Brainscape's Knowledge GenomeTM

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


See full index

Pharmacology > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

Loop Diuretics
Furosemide, Bumetanide
Mechanism of Action

A

Act on ascending loop of Henle as Na/K/2Cl co-transporter inhibitors to reduce reabsorption of Na/K and therefore water

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

Loop Diuretics

Indications

A

Acutely - pulmonary oedema, hyperkalaemia

Long term - oedematous states such as CHF, renal failure, liver failure

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

Loop Diuretics

Contraindications

A

Hypovolaemia/dehydration

Hepatic encephalopathy, hypokalaemia, hyponatraemia, gout (may inhibit uric acid secretion), may exacerbate DM

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

Loop Diuretics

Side Effects

A

Hypotension

Low electrolytes, Hearing loss/tinnitus at high doses

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

Loop Diuretics

Interactions

A

Affects renal secretion, increased risk of digoxin toxicity due to hypokalaemia and ototoxicity/nephrotoxicity of other drugs increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Thiazide-type diuretics

Names

A

Hydrochlorothiazide, Bendroflumethiazide, Indapamide, Chlortalidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Thiazide-type diuretics

Mechanism of Action

A

Inhibit Na/Cl cotransporter in distal convoluted tubule to prevent absorption of water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thiazide-type diuretics

Indications

A

Second line for hypertension treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thiazide-type diuretics

Contraindications

A

Low K+/Na+, gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thiazide-type diuretics

Side effects

A

Hyponatraemia, risk of low potassium/increased glucose

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

Thiazide-type diuretics

Interactions

A

Other potassium lowering drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thiazide-type diuretics

Prescription Advice

A

Give am to avoid nocturia, work wel with ACEi/AIIRB as work on opposing limbs of RAAS and K homeostasis

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

K+ Sparing Diuretics (Combo)

Names

A

Spironolactone, Amiloride (Co-amulifrose/co-amilozide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

K+ Sparing Diuretics

Mechanism of Action

A

Antagonist of aldosterone or act at ENaCs at DCT to reduce loss of K+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

K+ Sparing Diuretics

Indications

A

Combination therapy if patient is hypokalaemic due to loop/thiazide therapy, ascitic, or hypertensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

K+ Sparing Diuretics

Contraindications

A

Renal imparment, hyperkalaemia, increasing hypokalaemia, rising volume depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

K+ Sparing Diuretics

Side effects

A

hepatotoxicity, malaise, dizziness, gynaecomastia, breast pain, menstrual changes (spiro alters metabolism of testosterone in peripheral circulation)

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

K+ Sparing Diuretics

Interaction

A

Potassium supplements, renal clearance drugs (digoxin, lithium)

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

Beta-Blockers

Mechanism of Action

A

Anagonist of Beta-1 adrenoreceptors which gives negatively inotropic/chronotropic effect to reduce O2 demand and improve perfusion, reduces renin secretion, prolongs refractory period at AV node

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

Beta-Blockers

Indications

A

IHD, CHF, AF, SVT, HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Beta-Blockers

Contraindications

A

Asthma (bronchospasm), COPD (although not propranolol), haemodynamic instability, heart block, hepatic failure/heart failure require low dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Beta-Blockers

Side effects

A

Fatigue, cold extremities, headache, GI change, sleep disturbance, impotence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Beta-Blockers

Interactions

A

Non-dihydro CCBs (verapamil/dilitiazem) - together can cause heart block, bradycardia, asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Calcium Channel Blockers

Mechanism of Action

A

Reduce Ca entry into vascular/cardio-myocytes to reduce contractility, reduce AV conduction to slow ventricular rate and decrease afterload - overall reduces O2 demand of heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CCBs - Indications

A

Antihypertensives (dihydros)

Rhythm control drugs (SVT, AF, AFl, non-dihydros)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CCBs - contraindications

A

Poor LV function, AV nodal conduction delay, unstable angina and severe aortic stenosis (dihydros)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CCBs - Side effects

A

Dihydros - ankle oedema, flush, headache, palpitations
Verapamil - constipation, bradycardia, heart block, cardiac failure
Diltiazem - both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

CCBs - interactions

A

Beta-blockers - negatively chronotopic and inotropic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

CCBs - Dihydro vs non-dihydropytidine

A 
Dihydro = -dipine  (amlodipine, nifedipine)
Non-D = Verapamil and Diltiazem (verapamil most cardioselective)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ACE-inhibitors

Names

A

Rampiril, Lisinopril, Perindopril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

ACE-inhibitors

Mechanism of Action

A

Prevent conversion of AT1–>AT2. AT2 is a vasoconstrictor and stimulates aldosterone/ADH therefore afterload is reduced with ACEi and efferent glomerular arteriole dilates which promotes excretion of Na/H20 to reduce preload alongside systemic vasodilatation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

