CV drugs Flashcards
Monitoring + issues with amiodarone
TFT, LFT
Causes hypo + hyperthyroidism
Liver cirrhosis + pulmonary fibrosis
Brodie Trendelenburg test
Test to determine competency of valves in pts with varicose veins
What is Conn’s syndrome?
Primary hyperaldosteronism
Can cause HTN
Action of nitrates
Converted in NO which activates guanylyl cyclase, causing increase in cGMP
Action of cardiac glycosides
Inhibits Na+/K+ pump, increasing intracellular Ca2+
Class I antiarrhythmics
Sodium channel blockers
Flecainide
Class II antiarrhythmics
Beta blockers
Atenolol, metoprolol
Class III antiarrhythmics
Potassium channel blockers
Amiodarone
Class IV antiarrhythmics
Calcium channel blockers
Diltiazem
Class V antiarrhythmics
Digoxin
Action, CI, interactions + SE of ACE inhibitors
Ramipril
action: blocks conversion of Angiotensin 1 to 2. Reduces aldosterone secretion
CI: renal artery stenosis (Africans), AKI + pregnancy
interactions: NSAID (renal failure), metformin (hypoglycaemia), potassium sparing diuretics (hyperkalaemia)
SE: hypotension, dry cough, hyperkalaemia, angioedema
Name, action + CI of ARBs
Losartan
Blocks action of angiotensin II on AT1 receptor
Reduces vascular resistance
CI: renal artery stenosis, AKI, pregnancy
SE, interactions + key info of ARBs
SE: hypotension, hyperkalaemia, renal failure
NSAIDs + ARBs = risk of renal failure
Key info: better for Africans than ACEi. Take before bed
Indications, action + CI for amiodarone
Indications: VF, AF, atrial flutter, during cardiac arrest
CI: severe hypotension, AV block, heart block
Action: prolongs action potential, increases refractory period + reduces ventricular rate
SE, interactions + key info for amiodarone
SE: hypotension, bradycardia, AV block, photosensitivity, grey skin, pulmonary fibrosis, thyroid toxicity, myopathy + liver toxicity
Toxicity is increased with digoxin, diltiazem/ verapamil
it is metabolised by P450 + is a P450 inhibitor
Action + interactions of clopidogrel
Decreases platelet aggregation by binding to ADP receptors
P450 activates clopidogrel so efficacy is reduced by P450 inhibitors (omeprazole, ciprofloxacin, SSRIs, erythromycin)
Action, CI + interactions of beta blockers
Blocks beta receptors in heart, prolongs refractory period at AV node, reduces cardiac output
CI: asthma, COPD, heart block, peripheral artery disease
Causes HF + bradycardia with verapamil
Masks hypoglycaemia so caution in DM
SE of BB
Fatigue Cold extremities Headache Impotence Bradycardia
Action + CI of CCB
Reduce entry of Ca+ into cells = relaxing + vasodilating smooth muscle
CI: unstable angina, HF, aortic stenosis
SE + interactions of CCB
Amlodipine = flushing, headaches, palpitations, ankle swelling Verapamil = constipation, heart block, HF, bradycardia Diltiazem = both
With BB = HF
Metabolised by P450
Action + CI of digoxin
Inhibits Na+/K+ pump Cardiac glycoside Negatively chronotropic (reduces HR), positively inotropic (increases force of contraction) Reduces conductivity at AV node CI: heart block, VF
SE + interactions + key info for digoxin
SE: dizziness, xanthropia (yellow vision), rash, bradycardia
Toxicity can cause arrhythmias
Loop + thiazide diuretics increase risk of toxicity
Amiodarone, CCB, spironolactone + quinine increase risk of toxicity
Measure levels 6 hours post dose
SE + CI of nitrates
SE: flushing, headache, postural hypotension
CI: hypotension, hypovolaemia, aortic stenosis, raised ICP
Warfarin + abx interaction
Abx kill gut flora that synthesis Vit K so increase risk of bleeding
SE of nicorandil
Headache, flushing + anal ulceration
What is the action of nicorandil?
Potassium channel activator
Vasodilator - used in angina
Action + SE of statins
Inhibits HMG CoA reductase to reduce cholesterol synthesis in liver
SE:
headache, myalgia, myopathy, rhabdomyolysis
Key info about statins
Check LFTs - causes rise in ALT
Give at night
Metabolised by P450
How do thrombolytics work?
Activates plasminogen to form plasmin
Degrades fibrin
