Common cardiology drugs

Question 1

What is the mechanism of action of digoxin?

Answer 1

Decreased conduction through AV node which slows ventricular rate.
Inhibits the Na+/K+ ATPase pump

Question 2

What are the features of digoxin toxicity?

Answer 2

Generally unwell with lethargy, nausea, vomiting, anorexia, confusion,
Yellow green vision,
Arrhythmia’s,
Gynacomastia

Question 3

What are some precipitating factors for digoxin toxicity?

Answer 3

Hypokalaemia (means more digoxin can bind to the ATPase bump),
Increasing age,
Renal failure,
MI,
Drugs: Amiodarone, verapamil, diltiaxem, spironolactone, ciclosporin, thiazides, loop diuretics.
Hypothyroidism,
Hypoalbuminaemia

Question 4

What is the management of digoxin toxicity?

Answer 4

Digibind, correct arrhythmias and monitor potassium

Question 5

What are the adverse side effects of statins?

Answer 5

Myopathy,
Liver impairment (check LFTs at baseline, 3 months and 12 months),

Question 6

What are the contraindications of statins?

Answer 6

Macrolides (stop statins until patient completes course)
Pregnancy

Question 7

What are the side effects of calcium channel blockers?

Answer 7

All - ankle swelling, flushing and headaches.

Diltiazem and verapamil cause constipation, heart failure, bradycardia

Question 8

What are the side effects of beta blockers?

Answer 8

Bronchospasm, cold peripheries, fatigue, sleep disturbances, erectile dysfunction

Question 9

What are the contraindications for beta blockers?

Answer 9

Uncontrolled heart failure, asthma, sick sinus syndrome, concurrent verapamil use

Question 10

What are the adverse side effects of loop diuretics?

Answer 10

Hypotension,
Hyponatraemia, hypokalaemia, hypomagnesaemia, hypochloraemic alkalosis,
Ototoxicity,
Hypocalcaemia,
hyperglycaemia,
gout,
renal failure

Question 11

What are the side effects of Warfarin?

Answer 11

Haemorrhage,
Teratogenic,
Skin necrosis,
Purple toes