Cardiovascular pharmacology Flashcards
What is the classification of anti-arrhythmics?
Vaughan-Williams classification
Give the different classes of the Vaughan-Williams classification, types and examples.
Class I (sodium channel blocker) - fleicanide, lidocaine
Class II (beta-blockers) - bisporolol
Class III (potassium channel blocker) - amiodarone/ sotalol
Class IV (non-dihydropyridine Ca channel blocker) - verapamil
Why do you need to give a loading dose of amiodarone?
Amiodarone has a long half-life, lipophilic so higher doses are needed for it to stay in the blood
How do you monitor patients taking amiodarone?
TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
What are some adverse effects of amiodarone?
Hyper/Hypothyroidism
Pulmonary Fibrosis
Liver Fibrosis
Peripheral neuropathy
Slate-grey appearance
Photosensitivity
Thrombophlebitis
Bradycardia
Lengthens QT –> risk of torsades
What is an acceptable decline in renal function in patients started on ACE-inhibitors?
- serum creatinine increase by 30% from baseline
- eGFR fall by up to 25% from baseline
- serum potassium increase up to 5.5mmol/L
What is an acceptable decline in renal function in patients started on ACE-inhibitors?
- serum creatinine increase by 30% from baseline
- eGFR fall by up to 25% from baseline
- serum potassium increase up to 5.5mmol/L
What are some side effects of adenosine?
Bronchospasm
Chest pain
Name a drug which potentiates the effect of adenosine and one which reduces its effect
Enhances - Dipyridamole
Reduces - Theophylline
What is the mechanism of action of adenosine?
AV node blocker
A1 receptor agonist in AV node –> causes hyperpolarisation
Why is adenosine contraindicated in WPW?
Enhances conduction down accessory pathways
Why give an asymmetric dosing interval for standard release isosorbide mononitrate?
daily nitrate-free time of 10-14 hours –> reduce development of nitrate tolerance
Ways to reduce nitrate tolerance for angina?
isosorbide mononitrate modified release
asymmetric dosing interval i.e 7 hours apart
