Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 Cardiology > Cardiovascular drugs > Flashcards

Cardiovascular drugs Flashcards

1
Q

What are the 3 main groups of anti-cholestrol drugs ?

A
  1. Statins (simvastatin, atorvastatin)
  2. Fibrates
  3. PCSK 9 Inhibitors (evolocumab, alirocumab)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 main groups of anti-hypertensive drugs?

A
  1. Thiazide Diuretics
  2. Beta Blockers
  3. Vasodilators = Calcium channel blockers (CCB), Alpha Blockers, ACE Inhibitors (ACEI) & Angiotensin Receptor Blockers (ARBs)
  4. Mineralocorticoid antagonist (spironolactone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you recognise what is a statin ?

A

Think ‘statin’ at the end of its name e.g. simvastatin or artorvastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the mechanism of action of statins ?

A

They inhibit the action of HMG-CoA reductase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who should recieve a statin ?

A
  • All people with established CVD (stroke, TIA, ischaemic heart disease e.g. angina/MI, PVD)
  • Anyone with a 10-year cardiovascular risk >= 10% (using QRISK2)
  • Patients with T2DM should be assessed using QRISK2 like other patients are, to determine whether they should be started on statins
  • Patients with T1DM who were diagnosed more than 10 years ago OR are aged over 40 OR have established nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 2 main contraindications to statin use ?

A
  1. Macrolides (e.g. erythromycin, clarithromycin)
  2. Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the main potential adverse effects of statin use ?

A
  • Myopathy - myalgia, myositis, rhabdomyolysis and asymptomatic raised creatine kinase
  • Rhabdomyolysis can lead to renal failure
  • Liver impairment
  • Avoid in those who have had a stroke due to increased risk of ICH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give examples of fibrates and state what they are used for

A
  • e.g. Bezafibrate (think ‘fibrate’)
  • They are used for hypertriglyceridaemia or low HDL cholesterol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do PCSK 9 Inhibitors (evolocumab, alirocumab) work and what condition may they be used for (not 1st line tho)

A
  • Work by binding of PCSK9 to LDLR, this increases the number of LDLRs, thereby lowering LDL-C levels
  • May be used for Familial Hypercholesterolaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diuretics actions etc are covered in renal flashcards

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 2 main groups of beta-blockers and there mechanisms of actions?

A
  1. Cardioselective β Blockers - Only block β1 adrenoreceptors
  2. Non selective β Blockers - Block both β1 and β2 adrenreceptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you recgonise a beta-blocker?

A

Think ‘olol’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give examples of cardioselective beta-blockers and there main uses

A
  • e.g. Atenolol, bisoprolol
  • Used in angina, ACS, MI, hypertension and heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give examples of non-selective beta-blockers and there main uses

A
  • e.g. Propranolol, carvedilol (is both alpha & beta-blocker)
  • Used in thyrotoxicosis, migraine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the main side effects of beta-blockers?

A
  • bronchospasm - contraindicated in ‘severe’ asthma
  • cold peripheries
  • fatigue
  • sleep disturbances, including nightmares
  • erectile dysfunction
  • Can worsen heart failure in short term (esp cardiogenic shock ==> not used actuley in HF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 2 main groups of calcium channel blockers(CCB’s) and give examples of them ?

A
  1. Dihydropyridines e.g. Amlodipine, nifedipine, felodipine (think ‘ipine’)
  2. Rate limiting CCB’s e.g. Verapamil & Diltiazem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the general mechanism of action of CCB’s?

A

Voltage-gated calcium channels are present in myocardial cells, cells of the conduction system and those of the vascular smooth muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the difference in the action of dihydropyridines compared to rate limiting CCB’s ?

A

Dihydropyridines affect the peripheral vascular smooth muscle more than the myocardium and therefore do not result in worsening of heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When may dihydropyridines be used?

A

Used in hypertension and angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the main side effects of dihydropyridines ?

A
  • Flushing
  • Headache
  • Ankle swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When may rate-limting CCB’s be used ?

A
  • Used in hypertension and angina
  • Plus Supraventricular Arrhythmias (AF, SVT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the main side effects associated with rate-limiting CCB’s?

A
  • Hypotension
  • Bradycardia
  • Heart failure

Ankle swelling - dilatiazem

Constipation & flushing - Verapamil

23
Q

What is the mechanism of action of ACEi’s & give examples of them

A
  • They inhibit the conversion angiotensin I to angiotensin II
  • e.g. Lisinopril - think ‘pril’
24
Q

When are ACEi’s used?

A
  • Used in hypertension and heart failure
  • Diabetic nephropathy and have a role in the secondary prevention of IHD
25
Q

What are the contraindications to ACEi use?

A
  • Pregnancy and breastfeeding - avoid
  • Renovascular disease - bilateral renal artery stenosis
  • Aortic stenosis - may result in hypotension
  • Hereditary of idiopathic angioedema
  • specialist advice should be sought before starting ACE inhibitors in patients with a potassium >= 5.0 mmol/L
26
Q

What are the main side effects of ACEi’s?

