Brainscape's Knowledge GenomeTM

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


See full index

Pharmacology > CHD > Flashcards

CHD Flashcards

1
Q

What are the three characteristics of coronary arteries in CHD?

A

Narrow lumen, thickened hardened walls and a lack of ability for them to dilate effectively

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

What are three characteristics of the pain one may experience if they have stable angina?

A

heavy, squeezing or crushing pain
radiating to shoulder, neck, jaw or arms
may feel like indigestion
can last up to 30 minutes
may be caused by physical activity
may be a pattern

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

What should you do if you see someone on the street with stable angina?

A

tell them to stop and rest to correct O2 balance
Use a GTN sub-lingual spray
wait 5-10 minutes, if no change give another GTN
if no effect, call 000

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

What three drug classes do you use for stable angina?

A

Beta blockers, calcium channel blockers and long-acting nitrates

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

What is 1st line drug therapy for stable angina?

A

Beta blockers e.g. metoprolol without intrinsic sympathomimetic activity

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

What are two practice points for beta blockers? (2 marks)

A

do not stop abruptly or you may get an adrenergic surge
low dose and monitor

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

What are three factors to consider when using a BB? (3 marks)

A
  • type of airway disease (COPD less risky than asthma)
  • choice of BB- B1 selective preferred
  • start with low dose, monitor and review
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the second line treatment for stable angina? (2 marks)

A

CCB and nitrates

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

What types of Non dihydropyridine CCB is used fro stable angina?

A

rate limiting drugs such as verapamil and diltiazem

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

What is a risk of verapamil in stable angina?

A

can cause bradycardia and heart block

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

If using diltiazem in stable angina, what do you need to do?

A

monitor and use cautiously

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

What are 2 adverse effects of nitrates?

A

Hypotension, headache, gastric reflux

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

What is a contraindication of nitrates?

A

PDE5 inhibitors

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

What is the MOA of nitrates?

A

vasodilate which reduces preload by a lot and afterload by a lot to redistribute blood to ischemic zones

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

What are 3 practice points for nitrates?

A

reduce risk by having a nitrate free period of 4-8 hours per day
can be MR for 16 hours in a patch
ISDN tablets have effect of 6-8 hours

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

What do you use if you can’t use BBs, CCB or nitrates in CHD?

A

Nicorandil

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

What is the effect of nicorandil?

A

Produces venous and arterial dilation due to its nitrate moiety and its effect to open potassium channels in vascular smooth muscle

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

Name 3 adverse effects of nicorandil

A

headache, lethargy, nausea, dizziness, palpitation, flushing and myalgia

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

When would you not use Ivabradine?

A

if the HR was 70bmp or under

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

Do you use Ivabradine for heart failure or angina?

A

heart failure

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

What is perherxiline used for?

A

myocardial oxygen utilisation

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

What are the two main procedural options?

A

CABG and percutaneous coronary intervention (PCI)

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

What is first line antiplatelet treatment for stable angina?

A

low dose aspirin

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

Should you give statins to people with stable angina?

A

yes, regardless of cholesterol levels.

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

What is the differences in definitions of NSTEMI and STEMI?

A

NSTEMI is a nontransmural necrosis and a STEMI is a transmural necrosis

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

What is the difference between unstable angina and NSTEMI in terms of diagnosis?

A

Unstable Angina has negative biomarkers and a NSTEMI has positive biomarkers

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

What are 3 signs and symptoms of an ACS?

A

Sudden onset of symptoms
Central epigastric pain
discomfort
SOB
Nausea
Vomiting
Sweating
Fatigue
Clammy

26
Q

List three tests for managing ACS?

A

ECG
Blood tests
    - cardiac enzymes
- FBC
Creatinine and electrolytes
BGLs

27
Q

What is the priority after a STEMI is diagnosed and why? (3 marks)

A

reperfusion of the myocardium because it reduces the risk of death and damage which can have long term consequences

28
Q

Why might you not reperfuse a patient with ACS?

A

it is more than 12 hours after the symptom onset, the patient is asymptomatic and hemodynamically stable

29
Q

Why do you reperfuse a patient with a STEMI?

A

it is a total blockage of the coronary artery

30
Q

What are the two main options for reperfusion?

A

Percutaneous coronary intervention and fibrinolysis

31
Q

What type of reperfusion do you use if a patient has NSTEACS (Non-STEMI acute coronary syndrome)?

A

PCI

32
Q

How does a PCI occur?

