Cardiovascular Drugs

Question 1

Example of statin

Answer 1

Simvastatin

Question 2

What do statins do?

Answer 2

Block HMG CoA reductase - an enzyme involved in production of cholesterol in the liver

Question 3

When are used statins used?

Answer 3

For hypercholesterolaemia, diabetes, angina, MI, CVA, high risk of CVA/MI

Question 4

Side effects of statins?

Answer 4

Muscle inflammation (myopathy), rhabomyolsis

Question 5

What is rhabomyolsis?

Answer 5

The breakdown of skeletal muscle accumulating in toxic wastes which can lead to renal failure.

Question 6

How are statins taken?

Answer 6

Orally

Question 7

When do statins not work to lower LDL?

Answer 7

Familal hypercholesterolaemia - where LDL receptors are absent

Question 8

Example of fibrate?

Answer 8

Bezafibrate

Question 9

What do fibrates do?

Answer 9

Reduce the concentration of cholesterol in blood.

Question 10

When are fibrates used?

Answer 10

In hypertriglycaemia and low HDL cholesterol

Question 11

What do PCSK 9 Inhibitors do?

Answer 11

Lower LDL level in blood

Question 12

What are PCSK9 Inhibitors?

Answer 12

Monoclonal antibodies

Question 13

What are some examples of PCSK9 Inhibitors?

Answer 13

Evolocumab, alirocumab

Question 14

What do PCSK 9 inhibitors do?

Answer 14

Prevent the binding of PCSK9 to LDLR

Question 15

When are PCSK 9 inhibitors used?

Answer 15

Familial hypercholesterolaemia

Question 16

What are some anti platelet drugs?

Answer 16

Aspirin, pragugrel, clopidrogel and ticagrelor

Question 17

What do anti platelet drugs do?

Answer 17

Reduce platelet aggregation and clot formation

Question 18

When are anti platelet drugs used?

Answer 18

High risk of MI / CVA

Question 19

What are some side effects of anti platelet drugs?

Answer 19

Haemorrhage

Question 20

What are some examples of anti coagulant drugs - blood thinners?

Answer 20

Heparin, warfarin, rivaroxaban and dabigratan

Question 21

How is heparin taken?

Answer 21

IV

Question 22

How is warfarin taken?

Answer 22

Oral

Question 23

What do blood thinners do?

Answer 23

Prevent the clotting of blood

Question 24

When are blood thinners used?

Answer 24

DVT, PE, NSTEMI, AF

Question 25

What is a side effect of blood thinners?

Answer 25

Haemorrhage

Question 26

How is warfarin dose controlled?

Answer 26

By monitoring INR, every 8-12 weeks

Question 27

What does warfarin do?

Answer 27

Works against Vitamin K in the liver to reduce to production of clotting factors 2, 7, 9, 10`

Question 28

How do you reverse warfarin?

Answer 28

Vitamin K

Question 29

What is an example of fibrinolytic drugs?

Answer 29

Streptokinase

Question 30

What do fibrinolytic drugs do?

Answer 30

Break down the protein fibrin, the main constituent of blood clots - they dissolve the clot.

Question 31

When are fibrinolytic drugs used?

Answer 31

STEMI, selected PEs and CVAs

Question 32

What are the side effects of fibrinolytic drugs?

Answer 32

Haemorrhage

Question 33

When would you avoid anti-blood clotting drugs?

Answer 33

Trauma, recent haemorrhage, bleeding tendencies, peptic ulcer and severe diabetic retinopathy.

Question 34

What drugs are cough inducing?

Answer 34

ACE inhibitors

Question 35

What is an example of neprilysin inhibitors?

Answer 35

Sacubitril valsatran

Question 36

What are side effects of neprilysin inhibitors?

Answer 36

Hypotension, renal impairment, hyperkalaemia and angioneurotic oedema

Question 37

What are some side effects of Digoxin?

Answer 37

Yellow vision, bradycardia, ventricular arrhythmias, nausea, vomiting and heart block

Question 38

What does digoxin do? which is good

Answer 38

Blocks AV conduction, producing a degree of AV delay. Good in AF but bad if HR falls too much

Question 39

What does digoxin do? which is bad

Answer 39

Increases ventricular irritability which produces ventricular arrhythmias

Question 40

What is ivabradine used for?

Answer 40

To slow down heart rate in angina

Question 41

What is dobutamine used for?

Answer 41

Acute and potentially reversible heart failure, also cardiogenic shock

Question 42

How is dobutamine administered? What class of drug is it?

Answer 42

IV infusion, B adrenoreceptor agonist

Question 43

Is dobutamine used long term?

Answer 43

No

Question 44

How can adrenaline be administered?

Answer 44

IM, SC, IV, IV Infusion

Question 45

What class of drug is adrenaline?

Answer 45

B adrenoreceptor agonist

Question 46

What is adrenaline used for?

Answer 46

Cardiac arrest (IV); positive chronotropic and ionotropic actions (B1) dilation of coronary arteries (B2) redistribution of blood flow to the heart (A1) Anaphylatic shock (IM)

Question 47

What are the effects of B adrenoreceptor agonists?

Answer 47

Increased cardiac force, rate, CO but decreased cardiac efficiency

Question 48

What are the effects of B adrenoreceptor antagonists?

Answer 48

Little diff at rest, but during exercise/stress - rate, force, CO very depressed

Question 49

What are the uses of B adrenoreceptor antagonists?

Answer 49

Treatment of arrhythmias, angina, heart failure and hypertension