t fit into the Vaughn-Williams classification

A

digoxin and adenosine

53
Q

where do thiazide like diuretics act

A

DCT

54
Q

where does spironolactone act

A

collecting tubule

55
Q

dry cough, dizziness, tiredness, headaches

A

ACE inhibitors

56
Q

back/ leg pain, dizziness, headache

A

angiotensin receptor antagonist (ARB)

57
Q

flushes, headaches, ankle oedema, dizziness

A

Ca channel blockers

58
Q

raised potassium and blood sugar levels

A

thiazide like diuretics

59
Q

what is the treatment plan for heart failure

A

D A B

NOT C!
do not want to decrease contractility
unless co existing angina :) -amlodipine

60
Q

what are the symptoms of heart failure

A 
SOB
swelling 
lack of energy
difficulty sleeping
swollen abdomen
cough with frothy sputum
increased urination 
confusion
61
Q

what are the main drugs used in chronic heart failure

A 
furosemide
ramipril lisinopril
candersartan
bisoprolol
carvedilol
spironolactone
62
Q

where do loop diuretics act

A

thick ascending loop

63
Q

what are the 4 effects of angiotensin

A

vascular growth and hypertrophy
vasoconstriction
salt retention
aldosterone secretion

64
Q

what is the effect of beta blockers

A

slows heart rate
allows the ventricle to fill more completely
vasodilation- decreased afterload

65
Q

hyperkalaemia, hyponatraemia, nasea, hypotension

A

aldosterone receptor antagonists (spironolactone, eplerenone)

66
Q

acute gout

A

loop diuretics

67
Q

what does digoxin do

A

increased vagal activity

increases contractility by increasing Ca levels

68
Q

what are the initial treatments for acute heart failure

A

loop diuretics - venodilation and diuresis
opiates - reduce anxiety and preload
nitrates- reduce preload and afterload

69
Q

what are second line treatments for acute heart failure

A

ionotropes - beta agonists eg dobutamine
dopamine - increases renal perfusion
adrenaline- increases contractility

70
Q

disopyramide

A

1a sodium channel blocker

used in ventricular dysrhythmia and AF

71
Q

lignocaine

A

1b sodium channel blocker

prevents ventricular tachycardia and fibrillation after MI

72
Q

flecainide

A

1c sodium channel blocker

suppresses ventricular ectopics, paroxysmal AF and reccurent tachycardias

73
Q

sotalol

A

b blocker used in dysrhythmia

74
Q

amiodarone

A

potassium channel blocker

75
Q

verapamil

A

calcium channel blocker

76
Q

how do class 1 arrhythmia drugs work

A

reduce the rate of cardiac depolarisation during phase 1

77
Q

what does use dependant mean

A

work more effectively if there is high activity eg tachycardia

78
Q

how do b blockers work

A

reduce cAMP which reduces Ca influx

79
Q

what is the usual ending for arbs

A

-artan

80
Q

what is the care pathway for pts with hypetension

A

lifestyle interventions
patient education
annual review of care

if younger than 40 consider specialist referral

if stage 2 hypertension or organ damage then antihypertensive drugs

81
Q

what would you offer a pt with a dry cough after ACE inhib

A

Angiotensin 2 receptor blocker aka ARB

82
Q

what would you offer someone with resistant hypertension

A

further diuretic

or alpha blocker or beta blocker

83
Q

what ACE inhibitors would you use in hypertension

A

ramipril, lisinopril

84
Q

what arb would you use in hypertension

A

losartan

85
Q

what renin inhibitor would yo use in hypertension

A

aliskerin

86
Q

what calcium blockers would you use in hypertension

A

amlodipine, lercanidipine

i.e. dihydropyradine like

87
Q

what diuretics would you used in hypertension

A

indapamide, bendrofluomethiazide

88
Q

what b blockers would you use in resistant hypertension

A

atenolol or bisoprolol

89
Q

what alpha blockers would you use in resistant hypertension

A

doxazosin

90
Q

what loop diuretic would you use in chronic heart failure

A

furosemide

gout

91
Q

what ACE inhibitor would you use in chronic heart failure

A

ramipril and lisinopril

92
Q

what arb would you use in chronic heart failure

A

candesartan

93
Q

what B blocker would you use in chronic heart failure

A

bisoprolol or carvedilol

94
Q

what aldosterone receptor antagonist would you use in chronic heart failure

A

spironolactone

hyperkalaemia, hyponatraemia, nausea and hypotension

95
Q

what Ca inhibitor would you use in chronic heart failure with coexisting angina

A

amlodipine

96
Q

what is EDRF

A

endothelin derived relaxing factor

causes relaxation of smooth muscle in the vessel wall

97
Q

what are the 3 main drugs used in angina

A

nitrates
b blockers
ca antagonists

MD3001 (33 decks)

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