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CVS drugs > Drugs 1 > Flashcards

Drugs 1 Flashcards

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1
Q

what is Lidocaine

A 
blocks volatge gated NA+ channels 
local anaesthetic 
only blocks in open/inactive state aka blocks damaged depolarised tissue 
blocks during depoalrisation 
dissociated in time for next AP
blocks after an AP has occurred
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2
Q

when would you use lidocaine

A

after an MI - only if patient shows signs of ventricular tacycardia
give IV
not used prophyaltically following MI

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3
Q

what is propranolol

A

b-adrenoreceptor antagonist

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4
Q

describe b-adrenoreceptor anatgonists

A

e..g propranol
prevent supraventricualr tachycardia - slows conduction in AV node, slows Ventriuclar rate in patients with AF
used following an MI - becaue MI causes increased symathetiic actiivty.
b-blockes prevent ventricular arrythmais
reduced O2 demand - reduces myocardial ischaemia therefore good following MI

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5
Q

descrbie the mechanism of beta blockers on APs

A

decreases slope of pacemakrer potential in SA
slows conduction at AV node - stops supraventricular tachycardia going through (AF)
get a more normal ventricular rate

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6
Q

decribe class 4, L type Ca2+ channel blockers

A

decreases slope of AP at SA node
decreases AV nodal conduction
decreases force of contraction = negative ionotrophy (iron man= ionoptropy)
coronary and peripheral vasodilation

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7
Q

give 2 examples of Ca2+ channel blockers

A

Dihydropridine Ca2+ channel blockers

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8
Q

describe what adenosine is and uses

A

G alpha 1
produced endogenosuly at physillgical levels but can be given IV
Acts on receptors at AV node
v.short half life
enhances K+ conductance - hyperpolarises cells of conducting tissue
anti-arryhtmics - useful for terminating re-enterant SVT

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9
Q

describe class 3 anti arryhtmia drugs

A

prolong AP
block K+ channels = lengthens refractory period
can be pro-aryhtmic - prolongs QT interval

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10
Q

when would you use class 3 drugs

A

treat tachycardia associated with Wolff-parkinson White syndrome as this has a re-entry loop due to an extra conduction pathway)
effective for suppressing ventricular arrhyhtmias post MI

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11
Q

give an exam[ple of an ACE inhibitor

A

Perindopril

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12
Q

what is function of ace inhibitor

A

inhibits action of angiotensin converting enzyme (angiotensin 1 into 2)
acts on kidneys to increase Na+ and water reabsoprtion and is a vasoconstrictor
decreases vasomotor tone (decreases BP) = reduces afterload of heart
decreases fluid retention (decreases blood volume) = reduces preload of heart

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13
Q

when would you use ACE inhibitors

A

hypertension

heart failure

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14
Q

what problem do you get with ace inhibitors

A

can cause dry cough due to excess bradykinin (these get broken down into peptides)

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15
Q

what type of drug do you give to someone who cannot tolerate ACE inhibitors?

A

Angiotensin 2 receptor blockers (ARBs)

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16
Q

give an example of ARBs

A

Losartan

17
Q

what is furosemide

A

diuretic

18
Q

describe the mechanism of diuretics

A

loop of henle

reduces pulmoanry and peripheral oedema

19
Q

when would you give diuretics

A

heart failure
hypertension
congestive heart failure

20
Q

how does amlopidine, nicardipine work

A

ca2+ channel blockers
decreases peripheral resistance
decreases arterial bp
reduce workload of heart by reducing afterload

21
Q

how does verampamil work

A

act on heart
ca2+ channel blockers
reduce workload by reducing force of contraction

22
Q

when would you use ca2+ channel blockers

A

hypertension
angina
coronary artery spasms
SVTs - supraventricular tachycardias

23
Q

give an exmaple of a cardiac glycoside

A

digoxin

24
Q

how do cardiac glcosides work

A

increased vagal activity - action via CNS, slow AV conduction, slows HR
Positive inotropes
blocks Na+ K+ ATPase
Ca2+ is extruded via Na+ and Ca2+ exhancges driven by Na+ moving down conc gradient
leads to raise in [Na+] intracellular = decrease in activity of Na+ Ca2+ exchanger
cause increase in intracellular Calcium = more calcium stored in SR
incresaed force of contraction (inotropy)

25
Q

when would you give someone a cardiac glycoside

A

heart failure - AF

improves symtpoms but not long term outcome

26
Q

give an example of a b-adrenergic agonsit

A

dobutamine

27
Q

how does dobutamine work

A

b-adrengeric agonist

stimautels B1 receptors present at SA node, AV nod and on ventricualr myocytes

28
Q

when would you use dobtumaine

A

cardiogenic shock
acute but reversible heart failure
e.g. following cardiac surgery

29
Q

what type of drugs decrease workload

A

ACEi
ARBs
B-blockers

30
Q

what type of drugs increases contraction

A

cardiac gylcosides

31
Q

what is spiralactone

A

aldosterone has an escape pathway, this blocks it

32
Q

what does dyresis mean

A

urinate a lot

33
Q

how do you calcualte pulse pressure

A

systolic - diastolic aka big number minus little number

CVS drugs (1 decks)

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