ACE-inhibitors

Indications

A

HTN, CHF, IHD, diabetic nephropathy/CKD with proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

ACE-inhibitors

Contraindications

A

RAS, AKI, pregnancy/breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ACE-inhibitors

Side effects

A

Hypotension, dry cough, hyperkalaemia, angioedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

ACE-inhibitors

Interactions

A

K supplements/K sparing diuretics, NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Angiontensin II Receptor Blockers

Names

A

Losartan, Candesartan, Irbesartan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Angiotensin II Receptor Blockers

Mechanism of Action

A

Block action of angiotensin II on AT1 receptor with similar effect to ACEi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Angiotensin II Receptor Blockers

Inidcations

A

Replace ACEi if cough not tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Angiotensin II Receptor Blockers

Contraindications

A

RAS, AKI, pregnancy/breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Angiotensin II Receptor Blockers

Side Effects

A

Hypotension, hyperkalaemia, renal failure (short term)

Long term - cardiometabolic protective, renal protective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Angiotensin II Receptor Blockers

Interactions

A

Potassium supplements/K+ sparing diuretics, NSAIDs

42
Q

Angiotensin II Receptor Blockers

Prescription Advice

A

No effect on bradykinin, less likely to cause angioedema, useful in Afro-Caribbean origin

43
Q

Nitrates

Names

A

Isosorbide mononitrate (ISMN) glyceryl trinitrate (GTN)

44
Q

Nitrates

Mechanism of Action

A

Nitrates are converted to NO which incerases cGMP and reduces Ca in smooth muscle cells (mostly venous) causing dilatation, reducing preload and LV filling, reduce workload and relieve angina

45
Q

Nitrates

Indications

A

GTN - acute angina, ACS

ISMN - long acting prophylaxis of angina where CCB/BB are insufficient or given IV in pulmonary oedema treatment

46
Q

Nitrates

Contraindications

A

Severe aortic stenosis, haemodynamic instability (esp hypotensive)

47
Q

Nitrates

Side effects

A

Flushing, headaches, light-headedness, hypotension

48
Q

Nitrates

Interactions

A

Phosphodiesterase inhibitor (sildenafil) - prolongs the effect can lead to severe hypotension

49
Q

Digoxin
Cardiac Glycoside
Mechanism of Action

A

Inhibits Na/K-ATPase pumps to increase intracellular Ca (positively inotropic), also stimulates vagus nerve tone to reduce AV conduction rate (negatively chronotropic)

50
Q

Digoxin

Indications

A

AF/AFl (if CCB/BB ineffective), severe heart failure

51
Q

Digoxin

Contraindications

A

2nd degree heart block, intermittent complete heart block, ventricular arrhythmia, renal failure

52
Q

Digoxin

Side Effects

A

Bradycardia, anorexia, rash, dizziness, visual disturbance (yellow-green vision), gynaecomastia

53
Q

Digoxin

interactions

A

Diuretics, amiodarone, CCB, sprionolactone, quinine (all increase plasma concentration)

Can be precipitated by hypokalaemia

54
Q 
Amiodarone
Class III (I) antiarrhythmic
Mechanism of Action
A

Inhibits K+ channels to slow repolarisation, blocks Na channels to prevent depolarisation, slows conduction velocity, reduces ventricular rate can break arrhythmic circuit

55
Q

Amiodarone

Indications

A

Tachyarrhythmias (AF, AFL, SVT, VT, refractoy VF) when other drugs are ineffective

56
Q

Amiodarone

Contraindications

A

Severe hypotension, heart block, active thyroid disease

57
Q

Amiodarone

Side effects

A 
Hypotension
Pneumonitis/Hepatitis
Bradycardia
Photosensitivity
Skin becomes grey
Thyroid change
Corneal deposits
Peripheral Neuropathy
58
Q

Amiodarone

Interactions

A

Digoxin, dilitazem/verapamil

59
Q

Aspirin
Anti-platelet
Mechanism of Action

A

Irreversible COX-inhibitor reduces thromboxane in arachidonic pathway to reduce platelet aggregation, wears off as new platelets are synthesised

60
Q

Aspirin

Indications

A

ACS/Ischaemic stroke, long term preventative therapy, reduce risk of intracardiac thrombus in AF (if others contraindicated), control of moderate pain/fever

61
Q

Aspirin

Contraindications

A

Children, post viral <16 (Reye’s syndrome of liver/brain), aspirin hypersensitivity, 3rd trimester (may close DA early), PUD, gout

62
Q

Aspirin

Side Effects

A

GI irritation, ulceration/haemorrhage, bronchospasm, tinnitus, OD (leads to hyperventilation, metabolic acidosis, arrest)

63
Q

Aspirin

Interactions

A

Synergistic with other anti-platelets/anti-coagulants

64
Q

Clopidogrel
Antiplatelet
Mechanism of Action

A

Irreversibly binds ADP receptors on platelets to prevent coagulation

65
Q

Clopidogrel

Indications

A

As aspirin:ACS/Ischaemic stroke, long term preventative therapy, reduce risk of intracardiac thrombus in AF (if others contraindicated)

