Drugs used in cardiology Flashcards

1
Q

What do diuretics do?

A

block reabsorption of Na in kidneys to get rid of sodium and water

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2
Q

What are the two types of diuretics?

A

-thiazide diuretics and loop diuretics

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3
Q

What is the difference between the two types of diuretics?

A

thiazide diuretics are mild and loop diuretics are strong

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4
Q

When are thiazide diuretics used?

A

hypertension

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5
Q

When are loop diuretics used?

A

heart failure

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6
Q

Give an example of a thiazide diuretic

A

bendrofluazide

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7
Q

Give an example of a loop diuretic

A

furosemide

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8
Q

What are the side effects of diuretics?

A

-hypokalaemia, hyperglycaemia, increased uric acid and impotence

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9
Q

Give an example of a selective B blocker

A

atenolol

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10
Q

Give an example of a non selective B blocker

A

proanolol

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11
Q

When are selective B blockers used?

A

angina, hypertension and heart failure

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12
Q

When are non selective B blockers used?

A

Thyrotoxicosis- Overactive thyroid gland

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13
Q

What are the side effects of B blockers?

A
  • tiredness
  • heart failure (can worsen heart failure in short term)
  • cold peripheries
  • cause bronchospasm in asthmatics
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14
Q

What are the two types of calcium antagonists?

A
  • Dihydropyridines

- Rate limiting calcium antagonists

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15
Q

When are Rate limiting calcium antagonists

used?

A

Used in hypertension and angina
Plus Supraventricular Arrhythmias (AF, SVT)

They block the conduction in AV node

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16
Q

When are Dihydropyridines

used?

A

in hypertension and angina

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17
Q

What is a side effect of Dihydropyridines

A

ankle oedema (cosmetic side effect not serious)

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18
Q

When should you not use rate limiting calcium antagonists?

A

in conjunction with B blockers

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19
Q

What do alpha blockers do?

A

Block a adrenoceptors to cause vasodilation

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20
Q

When are alpha blockers used?

A

in hypertension and prostatic hypertrophy

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21
Q

What is an example of an alpha blocker?

A

doxazosin

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22
Q

What are the side effects of alpha blockers?

A

postural hypotension

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23
Q

What are angiotensin converting enzyme inhibitors?

A

Block angiotensin I becoming angiotensin II

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24
Q

In what ways does angiotensin converting enzyme inhibitor effect the kidney?

A

Good for kidneys in diabetic nephropathy (diabetic kidney disease)
Bad for kidneys in renal artery stenosis (different kidney disease)

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25
Q

What is an example of an angiotensin converting enzyme

A

lisinopril

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26
Q

What are the side effects of angiotensin converting enzyme?

A

Cough
Renal dysfunction – need to measure kidney function after starting this drug
Angioneurotic oedema – life threatening. Allergic response. Larynx can get swollen. Rare.

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27
Q

When must you never use angiotensin converting enzyme?

A

In pregnancy induced hypertension

28
Q

What is a drug ending in -pril most likely to be?

A

ACE inhibitor

29
Q

What do angiotensin receptor blockers do?

A

Block angiotensin II receptors

30
Q

What is an example of an angiotensin receptor blocker?

A

Losartan

31
Q

In what ways do angiotensin receptor blockers affect the kidneys?

A

Good for kidneys in diabetic nephropathy

Bad for kidneys in renal a stenosis

32
Q

When are angiotensin receptor blockers used?

A

hypertension and heart failure

33
Q

What are the side effects of angiotensin receptor blockers?

A

renal dysfunction but no cough

34
Q

When should angiotensin receptor blockers not be used?

A

pregnancy induced hypertension

35
Q

What are nitrates used for?

A

angina and acute heart failure

36
Q

What do nitrates do?

A

venodilators

37
Q

What is an example of nitrates?

A

isosobide monoritrate

38
Q

What are the side effects of nitrates?

