CVS Flashcards
(33 cards)
Digoxin
Cardiac glycoside, inhibits Na/K ATPase, mainly in the myocardium. This increases intracellular Na+, leading to a reversal in 3Na+/Ca2+ channel, which now exports Na+ and imports Ca2+ instead of ti’s usual. This lengthens phase 0 and phase 4 of the cardiac action potential, leading to a lower heart rate.
Bendroflumethiazide
Thiazide diuretic, therefore blocks Na/Cl co-transporter in the DCT. Used mainly in hypertension as it also has vasodilatory effect
Indapamide
Thiazide like diuretic
Amioderone
K+/type three anti-arythmic, used in AF (as the rhythm control) in conjunction with propranolol as the rate control
amlodipine
Ca2+/type 3
verapamil
Ca2+/type 3, could be used in place of BB propranolol as as the rate controlling part of of rate and rhythm controlling part of how to deal with AF, unless there’s heart block
Amiloride
Enac inhibitor - K+ sparing (as Na+ isn’t going out, meaning you don’t need to swap if for a K+ to keep the electroneutrality)
flecanide
Na+, 1C, can’t be used if there’s structural damage
adenosine
chemical cardioversion, really short half life, flush in with saline so it doesn’t get broken down before it reaches the heart, it stops the SAN and the AVN
Alteplase
thrombolysis, good for ischaemic stroke, can lead to haemorragic stroke somewhere else in the brain as clotting is disabled
propanolol
BB, used as the rate controlling part of of rate and rhythm controlling part of how to deal with AF
What stimulates RAAS?
Sympathetic activity and low NaCl
why is amlodapine the only Ca2+ blocker you can give for HF?
it’s action is specific to vascular smooth muscle
what is the order for HF?
ACE Diuretics, Amioderone, Ca2+, anticoag and aspirin if Hx of thrombotic, IV ionotropes for acute heart failure
Why is verapamil given for AF, but not amlodapine?
as amlodapine only affects vascular smooth muscle, would have no affect on the heart
which first given hypertension?
ACEi, unless over 55/black, Ca2+ - if doesn’t work the other one, if still not working thiazide, then if still not working spironolactone (this is an aldosterone receptor antagonist)
why dry cough if on ACEi?
angiotensin 2 breaks down bradykinin, there will be less angiotensin to break down bradykinin - which causes a dry cough
what could you give if the patient had a dry cough on an ACEi?
Angiotensin 2 receptor blocker
orlistat
anti obesity drug, inhibits pancreatic lipase - like an acarbase but for fat rather than sugar - prevents onset of type 2 DM in fatties
GTN - glyceryltrinitrate
Simple Angina - metabolised to NO, venodilator, (reduce preload, therefore reduces oxygen demand of the heart as it’s not having to pump as hard) and vasodilator (reduces after load). ADRs; postural hypotension/dizziness (this happens as the blood is in the veins so is susceptible to gravity) - also give secondary prevention of CVS disease - statins, aspirin, ACEi if they have angina and diabetes, antihypertensives if they have hypertension
Angina treatment
Beta blocker or Ca2+ channel blocker (amlodapine) + GTN for when necessary - for unstable you can consider stenting
MI treatment
For STEMI; percutaneous coronary intervention - this is a stent, has to be done within 2 hours, if later than that thrombolise
Statins
HMG - CoA reductase blocker, this is used in the production of cholesterol
unstable angina/NSTEMI treatment
Aspirin and clopidagrel
