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Hugh's MD2 Foundation > Coronary (not chronic) Heart Disease Therapeutics > Flashcards

Coronary (not chronic) Heart Disease Therapeutics Flashcards

1
Q

What are the front line drugs in coronary heart disease?

A

Beta-blockers

Statins

Angiotension system blockers (ACEi and ARBs)

Anti-platelets

Antianginals

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2
Q

How do beta-blockers aid in the treatment of coronary heart disease?

A

Block sympathetic input > Reduce HR and contractility > Reduce O2 demand > Reduce ischaemia = Symptomatic control

Reduced SNS driven pathological ventricle remodelling = Long term improvement in mortality

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3
Q

Which beta-blockers are used in coronary heart disease?

A

Metoprolol

Atenolol

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4
Q

What are the side effects of beta-blockers?

A

Exercise intolerance

Lethargy

Tiredness

Bronchospasm

Hypotension

Bradycardia

Erectile dysfunction

Vivid dreams

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5
Q

When are beta-blockers contraindicated?

A

Hypoglycaemic diabetics as they might mask hypo’s

Hyperglycaemic as they disrupt control

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6
Q

What cohort of patients with CHD should be on statins?

A

All of them regardless of LDL levels

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7
Q

What are the side effects of statins?

A

Rare

Myalgia

Rhadomyolysis

Elevated AST and ALT

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8
Q

Arrange these statins in order of their potency

Atorva

Rosuva

Simva

Prava

A

Prava

Simva

Atorva

Rosuva

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9
Q

Why are angiotension system inhibitors used in coronary heart disease?

A

Prevent their stimulation of pathological ventricular remodelling. Enlarged ventricles are more susceptible to CHD (and HF)

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10
Q

Which ACEi are used for coronary heart disease?

A

Perindopril

Ramipril

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11
Q

What are the side effects of ACEi?

A

Dry cough

Hyperkalaemia

Renal impairment

Hypotension

Angioedema

Teratrogen

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12
Q

What angiotension receptor blockers are used in CHD?

A

Irbesartan

Candesartan

Olmesartan

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13
Q

What dose of aspirin is used in CHD?

A

75-150mg

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14
Q

How does clopidogrel work?

A

Inhibits ADP necessary for platelet activation

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15
Q

When is clopidogrel used?

A

When aspirin is contraindicated (bleeding risk)

Or on top of aspirin

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16
Q

What major drug drug interaction does clopidogrel have?

A

With PPIs as they block metabolism of its pro-form

17
Q

How are nitrates used in CHD? How do they work?

A

Symptomatic control

Dilate coronary arteries

18
Q

What are the side effects of nitrates?

A

Headache

19
Q

Which Ca channel blockers are sometimes used in CHD?

A

Dihydropyridines eg amlodipine

  • vasodilate: peripheral and coronary

No mortality benefit

20
Q

What are the side effects of dihydropyridines?

A

Hypotension

Peripheral oedema

Flushing

21
Q

Why don’t verapamil and diltiazem provide long term mortality benefit?

A

They don’t prevent pathological remodelling

Hugh's MD2 Foundation (47 decks)

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