Drugs used in Cardiology Flashcards
where does Abciximab take affect?
Irreversibly binds Gpiib/iia glucoprotein receptors on platelets.
Inhibits platelet aggregation.
Adenosine - which channel does it affect?
How long is the half life?
Potassium channel activator.
8-10 seconds
When is adenosine used?
causes sinus node arrest
- to terminate SVT / VT
what are the 4 main side effects of adenosine?
anxiety
bronchospams
chest tightness
facial flushing
what is the mechanism of action of Amiodarone?
Prolong refractory period -> QT interval
What is the main use of Amiodarone?
Control SVT
Recurrent VT or HOCM
what is the half life of Amiodarone?
26-126 days
what is the onset time of Amiodarone?
PO = <3 weeks
IV = <3 hours
which two drugs can be potentiated by Amiodarone?
Digoxin
Warfarin
(protein binding can displace these)
what are the key side effects of Amiodarone?
- arrhythmias: torsades
- ataxia
- hepatitis (reversible)
- thyroid dysfunction
- metallic taste
- slate grey appearances
- pulmo fibrosis
- reversible corneal deposits (90%)
when are ACEi contraindicated?
in bilateral renal artery stenosis
(caution in severe renal disease)
Why do ACEi cause cough?
They inhibit the breakdown of bradkinin
when are ARBs contraindicated?
In patients with poor renal blood flow
1. Renal artery stenosis
2. Cardiac failure
3. Hypovolaemia
what is the half life of Flecanide?
16h
What are the two main side effects of Flecanide?
Vertigo
Vsual disturbances
when is Flecanide the drug of choice?
WPW
AF
what is Flecanide used to treat?
- ventricular arrhythmia
- chemical cardioversion of acute atrial arrhythmia
digoxin MOA
slow conduction at AV node
what conditions is Digoxin used for?
Flutter
AF
When would you choose Digoxin over Bisoprolol for AF?
heart failure
How is Digoxin excreted?
renally
- accumulates in renal impairment
what is pulsus bigeminus?
a single ectopic beat, following each regular heartbeat
what 3 abnormalitites are seen on ECG in pateints taking Digoxin?
‘reverse tick’
1 degree HB
pulsus bigeminus
which 3 electrolyte imbalances predispose to digoxin toxicity?
Hypokalaemia
hypomagnesaemia
hypercalcaemia
name 5 toxic effects of digoxin:
anorexia
arrhythmia (HB)
diarrhoea
nausea / vomiting
yellow vision (xanthopsia)
HMG-CoA reductase inhibitors do what?
inhibit synthesis of cholesterol
when is cholesterol synthesised?
night time.
- fasting,
- high hepatic blood flow
what is HMG-CoA reducatse inhibitors MOA?
reduces LDL
increases cholesterol clearance
increases HDL
what are the targets for total serum cholesterol + LDL?
serum = <5
LDL <3
2x MOA of Nicorandil
- k+ channel opener -> arterial vasodilation
- component of vaso dilitation -> venous relaxation
What is Nicorandil used for?
It is an Anti-anginal agent
Side effects of nicorandil
Transient headache
flushing
dizziness
What is the recognised potential side effect of Clopidogrel?
neutrophilia
What electrolyte disturbances are associated with thiazide diuretics?
Hyponatremia
Hypokalaemia
Hypomagnesaemia
Side effects of Thiazide duiretics include
Gout - reduced tubular clearance if urate.
Tranisently impaired insulin release.
Postural hypotension
Rare side effects of Thiazide duiretics
Agranulocytosis
Pancreatitis
Thrombocytopenia
Photosensitive rash
what are the five pillars of HFrEF Pharmacotherapy
ACEI,
ARB (~artan)
MRA (spiro / eplerenone)
Neprilysin inhibitor (Sacubitril-valsartan)
SGLT2i (~flozin)
