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02 Toxicology > Drugs used in Cardiology > Flashcards

Drugs used in Cardiology Flashcards

1
Q

where does Abciximab take affect?

A

Irreversibly binds Gpiib/iia glucoprotein receptors on platelets.
Inhibits platelet aggregation.

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2
Q

Adenosine - which channel does it affect?
How long is the half life?

A

Potassium channel activator.

8-10 seconds

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3
Q

When is adenosine used?

A

causes sinus node arrest
- to terminate SVT / VT

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4
Q

what are the 4 main side effects of adenosine?

A

anxiety
bronchospams
chest tightness
facial flushing

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5
Q

what is the mechanism of action of Amiodarone?

A

Prolong refractory period -> QT interval

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6
Q

What is the main use of Amiodarone?

A

Control SVT
Recurrent VT or HOCM

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7
Q

what is the half life of Amiodarone?

A

26-126 days

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8
Q

what is the onset time of Amiodarone?

A

PO = <3 weeks
IV = <3 hours

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9
Q

which two drugs can be potentiated by Amiodarone?

A

Digoxin
Warfarin
(protein binding can displace these)

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10
Q

what are the key side effects of Amiodarone?

A
  1. arrhythmias: torsades
  2. ataxia
  3. hepatitis (reversible)
  4. thyroid dysfunction
  5. metallic taste
  6. slate grey appearances
  7. pulmo fibrosis
  8. reversible corneal deposits (90%)
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11
Q

when are ACEi contraindicated?

A

in bilateral renal artery stenosis

(caution in severe renal disease)

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12
Q

Why do ACEi cause cough?

A

They inhibit the breakdown of bradkinin

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13
Q

when are ARBs contraindicated?

A

In patients with poor renal blood flow
1. Renal artery stenosis
2. Cardiac failure
3. Hypovolaemia

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14
Q

what is the half life of Flecanide?

A

16h

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15
Q

What are the two main side effects of Flecanide?

A

Vertigo
Vsual disturbances

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16
Q

when is Flecanide the drug of choice?

A

WPW
AF

17
Q

what is Flecanide used to treat?

A
  1. ventricular arrhythmia
  2. chemical cardioversion of acute atrial arrhythmia
18
Q

digoxin MOA

A

slow conduction at AV node

19
Q

what conditions is Digoxin used for?

A

Flutter
AF

20
Q

When would you choose Digoxin over Bisoprolol for AF?

A

heart failure

21
Q

How is Digoxin excreted?

A

renally
- accumulates in renal impairment

22
Q

what is pulsus bigeminus?

A

a single ectopic beat, following each regular heartbeat

23
Q

what 3 abnormalitites are seen on ECG in pateints taking Digoxin?

A

‘reverse tick’
1 degree HB
pulsus bigeminus

24
Q

which 3 electrolyte imbalances predispose to digoxin toxicity?

A

Hypokalaemia
hypomagnesaemia
hypercalcaemia

25
Q

name 5 toxic effects of digoxin:

A

anorexia
arrhythmia (HB)
diarrhoea
nausea / vomiting
yellow vision (xanthopsia)

26
Q

HMG-CoA reductase inhibitors do what?

A

inhibit synthesis of cholesterol

27
Q

when is cholesterol synthesised?

A

night time.
- fasting,
- high hepatic blood flow

28
Q

what is HMG-CoA reducatse inhibitors MOA?

A

reduces LDL
increases cholesterol clearance
increases HDL

29
Q

what are the targets for total serum cholesterol + LDL?

A

serum = <5
LDL <3

30
Q

2x MOA of Nicorandil

A
  1. k+ channel opener -> arterial vasodilation
  2. component of vaso dilitation -> venous relaxation
31
Q

What is Nicorandil used for?

A

It is an Anti-anginal agent

32
Q

Side effects of nicorandil

A

Transient headache
flushing
dizziness

33
Q

What is the recognised potential side effect of Clopidogrel?

A

neutrophilia

34
Q

What electrolyte disturbances are associated with thiazide diuretics?

A

Hyponatremia
Hypokalaemia
Hypomagnesaemia

35
Q

Side effects of Thiazide duiretics include

A

Gout - reduced tubular clearance if urate.

Tranisently impaired insulin release.

Postural hypotension

36
Q

Rare side effects of Thiazide duiretics

A

Agranulocytosis
Pancreatitis
Thrombocytopenia
Photosensitive rash

37
Q

what are the five pillars of HFrEF Pharmacotherapy

A

ACEI,
ARB (~artan)
MRA (spiro / eplerenone)
Neprilysin inhibitor (Sacubitril-valsartan)
SGLT2i (~flozin)

38
Q
A

02 Toxicology (7 decks)

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