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E-lfh FRCA Primary: Pharmacology - Cardiovascular > Drugs used in ischaemic heart disease > Flashcards

Drugs used in ischaemic heart disease Flashcards

1
Q

Which of the following are true or false?

The first line treatment for angina is a long-acting nitrate

A

False. The first line treatment is a β-blocker.

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2
Q

Which of the following are true or false?

Patients should continue DAPT indefinitely following PCI

A

False. DAPT should continue for six to twelve months.

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3
Q

Which of the following are true or false?

Spinal anaesthesia is contraindicated in a patient receiving aspirin monotherapy

A

False. Spinal anaesthesia is considered safe in a patient receiving aspirin monotherapy.

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4
Q

Which of the following are true or false?

Routine spinal anaesthesia is appropriate in a patient who stopped ticagrelor 48 hours previously

A

False. Ticagrelor should be withdrawn five days preoperatively

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5
Q

Which of the following are true or false?

Aspirin reversibly binds cyclo-oxygenase - 2

A

False. Aspirin is an irreversible COX-1 inhibitor.

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6
Q

The following medication should be continued on the day of surgery:

Rosuvastatin

A

True. Statins are safe to continue in the perioperative period. There is discussion about plaque stabilization with statins, however no solid evidence translating to improved outcomes.

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7
Q

The following medication should be continued on the day of surgery:

Amlodipine

A

True. Amlodipine is safe to continue peri-operatively.

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8
Q

The following medication should be continued on the day of surgery:

Atenolol

A

True. β-blockers should be continued as patients taking β-blockers who have a perioperative MI are more likely to survive than those who are not.

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9
Q

The following medication should be continued on the day of surgery:

Ramipril

A

False. It is recommended that ACE inhibitors are stopped due to the risk of profound hypotension with anaesthesia.

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10
Q

The following medication should be continued on the day of surgery:

Ticagrelor

A

False. Ticagrelor should be discontinued five days preoperatively due to the risk of haemorrhage.

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11
Q

Which of the following is true or false about the mechanism of action of drugs used in CAD?

β-blockers are selective antagonists of the β-2-adrenoreceptor

A

False. β-blockers all have some effect at both β-1 and β-2-adrenoreceptors.

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12
Q

Which of the following is true or false about the mechanism of action of drugs used in CAD?

Calcium channel blockers affect L type calcium channels

A

True

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13
Q

Which of the following is true or false about the mechanism of action of drugs used in CAD?

Ticagrelor metabolism is not affected by CYP enzyme inhibition

A

False. Metabolised via CYP3A, and consequently should not be used with strong CYP3A inhibitors or inducers: clarithromycin, diltiazem, verapamil and grapefruit juice.

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14
Q

Which of the following is true or false about the mechanism of action of drugs used in CAD?

Nitrates act via direct arterial vasodilation

A

False. Nitrates function by vasodilation of veins via the production of nitric oxide.

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15
Q

Which of the following is true or false about the mechanism of action of drugs used in CAD?

ACE inhibitors and angiotensin receptor blockers both increase levels of bradykinin

A

False. Only ACE inhibitors increase the levels of bradykinin.

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16
Q

The following are side effects related to drug therapy in CAD:

Bisoprolol frequently causes headache

A

False. Some β-blockers such as propranolol may be used for migrane prophylaxis.

17
Q

The following are side effects related to drug therapy in CAD:

Amlodipine is known to cause bradycardia

A

False. As a dihydropyridine CCB amlodipine does not cause bradycardia.

18
Q

The following are side effects related to drug therapy in CAD:

Verapamil is known to precipitate heart failure

A

True. Verapamil has negative inotropic effects.

19
Q

The following are side effects related to drug therapy in CAD:

Prolongation of neuromuscular blockade occurs with calcium channel blockers

A

True. This is a known side effect.

20
Q

The following are side effects related to drug therapy in CAD:

Ondansetron is the first line antiemetic in a patient taking ranolazine

A

False. Ranolazine prolongs the QT interval and other drugs known to prolong the QT interval should be used with caution.

E-lfh FRCA Primary: Pharmacology - Cardiovascular (7 decks)

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