Cardiovascular drugs

Question 1

Why is GTN tablet uncommonly used nowadays?

Answer 1

It is light sensitive do has a very short shelf life

Question 2

What is the most common side effect of GTN?

Answer 2

Headaches

Question 3

Why are Nitrates only given twice a day?

Answer 3

They generate a tolerance and efficacy is lost. You must have at least 8 hours where there is no drug in the body

Question 4

Give an example of a cardio selective beta blocker?

Answer 4

Atenolol

Question 5

What is meant by a cardio selective beta blocker?

Answer 5

A beta blocker which only binds to beta 1 adrenoceptors on the heart rather than beta 2 receptors in the airways and smooth muscle arterioles.

Question 6

Give an example of a none selective beta blocker?

Answer 6

Propranolol

Question 7

Give 2 calcium channel blockers which act on L type calcium channels in the heart

Answer 7

Verapamil and diltiazem

Question 8

What are the side effects of L type calcium channel blockers?

Answer 8

Ankle oedema and arrythmias (bradycardia and heart block)

Question 9

Give an example of a dihydropyridine and what is it used for?

Answer 9

Amlodipine- Smooth muscle calcium channel blocker used in hypertension

Question 10

What is Ivabradine used for and how does it work?

Answer 10

Heart failure

Off loads the heart by inhibiting funny current channels in the SA node

Question 11

Why will ivabradine only work when the patient is in sinus rhythm?

Answer 11

Because it acts on the SA node

Question 12

What is the side effect of ivabradine ?

Answer 12

Blurred vision

Blue flickering vision

Question 13

Give an example of a K ATP channel opener and what is i used for?

Answer 13

Nicorandil used in angina

Question 14

What is the side effect of nicorandil?

Answer 14

Mouth ulcers which can spread to the GI tract causing fistulas

Question 15

Give an example of a late sodium channel modulator, how does it work and what is it used for?

Answer 15

Ranolazine
Acts metabolocally to reduce the load of the heart
Used in angina uncontrolled by other medications

Question 16

What are the side effects of spironolactone?

Answer 16

Vomiting, diahorroea, headache, gynecomastia and erectile dysfunction

Question 17

What drug can be used if a patient cannot tolerate beta blockers for arrhythmia?

Answer 17

Digoxin

Question 18

What is spironolactone used for and how does it work?

Answer 18

Used in heart failure as it blocks aldosterone

Question 19

Why do beta blockers cause worsening of intermittent claudication?

Answer 19

They block the beta 2 receptors in the smooth muscle arterioles preventing dilation (non selective)

Question 20

What are the side effects of beta blockers?

Answer 20

Erectile dysfunction in men. Bronchospasm and heart block

Question 21

What drugs are given in a NSTEMI?

Answer 21

1) Asprin
2) Clopidogrel/Ticagrelor/Prasugel
3) Fondaparinux
4) Beta blocker
5) IV GTN
6) Glycoprotein IIB/IIIA inhibators

Question 22

What is used to acutely manage STEMI?

Answer 22

Morphine IV and antiemitic 
Oxygen if hypoxic 
Nitrates
Asprin 300mg 
Clopidigrel 300mg/ Ticagrelor 180mg

Question 23

Give 2 examples of antiemitics used in the management of acute MI?

Answer 23

Metoclopramide

Cyclazine