CV Pharmocology Flashcards
What drugs are used in the treatment of CV diseases?
ACE Inhibitors
Beta Blockers
Calcium Antagonist
Diuretic
Describe the sequence of drugs used to treat normal hypertension
- Patients younger that 55 start with an ACEI/ARB and older patients with Calcium Antagonist
- Then C/A
- Then a diuretic
What drugs are used to treat severe hypertension?
Beta or alpha blocker or spironolactone
What drugs are used in all patients with CHF?
DAB
Diuretic to rid the body of fluid retention
ACE Inhibitor and Beta blocker to remodel the heart
If CHF patients are still exhibiting signs like breathlessness after initial drug treatment, what drugs should be used?
Spironolactone and Eplerenone
Who would receive Cardiac synchronisation therapy?
CHF patients with long QRS segments on an ECG where drug treatment has failed
What can be done for patients with severe CHF
implantable cardiac defibrillators
What is sacubitril vasartan?
new dual drug used in severe heart failure that replaces ACEI or ARB
What is used to prolong survival in patients with Angina?
SAAB
Statin, aspirin, ACE inhibitor and beta blocker
What is used to relieve the symptoms of angina
beta blocker
calcium antagonist/nitrates
coronary angioplasty
New antianginals - ivabradine and ranolazine
How can chest pain be classified?
Non cardiac or cardiac
cardiac chest pain can be classified as troponin -ve which is called troponin -ve ACS.
troponin +ve can be classified as a STEMI or non-STEMI
Who might receive fondaparinux?
STEMI patient
synthetic pentasaccharide that inhibits activated factor X
describe the emergency management of STEMI
aspirin with angioplasty or thrombolysis
decribe the similarities in treatment of STEMIs and non-STEMIs
they both receive aspirin and clopidogrel/ticagrelor
they both receive SAABs as prophylaxis
describe the differences in treatment of STEMIs and non-STEMIs
use of angioplasty is selective in non-STEMIs
STEMIs recieve heparin/fondaparinux
how is troponin -ve ACS syndrome treated
SAAB with selective anioplasty
if someone with ACS has ongoing chest pain, what may they recieve
a glycoprotein Iib/IIIa inhibitor like tirofiban
what are the targets of treatment of atrial fibrillation?
prevention of emboli using warfarin/rivaroxiban
control of rate using beta blocker, digoxin
control of rhythm (seldom) using DC cardioversion, amiodarone in CHF, and sotalol/slecinide if heart structure is normal
what causes stroke
cerebral thrombosus, embolus and haemorrhage
what is the role of a CT scan in the treatment of stroke?
differentiates between clot or haemorrhage
how is a non haemorrhagic stroke treated?
emergency thrombolysis, aspirin and clopidogrel
statin, ACE inhibtior and indapamide
what is the targets of antianginal drugs
decrease the metabolic demands on the muscle by decreasing the preload/afterload or slowing down the heart
What beta blockers are used in angina
bisoprolol and atenolol
what is carvedilol used for
patients with CHF
which beta receptors are important in angina
beta 1 - control rate of the heart and thus correlates to oxygen consumption
what is the mechanism of calcium antagonists
vasodilator
prevents constriction of smooth muscle
prevent opening of voltage gated L type Ca2+ channels upon depolarisation
preventing entry of extracellular calcium
Name types of calcium antagonists and give examples
DHP derivatives eg. amlosipine and lercandipine
Rate limiting eg. verapamil and dilitiazen
what effect of calcium antagonists is important for variant angina
dilation of coronary vessels
what calcium antagonists are safe for CHF patients
amlodipine and lecanidipine
what are the contraindications of verapramil and dilitiazem?
heart failure, brachycardia, AV block, beta blocker