A

headache, hypotension/collapse

39
Q

What is nitrate tolerance like?

A

tolerance common. Leave 8hours a day nitrate free

40
Q

Give examples of antiplatelet agents

A

Aspirin, Clopidogrel, Ticagrelor, Prasugrel

41
Q

What do antiplatelet agents do?

A

All prevent new thrombosis

42
Q

When are antiplatelet agents used for?

A
  • angina
  • acute MI
  • CVA/TIA
  • patients at high risk of MI and CVA
43
Q

What are the side effects of antiplatelet agents?

A

Haemorrhage anywhere
Peptic ulcer  haemorrhage
Aspirin sensitivity  Asthma

44
Q

What are anticoagulants used for?

A

Prevent new thrombosis

45
Q

What are anticoagulants used in?

A
  • Deep Vein Thrombosis
  • Pulmonary embolism
  • NSTEMI
  • Atrial Fibrillation (stop them having embolus from this)
46
Q

What are examples of anticoagulants?

A
  • heparin (IV only)
  • warfarin (oral only)
  • rivaroxaban
  • dabigatran
47
Q

What are side effects of warfarin?

A

Haemorrhage anywhere
Control dose carefully by INR = International Normalised Ratio (measure how thin the blood is when using warfarin)
Reversed by Vitamin K

48
Q

What anticoagulant drugs dont need monitoring?

A

-rivaroxaban and dabigatran. However they aren’t reversible

49
Q

What do fibrinolytic drugs do?

A

dissolve formed clot

50
Q

What are examples of fibrinolytic drugs?

A
  • Streptokinase

- tissue Plasminogen activator (tPA)

51
Q

When are fibrinolytic drugs used?

A
Use in STEMI (ST elevation myocardial infarction)
Pulmonary embolism (selected cases only)
CVA (selected cases only)
52
Q

What are the side effects of fibrinolytic drugs?

A

Haemorrhage serious risk (higher than anticoagulant)

Avoid in

  • recent haemorrhage (some CVAs)
  • trauma
  • bleeding tendencies
  • severe diabetic retinopathy
  • peptic ulcer
53
Q

What are the two types of anticholestrol drugs?

A

statins and fibrates

54
Q

What do statins do?

A

blocks HMG CoA reductase

55
Q

What are statins used in?

A
  • hypercholesterolaemia
  • diabetes
  • Angina/MI
  • CVA/TIA
  • High risk of MI and CVA
56
Q

What are the side effects of statins?

A
  • myopathy

- rhabdomyolysis renal failure

57
Q

What are fibrates used in?

A
  • hypertriglyceridaemia

- low HDL cholesterol

58
Q

What is an example of a statin?

A

simvastatin

59
Q

What is an example of a fibrin?

A

bezafibrate

60
Q

What Anti arrhythmic drugs can be used to treat supraventricular arrhythmias?

A

adnesoine in acute phase

61
Q

What anti arrhythmic drug can be used to treat ventricular/supraventricular arrhythmias?

A
  • amiodarone
  • beta blockers
  • flecaindie
62
Q

What are some characteristics of amiodarone?

A
  • best anti arrhythmic
  • takes ages to accumulate and disappear in the body
  • Bad side effects
63
Q

Side effects of amiodarone

A

-Phototoxicity
-Pulmonary fibrosis
-Thyroid abnormalities
(Hypo or Hyper)

64
Q

What are the two effects of digoxin?

A
  • Blocks atrial-ventricular (AV) conduction

- Increases ventricular irritability which produces ventricular arrhythmias

65
Q

What is the positive effect of digoxin?

A

produces a degree of AV conduction delay

66
Q

What are the negative effects of digoxin?

A

has a narrow therapeutic index so can cause arrhythmias

67
Q

What are the side effects of toxic digoxin?

A
  • Nausea, vomiting
  • Yellow vision
  • Bradycardia, Heart Block
  • Ventricular Arrhythmias