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Alan's lecture - Pharmacology > CVS 2 > Flashcards

CVS 2 Flashcards

1
Q

ischemic heart disease is split into chronic arterial disease and acute coronary syndromes. TRUE OR FALSE?

A

TRUE

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2
Q

what does chronic alterial disease have?

A
  • stable agina
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3
Q

hwat does acute coronary syndrome have?

A
  • Unstabel agina
  • Non ST elevated myocardial infraction
  • ST elevated myocradial infratcion
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4
Q

what is iscehmic heart disease?

A
  • heart disease caused by reduced blood flow to the heart region
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5
Q

The resulting symptoms of Ischemic heart disease is Angina. TRUE OR FALSE?

A

TRUE

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6
Q

what occurs in stable agina?

A
  • The vessel is partly blocked
  • Pain and breathleness
  • Pain goes away after resting
  • No cardiac cell death
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7
Q

what occurs in unstable angina?

A
  • plaque ruptures causing platelets to aggregate which leads to further blockage
  • Pain usually does nto go away affter rest
  • No cardiac cell death
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8
Q

What occurs in the two types of myocardial infarction

A

Non ST elevelated myocardial infacrtion

  • vessels are blocked but not compeletly - there is still some blood flow
  • You a small area of tissue death

ST elevated myocardial infacrtion

  • Compeleteblockage of vessel
  • leads to large area tissue death
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9
Q

What are the treatment goals for stable angina?

A
  • Improve coronary blood flow

- decrease cardiac oxygen demande

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10
Q

What is the treatment goals for unstable angina and NSTEMI?

A
  • Prevent futher formation of thrombus

- Porvide symptom relief

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11
Q

what are the treatment goals for STEMI?

A
  • re-establish perfusion

- Symptom relief

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12
Q

what are the treatment options for stable angina?

A
  • Organic nitrates
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13
Q

how do organic nitrates help improve symptms of angina?

A
  • Organic nitrates produce - NO
  • This causes arterial dilation
  • Venous dilation - which is the main therapeutic effect
  • The effects of these improves blood flow to the heart
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14
Q

NO causes vascular smooth muscle relaxation - this is how it reliefs symptoms of angina. TRUE OR FALSE?

A

TRUE

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15
Q

Provide an example of nitrate drug used for treatmenr of stable angina?

A
  • Glycerol trinitrate - prefered choice/ fast onset of action t1/2 5min
  • can be given buccal (given in emergencies), sublingual and transdermal patch
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16
Q

Isosorbide mononitrate has slow onset of action (low first pass metabolism) . true or false?

A

true

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17
Q

Isosorbide dinitrate has fast first pass metabolism. TRUE OR FALSE?

A

TRUE

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18
Q

Nitrates increase heparin. TREU OR FALSE?

A

TRUE

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19
Q

What are the ADRs for nitrates?

A
  • Hypotension

- diziness flushing

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20
Q

what are the drug interactions with nitrates?

A
  • PDE inhbitors

- Diuretics - hypotensive effects

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21
Q

B adrenergic antangonists reduce myocardial oxygen demand. TRUE OR FALSE?

A

TRUE

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22
Q

B2 partial agonists and a1 antagonists cause vasodilation. TRUE OR FALSE?

A

TRUE

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23
Q

Give a drug name for B adrenergic antagonist?

A
  • Propanolol B1 and B2 non-selective
24
Q

atelnolol and metorprolol are B1 selective antangonist. TRUE OR FALSE?

25
Q

Propanolol is a B1 and B2 non selective. TRUE OR FALSE?

26
Q

B adrenergic antagonists are indicated for prophylatic treatment of angina which reduces cardiac workleoad. TRUE OR FALSE?

27
Q

why is pindolol useful? -

A

It inhibits tachycardia while minimizing bradycardia

28
Q

pindolol is a B1 partial agonists. TRUE OR FALSE?

29
Q

what are some ADRs for B adrnergic antagonists? -

A
  • bronchoconstriction especially in asthma
  • Bradycardia
  • erectile dysfunction
  • Sleep disturbance
30
Q

Some B adrenergic antagonists can mask signs of hypoglycemia and should be used in caution with patients with diabetes. TRUE OR FALSE?

31
Q

What are some drug interaction of B adreneragic antagonists?

A
  • not to be used with verapamil
32
Q

what are ca2+ channle blockers used for?

A

For prophylactic frequent angina attacks

33
Q

what are the vascular effects that Dihydro - pyridines has?

A
  • Lowers workload
  • Arterial dilation
  • lowers O2 demand
34
Q

what effects does varepamil have?

A
  • Lowers work load and O2 demands
35
Q

Verapamil has cardiac and vascular effects, while Dihydro-pyridine only has vascular effects. TRUE OR FALSE?

36
Q

Calcium channel blockers have their effects mostly on ateries whilst Nitrates have their effects on veins. TRUE OR FLASE?

37
Q

Ca2+ channel blockers reduce the rate and contractility of the heart. TRUE OR FALSE?

38
Q

Inhibition of cardiac myocyte contraction leads to reduced workload and less O2 demand. TRUE OR FALSE?

39
Q

Ca2+ channel blockers - block action potential at AV node which reduces contractility further, thus reducing workload. TRUE OR FALSE?

40
Q

Provide an example of a dihydropyriidines ca2+ channle blocker?

A

-Amlodipine - lonh half life 30-60hr

41
Q

Short acting dihydropyridines have increased risk of M.I and hence increased O2 demands. TRUE OR FALSE?

42
Q

Grape fruit juice should be avoided with Dihydropyridines as there are several potential interactions with CYt P450 dependent drugs. TRUE OR FALSE?

43
Q

Diltiazem is indicated for hypertension and prophylactic angina. TRUE OR FALSE?

44
Q

What is verapamil indicated for?

A
  • Supraventricular tachycardia
45
Q

Verapamil is not first choice but can also be used to treat prophylactic angina and hypertension. TRUE OR FALSE?

46
Q

What are the ADRs for verapamil?

A
  • Bradycardia

- Hypotention

47
Q

The Drug interactions of Verapamil are the same as Diltiazem, but verapamil has intrecations with grape fruit juice. TRUE OR FALSE?

48
Q

K+ channel openers are indicated for treatment of angina. TRUE OR FALSE?

49
Q

K+ channel openers are also NO donors - they are used when nitrates become a problem. TRUE OR FALSE?

50
Q

What are the contraindications, interations and ADRs for K+ channel openers?

A

ADRs

  • reflex tachycardia
  • Flushing, headaches

Contrandicated:
- cariogenic shock

Intrections:
- Sildenafil

51
Q

What are the 4 typesof treatment options for stable angina?

A
  • Nitrates
  • B adrenergic antangonists
  • Ca2+ channel blockers
  • K+ channel openers
52
Q

How todo you avoid M.I?

A
  • lifestyle changes
  • Apsirin - blood thinner
  • Angioplasty
  • statins - reduces blood cholesterol
53
Q

What are the treatment options for unstable angina?

A
  • Inhibit platete aggregating - aspirin, heparin , ca2+ channel blockers
  • ACE inhibitors e.g ramipril
  • Nitrates to provide symtpom relief
  • Cholestrol reduction
  • Angioplasty
54
Q

What is acute myocardial infarction?

A
  • Occlusion of the arteris leading to cardiac tissue death
55
Q

What treatments can be given for M.I?

A
  • Aspirin - anti-platetel aggreagation
  • ACE - inhibitors
  • Diuretics
  • Thrombolytics - alteplase
  • Anti-emetics
  • Anti-coagulants - heparin and warfirin

Alan's lecture - Pharmacology (16 decks)

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