A

Insertion of a catheter via radial or femoral artery and guided to heart. Xray control to visualise structures.
Angioplasty is carried out (inflation of balloon to compress plaque)
stent insertion

33
Q

What are the two types of stents used in PCI

A

Drug eluting stents and Bare metal stents

34
Q

How does a drug eluting stent work?

A

releases a cytotoxic drug to slow tissue regrowth

35
Q

Name two antiplatelet therapies

A

low dose aspirin and clopidogrel

36
Q

Name two antithrombin therapies

A

LMWH (enoxaparin and fondaparinux)
Bivalirudin

37
Q

What is one fibrin selective drug for thrombolysis?

A

Fibrin selective- tenecteplase, reteplase and alteplase

38
Q

What are three complications of ACS?

A

Arrhythmias, heart failure, mural thrombus, pulmonary embolism and infarct extension

39
Q

What are three factors which make a NSTEACS patient high risk?

A

persistent chest pain/ discomfort
elevated cardiac enzymes
Systolic BP 90 or under
Previous CABG and PCI
Sustained ventricular tachycardia

40
Q

Why is post ACS treatment important? (2 marks)

A

reduce early complications and hospital started meds may be seen as more important thus improving compliance

41
Q

What are the fab four drug therapies for post-ACS therapy?

A

Antiplatelets
Beta blockers
ACEI (after BB stabilisation)
Statin

42
Q

What is DAPT?

A

Dual anti-platelet therapy combining antiplatelets with MOAs.

43
Q

What do you need to monitor in patients on ACEIs or ARBS?

A

k+

44
Q

What factors affect CV risk?

A

Age, Aboriginal and Torres Strait Islander peoples, having a TIA recently, diabetes, Lipids, Systolic

45
Q

what are 3 characteristics of the clinical presentation of stable angina?

A

 Chest discomfort
 Heavy squeezing or crushing pain which may radiate to shoulder, jaw, neck and arms
 Triggered by physical activity

46
Q

what are 3 characteristics of the clinical presentation of acute coronary syndrome?

A

 SOB
 N and V
 Sweating
 Fatigue
 Central or epigastric pain
 discomfort

47
Q

What are 4 drugs/drug classes you use for stable angina?

A

Beta bockers
Calcium channel blockers
long acting nitrates
nicorandil

48
Q

What are 2 adverse effects of beta blockers?

A

AEs- bradycardia, hypotension, orthostatic hypotension, nausea, diarrhoea, dyspnoea.

48
Q

What are 2 precautions of beta blockers?

A

Contraindicated in severe and poorly controlled asthma. Bradycardia, can impair peripheral circulation, can mask clinical signs of hyperthyroidism

49
Q

What are 2 adverse effects of calcium channel blockers?

A

Nausea, headache and dizziness

50
Q

What are 2 precautions of calcium channel blockers?

A

can increase risk of muscle weakness and respiratory depression. Contraindicated in cardiogenic shock

51
Q

What are 2 precautions of long acting nitrates

A

contraindicated in hypovolaemia and raised intracranial pressure

52
Q

What are 2 adverse effects of long acting nitrates?

A

headache, flushing, palpitations, orthostatic hypotension, peripheral oedema

53
Q

What are 2 adverse effects of nicorandil?

A

headache, nausea, dizziness, lethargy, palpitations, flushing and myalgia

54
Q

What are 2 precautions of nicorandil?

A

associated with fistula formation in diverticula disease and contraindicated with PDE5 inhibitors

55
Q

What do you use for confirmed ACS?

A

P2Y12 antagonists

56
Q

What are 2 adverse effects of long acting P2Y12 antagonists?

A

bleeding and skin reactions

57
Q

What is 1 precaution of long acting P2Y12 antagonists?

A

risk of bleeding

57
Q

What are 4 cardioprotective drugs in ACS

A

Aniplatelets, beta blockers, AceIs and statins

58
Q

What drug do you use post ACS, what are 2 side effects and what are 1 precaution?

A

eplerenone SE: hyperkalaemia, hypotension and dizziness. and Precautions- hyperkalaemia

59
Q

What do you monitor with ACEIs?

A

Monitor potassium concentration and renal function

60
Q

what do you monitor with eplerenone?

A

potassium levels

61
Q

What can you do to encourage better heart health?

A

encourage them to weigh thmeselves daily, undertake physical activity, restrict salt, fluid and alcohol, smoking cessation.

Pharmacology (23 decks)

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