66
Q

Clopidogrel

Contraindications

A

Active bleeding, elective surgery (7-10 days as this is average lifespan of platelet)

67
Q

Clopidogrel

Side effects

A

bleeding, thrombocytopenia, GI upset

68
Q

Clopidogrel

Interactions

A

Pro-drug of CYP450 therefore inhibitors reduce efficacy (omeprazole, cipro, erythromycin, antifungals, some SSRIs), caution with other antiplatelets/coags

69
Q

Tissue Plasminogen Activator (Fibrinolytics)

Names

A

Alteplase, Streptokinase

70
Q

TPa

Mechanism of Action

A

Catalyse conversion of plasminogen to plasmin to dissolve fibrinous clots and recanalise occlude vessels to reperfuse affected tissue, very short half-life

71
Q

TPa

Indications

A

Acute ischaemic stroke, acute STEMI, massive PE

72
Q

TPa

Contraindications

A

Predisposition to bleeding, intracranial haemorrhage, previous streptokinase (risk of Abs if repeat dosing)

73
Q

TPa

Side effects

A

N&V, bruising, hypotension, bleeding, allergic reaction, cardiogenic shock/arrest, reperfusion injury

74
Q

TPa

Interactions

A

ACE-i increase risk of anaphylaxis

Risk of haemorrhage if also taking antiplatelet/coag

75
Q

TPa

prescription advice

A

Injection only, dose based on weight

76
Q

Heparin

Names

A

Enoxaparin, Dalteparin, Fondaparinux, Unfractioned heparin

77
Q

Heparin

Mechanism of Action

A

UFH - activates antithrombin
LMWH - preferentially inhibit Xa to give predictable effect
Fondaparinux - only inhibits Xa, no monitoring needed, used in ACS

78
Q

Heparin

Indications

A

VTE prophylaxis/treatment

ACS

79
Q

Heparin

Contraindications

A

Bleeding, clotting disorders, severe uncontrolled hypertension, invasive procedures, renal impairment, falls risk

80
Q

Heparin

Side effects

A

Bleeding, injection site reaction, heparin-induced-thrombocytopenia

81
Q

Heparin

Interactions

A

Anthrombotics, can be reversed by protamine (excl fondaparinux)

82
Q

Warfarin
Anticoagulant
Mechanism of Action

A

Inhibits vitamin K epoxide reductase to prevent coagulation factor synthesis of FX, IX, VII, II

83
Q

Warfarin

Indications

A

Prevent VTE or embolism in AF/valve replacement, arterial events prevented by antiplatelets (not anticoagulant)

84
Q

Warfarin

Contraindications

A

haemorrhage, liver disease, pregnancy

85
Q

Warfarin

Side effects

A

Bleeding (epistaxis, retroperitoneal haemorrhage)

86
Q

Warfarin

Interactions

A

Low TPI, metabolised by CYP450, also abx can reduce gut flora that synth vK so potentiate the effect

87
Q

NOACs

Name

A

Rivaroxaban, Dabigatran, Apixaban

88
Q

NOAC

Mechanism of action

A

Selectively inhibit FXa, and prothrombinase to to reduce thrombin

89
Q

NOAC Indications

A

Thromboprophylaxis, warfarin substitute

90
Q

NOAC

Contraindications

A

bleeding, artificial heart valve, clotting disorders, renal/hepatic impairment

91
Q

NOAC

Side effects

A

Allergy, anaemia, tachycardia, hypotension

92
Q

NOAC

Interactions

A

Other antiplatelets/anticoagulants

93
Q

Statin

Name

A

Simvastatin
Atorvastatin
Pravastatin
Rosuvastatin

94
Q

Statin

Mechanism of action

A

Inhibits HMG-CoA reductase, reducing LDL and increasing clearance and increases HDL to slow/reverse atherosclerotic process

95
Q

Statin

Indications

A

Hyperlipidaemia, control of risk factors in CAD

96
Q

Statin

Contraindications

A

Hepatic impairment, pregnant/breast feeding

97
Q

Statin

Side effects

A

headache, muscle aches, rhabdomyolysis, increases liver enzymes

98
Q

Statin

Interactions

A

Grapefruit juice, alcohol, CYP450 inhibitors (amiodarone, itraconazole, protease inhibitors)

99
Q

Nicorandil

Indication/side effects

A

Second line anti-anginal

Causes serious mucosal ulceration, headache, flushing

100
Q

Flecainide
Class 1c anti-arrhythmic

Pre-dose test

Contraindications

A

Potent sodium channel blocker

Echo to rule out structural ischaemic damage

Previous MI - electrical conduction already hindered

Pharmacology (14 decks)

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