commonly used drugs

Question 1

ACE inhibitors

Answer 1

hpt and hf
moa
inhibits ang I->II, reduced ang II causes vasodilation and reduced bp,
reduced aldosterone release so decreased sodium and water retention,
dilated efferent arterioles, reduced glomerular cap pressure so decreased stress on kidneys

Question 2

ACE side effects contras

Answer 2

side effects
cough (increased bradykinin)
angioedema
hyperkalaemia

contras
pregnancy
renovascular disease
aortic stenosis

interactions
high dose diuretics - increases risk of hypotension

Question 3

monitoring on ACE

Answer 3

u and e
creatinine and k increase after starting - 30% from baseline and 5.5 mmol
renal impairment

Question 4

name 3 ace inhibitors

Answer 4

ramipril, enalapril, lisinopril

Question 5

adenosine moa

Answer 5

used in SVTs
moa
transient heart block in AV node
agonist of A1 receptor in Av node, inhibits adenylyl cyclase, reduced cAMP causeing hyperpolarisation by increasing potassium flux
short half life of 8-10 s

Question 6

adverse effects adenosine

Answer 6

chest pain
bronchospasm - avoid in asthmatics
transient flushing
enhance conduction down accessory pathways resulting in increased ventricular rate

Question 7

amiodarone moa

Answer 7

antiarrhythmic agent for atrial, nodal and ventricular tachycardia
blocks potassium channels, inhibiting repolarisation, prolonging action potential

Question 8

adverse effects of amiodarone

Answer 8

thyroid dysfunction: both hypothyroidism and hyper-thyroidism
corneal deposits
pulmonary fibrosis/pneumonitis
liver fibrosis/hepatitis
peripheral neuropathy, myopathy
photosensitivity
‘slate-grey’ appearance
thrombophlebitis and injection site reactions
bradycardia
lengths QT interval

Question 9

ang II blockers indications

Answer 9

used when ACE not tolerated
shown to reduce progression of renal disease in patients with diabetic nephropathy
evidence base that losartan reduces CVA and IHD mortality in hypertensive patients

Question 10

3 ang II examples

Answer 10

candesartan
losartan
irbestartan

Question 11

ang II side effects and cautions

Answer 11

hypotension
hyperkalaemia

caution in renovascular disease

Question 12

anti platelet guidelines

Answer 12

ACS and PCI - 1st line aspirin and ticagrelaor/plasurgrel, is aspirin contrad clopidogrel.

TIA, Ischaemic stroke, peripheral arterial disease - lifelong clopidogrel 1st line, 2nd line aspirin and dipyridamole