Heart Failure Flashcards
Name 3 ACE inhibitors
Ramipril, Lisinopril, Captopril
What are contrainidications for ACE inhibitors?
Pregnancy, renovascular disease and aortic stenosis.
How do ACE inhibitors work?
Inhibit angiotensin converting enzyme, reducing levels of angiotensin II and aldosterone, causing salt/water loss, vasodilation, lowered peripheral resistance and lowered bradykinin breakdown.
What are some ACE inhibitor ADRs?
Dry cough, angio-oedema, renal failure, hyperkalaemia, hypotension, dizzinedd, headache, diarrhoea, muscle cramps.
Name two angiotensin receptor blockers
Losartan and Volsartan
Name contraindications for angiotensin receptor blockers
Pregnancy, renovascular disease, aortic stenosis.
What are angiotensin receptor blocker ADRs?
Hyperkalaemia and renal failure.
Name 4 beta-blockers
Bisoprolol, atenolol, propranalol, metoprolol
What conditions would you use beta-blockers in?
Angina, after MIs, hypertension and arrhythmia.
What conditions would you use ACE inhibitors in?
Heart failure and hypertension.
Name some ACE inhibitor contraindications
Bradycardia, Congestive Heart Failure, hypotension, AV block
Name a non-selective beta-blocker, and state a clinical disadvantage they have over selective beta blockers?
Propranolol, and it can cause bronchospasm in asthmatics.
How do beta-blockers work?
Antagonise Beta1-adrenoreceptors, decreasing heart inotropy and chronotropy, as well as reducing renin release.
Name ADRs of beta-blockers
Insomnia, dizziness, fatigue, bronchospasm, cold extermities, hypotension, bracycardia, decreased glucose tolerance.
Name two DDIs of beta-blockers
Calcium channel blockers and salbutamol (or other airway beta-blockers).
What do calcium channel blockers do?
Bind to alpha-subunits of L-type calcium channels, causing arterial vasodilation, decreased inotropy and slowed sinoatrial and atrioventricular conduction.
Name the three classes of calcium channel blockers, and which one is most unusual?
Dihydropyridines, Phenylalkylamines, and Benzothiazapines. Dihydropyridines are the most unusual as they predominantly are arterial vasodilators.
Name two dihydropyridiines
Amlodipine and Nifedipine
Name a phenylalkylamine
Verapamil
Name a benzothiazapine
Diltiazem
Name some ADRs of phenylalykamines and benzothiazapines
Constipation, bradycardia and worsening of heart failure.
Name some ADRs of dihydropyridines
Tachycardia, palpitations, flushing, sweating, oedema, throbbing headaches.
Name a direct renin inhibitor
Aliskiren
What are some contraindications of aliskiren?
Pregnancy, hyperkalaemia, hyponatraemia, hypovolaemia, renal failure.
What are some ADRs of aliskiren?
Angio-oedema, hyperkalaemia, hypotension.
What as a DDI of direct renin inhibitors?
Any diuretics, particularly furosemide.
How does digoxin (cardiac glycoside) work?
Binds to Na/K-ATPase channels, inhibiting them, causing increased intracellular sodium, reversing NCX, and increasing intracellular calcium and inotropy.
Name some signs and symptoms of digoxin toxicity
Arrythmia, heart block, visual disturbances, cramps, vomiting, diarrhoea, delirium, confusion and headache.
