Drugs used in cardiology

Question 1

What do diuretics do?

Answer 1

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

Question 2

What are the two types of diuretics?

Answer 2

-thiazide diuretics and loop diuretics

Question 3

What is the difference between the two types of diuretics?

Answer 3

thiazide diuretics are mild and loop diuretics are strong

Question 4

When are thiazide diuretics used?

Answer 4

hypertension

Question 5

When are loop diuretics used?

Answer 5

heart failure

Question 6

Give an example of a thiazide diuretic

Answer 6

bendrofluazide

Question 7

Give an example of a loop diuretic

Answer 7

furosemide

Question 8

What are the side effects of diuretics?

Answer 8

-hypokalaemia, hyperglycaemia, increased uric acid and impotence

Question 9

Give an example of a selective B blocker

Answer 9

atenolol

Question 10

Give an example of a non selective B blocker

Answer 10

proanolol

Question 11

When are selective B blockers used?

Answer 11

angina, hypertension and heart failure

Question 12

When are non selective B blockers used?

Answer 12

Thyrotoxicosis- Overactive thyroid gland

Question 13

What are the side effects of B blockers?

Answer 13

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

Question 14

What are the two types of calcium antagonists?

Answer 14

• Dihydropyridines

- Rate limiting calcium antagonists

Question 15

When are Rate limiting calcium antagonists

used?

Answer 15

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

They block the conduction in AV node

Question 16

When are Dihydropyridines

used?

Answer 16

in hypertension and angina

Question 17

What is a side effect of Dihydropyridines

Answer 17

ankle oedema (cosmetic side effect not serious)

Question 18

When should you not use rate limiting calcium antagonists?

Answer 18

in conjunction with B blockers

Question 19

What do alpha blockers do?

Answer 19

Block a adrenoceptors to cause vasodilation

Question 20

When are alpha blockers used?

Answer 20

in hypertension and prostatic hypertrophy

Question 21

What is an example of an alpha blocker?

Answer 21

doxazosin

Question 22

What are the side effects of alpha blockers?

Answer 22

postural hypotension

Question 23

What are angiotensin converting enzyme inhibitors?

Answer 23

Block angiotensin I becoming angiotensin II

Question 24

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

Answer 24

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

Question 25

What is an example of an angiotensin converting enzyme

Answer 25

lisinopril

Question 26

What are the side effects of angiotensin converting enzyme?

Answer 26

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

Question 27

When must you never use angiotensin converting enzyme?

Answer 27

In pregnancy induced hypertension

Question 28

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

Answer 28

ACE inhibitor

Question 29

What do angiotensin receptor blockers do?

Answer 29

Block angiotensin II receptors

Question 30

What is an example of an angiotensin receptor blocker?

Answer 30

Losartan

Question 31

In what ways do angiotensin receptor blockers affect the kidneys?

Answer 31

Good for kidneys in diabetic nephropathy | Bad for kidneys in renal a stenosis

Question 32

When are angiotensin receptor blockers used?

Answer 32

hypertension and heart failure

Question 33

What are the side effects of angiotensin receptor blockers?

Answer 33

renal dysfunction but no cough

Question 34

When should angiotensin receptor blockers not be used?

Answer 34

pregnancy induced hypertension

Question 35

What are nitrates used for?

Answer 35

angina and acute heart failure

Question 36

What do nitrates do?

Answer 36

venodilators

Question 37

What is an example of nitrates?

Answer 37

isosobide monoritrate

Question 38

What are the side effects of nitrates?

Answer 38

headache, hypotension/collapse

Question 39

What is nitrate tolerance like?

Answer 39

tolerance common. Leave 8hours a day nitrate free

Question 40

Give examples of antiplatelet agents

Answer 40

Aspirin, Clopidogrel, Ticagrelor, Prasugrel

Question 41

What do antiplatelet agents do?

Answer 41

All prevent new thrombosis

Question 42

When are antiplatelet agents used for?

Answer 42

- angina - acute MI - CVA/TIA - patients at high risk of MI and CVA

Question 43

What are the side effects of antiplatelet agents?

Answer 43

Haemorrhage anywhere Peptic ulcer  haemorrhage Aspirin sensitivity  Asthma

Question 44

What are anticoagulants used for?

Answer 44

Prevent new thrombosis

Question 45

What are anticoagulants used in?

Answer 45

- Deep Vein Thrombosis - Pulmonary embolism - NSTEMI - Atrial Fibrillation (stop them having embolus from this)

Question 46

What are examples of anticoagulants?

Answer 46

- heparin (IV only) - warfarin (oral only) - rivaroxaban - dabigatran

Question 47

What are side effects of warfarin?

Answer 47

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

Question 48

What anticoagulant drugs dont need monitoring?

Answer 48

-rivaroxaban and dabigatran. However they aren't reversible

Question 49

What do fibrinolytic drugs do?

Answer 49

dissolve formed clot

Question 50

What are examples of fibrinolytic drugs?

Answer 50

- Streptokinase | - tissue Plasminogen activator (tPA)

Question 51

When are fibrinolytic drugs used?

Answer 51

``` Use in STEMI (ST elevation myocardial infarction) Pulmonary embolism (selected cases only) CVA (selected cases only) ```

Question 52

What are the side effects of fibrinolytic drugs?

Answer 52

Haemorrhage serious risk (higher than anticoagulant) Avoid in - recent haemorrhage (some CVAs) - trauma - bleeding tendencies - severe diabetic retinopathy - peptic ulcer

Question 53

What are the two types of anticholestrol drugs?

Answer 53

statins and fibrates

Question 54

What do statins do?

Answer 54

blocks HMG CoA reductase

Question 55

What are statins used in?

Answer 55

- hypercholesterolaemia - diabetes - Angina/MI - CVA/TIA - High risk of MI and CVA

Question 56

What are the side effects of statins?

Answer 56

- myopathy | - rhabdomyolysis renal failure

Question 57

What are fibrates used in?

Answer 57

- hypertriglyceridaemia | - low HDL cholesterol

Question 58

What is an example of a statin?

Answer 58

simvastatin

Question 59

What is an example of a fibrin?

Answer 59

bezafibrate

Question 60

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

Answer 60

adnesoine in acute phase

Question 61

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

Answer 61

- amiodarone - beta blockers - flecaindie

Question 62

What are some characteristics of amiodarone?

Answer 62

- best anti arrhythmic - takes ages to accumulate and disappear in the body - Bad side effects

Question 63

Side effects of amiodarone

Answer 63

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

Question 64

What are the two effects of digoxin?

Answer 64

- Blocks atrial-ventricular (AV) conduction | - Increases ventricular irritability which produces ventricular arrhythmias

Question 65

What is the positive effect of digoxin?

Answer 65

produces a degree of AV conduction delay

Question 66

What are the negative effects of digoxin?

Answer 66

has a narrow therapeutic index so can cause arrhythmias

Question 67

What are the side effects of toxic digoxin?

Answer 67

- Nausea, vomiting - Yellow vision - Bradycardia, Heart Block - Ventricular Arrhythmias