A
  • Cough
  • Renal dysfunction
  • Hyperkalaemia
  • Angioedema
27
Q

What is the mechanism of action of ARB’s & give examples of them

A
  • Block effects of angiotensin II at the AT1 receptor
  • e.g. Candesartan & Losartan think ‘sartan’
28
Q

When are ARB’s used ?

A

When ACEi is not tolerated usually due to the development of a cough. (i.e. same uses as ACEi’s)

29
Q

What are the main side effects of ARB’s?

A

Like ACE inhibitors they should be used with caution in patients with renovascular disease (dont use if renal artery stenosis)

Side-effects include:

  • Hypotension
  • Renal dysfunction
  • Hyperkalaemia.
30
Q

What is the mechanism of action of alpha blockers & give examples of them?

A
  • Block a adrenoceptors to cause vasodilatation
  • e.g. doxazosin (for HTN) and tamsulosin (for BPH)
31
Q

What are the uses of alpha blockers ?

A

Use in hypertension and BPH

32
Q

What are the side effects of alpha blockers?

A
  • Postural hypotension
  • Drowsiness
  • Dyspnoea
  • Cough
33
Q

When should caution be taken in the use of alpha blockers?

A

Patients who are having cataract surgery due to the risk of intra-operative floppy iris syndrome

34
Q

Mineralocorticoid antagonists covered in renal flashcards

A
35
Q

What are the 3 main groups of vasodilating drugs ?

A
  1. Nitrates
  2. Nicorandil (K ATP channel opener)
  3. Calcium Antagonists (Dihydropyridine)
36
Q

What are the 3 main groups of drugs used to slow heart rate ?

A
  1. Beta Blockers
  2. Calcium Antagonists (Diltiazem, Verapamil)
  3. Ivabradine
37
Q

What is the mechanism of action of nitrates & give examples of them

A
  • Mechanism of action = vasodilators by causing the release of NO in smooth muscle, resulting in converting GTP to cGMP, which in turn leads to a fall in intracellular calcium levels
  • e.g. Isosorbide mononitrate, GTN & isosorbide dinitrate
38
Q

When are nitrates used ?

A

Angina & Acute heart failure

39
Q

What are the side effects of nitrates ?

A
  • Headaches & flushing
  • Hypotension/Collapse
  • Tachycardia
40
Q

What is recommended to help prevent nitrate tolerance developing ?

A

Leave 8 hr/day nitrate-free

41
Q

What is the mechanism of action of nicorandil and its use

A
  • It is a potassium-channel activator with vasodilation is through activation of guanylyl cyclase which results in increase cGMP.
  • Used to treat angina
42
Q

What are the side effects of nicoradnil and the one contraindication to its use

A
  • Headache & flushing
  • Mouth/GI ulceration
  • Contraindicated if LVF
43
Q

What is the mechanism of action of ivrabradine & its use

A
  • Acts on the If (‘funny’) ion current in the SA node to reduce HR
  • Use in angina & HF
44
Q

What are the side effects of ivrabradine ?

A
  • Altered visual disturbance
  • Headache
  • Bradycardia, heart block
45
Q

What is the mechanism of action of Ranolazine & its use ?

A
  • It is a late sodium channel modulator which decreases calcium load on heart
  • Effective for refractory angina
46
Q

What is the mechanism of action of fibrinolytic drugs & give examples of them

A
  • Thrombolytic drugs activate plasminogen to form plasmin. This in turn degrades fibrin and help breaks up thrombi.
  • e.g. alteplase, tenecteplase, streptokinase & tissue Plasminogen activator (tPA)
47
Q

What is the main use of fibrinolytic drugs ?

A
  • Primarily used for STEMI
  • But sometimes used for PE’s or strokes (selected cases only)
48
Q

What is the main side effect of fibrinolytic drugs ?

A

Haemorrhage serious risk

49
Q

What are the main contraindications to fibrinolytic drug use ?

A
  • Recent haemorrhage (stokes < 3months), trauma or surgery
  • Bleeding tendencies or active bleeding
  • Severe diabetic retinopathy
  • Peptic ulcer
50
Q

What is the mechanism of action of digoxin ?

A
  1. Blocks atrial-ventricular (AV) conduction which slows HR in AF or atrial flutter (good effect)
  2. Increases ventricular irritability which produces ventricular arrhythmias (bad effect)
51
Q

What is the main use of digoxin ?

A

Rate control in AF

52
Q

What is the problem with digoxin ?

A

It has a narrow theraputic window so easy to result in digoxin toxicity

53
Q

What are the signs of digoxin toxicity ?

A
  • Nausea, vomiting
  • Yellow-green vision
  • Bradycardia, Heart Block
  • Ventricular Arrhythmias
54
Q

What is the management of digoxin toxicity ?

A
  • Digibind
  • correct arrhythmias
  • monitor potassium

Y4 Cardiology (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions