Heart Failure

Question 1

Name 3 ACE inhibitors

Answer 1

Ramipril, Lisinopril, Captopril

Question 2

What are contrainidications for ACE inhibitors?

Answer 2

Pregnancy, renovascular disease and aortic stenosis.

Question 3

How do ACE inhibitors work?

Answer 3

Inhibit angiotensin converting enzyme, reducing levels of angiotensin II and aldosterone, causing salt/water loss, vasodilation, lowered peripheral resistance and lowered bradykinin breakdown.

Question 4

What are some ACE inhibitor ADRs?

Answer 4

Dry cough, angio-oedema, renal failure, hyperkalaemia, hypotension, dizzinedd, headache, diarrhoea, muscle cramps.

Question 5

Name two angiotensin receptor blockers

Answer 5

Losartan and Volsartan

Question 6

Name contraindications for angiotensin receptor blockers

Answer 6

Pregnancy, renovascular disease, aortic stenosis.

Question 7

What are angiotensin receptor blocker ADRs?

Answer 7

Hyperkalaemia and renal failure.

Question 8

Name 4 beta-blockers

Answer 8

Bisoprolol, atenolol, propranalol, metoprolol

Question 9

What conditions would you use beta-blockers in?

Answer 9

Angina, after MIs, hypertension and arrhythmia.

Question 10

What conditions would you use ACE inhibitors in?

Answer 10

Heart failure and hypertension.

Question 11

Name some ACE inhibitor contraindications

Answer 11

Bradycardia, Congestive Heart Failure, hypotension, AV block

Question 12

Name a non-selective beta-blocker, and state a clinical disadvantage they have over selective beta blockers?

Answer 12

Propranolol, and it can cause bronchospasm in asthmatics.

Question 13

How do beta-blockers work?

Answer 13

Antagonise Beta1-adrenoreceptors, decreasing heart inotropy and chronotropy, as well as reducing renin release.

Question 14

Name ADRs of beta-blockers

Answer 14

Insomnia, dizziness, fatigue, bronchospasm, cold extermities, hypotension, bracycardia, decreased glucose tolerance.

Question 15

Name two DDIs of beta-blockers

Answer 15

Calcium channel blockers and salbutamol (or other airway beta-blockers).

Question 16

What do calcium channel blockers do?

Answer 16

Bind to alpha-subunits of L-type calcium channels, causing arterial vasodilation, decreased inotropy and slowed sinoatrial and atrioventricular conduction.

Question 17

Name the three classes of calcium channel blockers, and which one is most unusual?

Answer 17

Dihydropyridines, Phenylalkylamines, and Benzothiazapines. Dihydropyridines are the most unusual as they predominantly are arterial vasodilators.

Question 18

Name two dihydropyridiines

Answer 18

Amlodipine and Nifedipine

Question 19

Name a phenylalkylamine

Answer 19

Verapamil

Question 20

Name a benzothiazapine

Answer 20

Diltiazem

Question 21

Name some ADRs of phenylalykamines and benzothiazapines

Answer 21

Constipation, bradycardia and worsening of heart failure.

Question 22

Name some ADRs of dihydropyridines

Answer 22

Tachycardia, palpitations, flushing, sweating, oedema, throbbing headaches.

Question 23

Name a direct renin inhibitor

Answer 23

Aliskiren

Question 24

What are some contraindications of aliskiren?

Answer 24

Pregnancy, hyperkalaemia, hyponatraemia, hypovolaemia, renal failure.

Question 25

What are some ADRs of aliskiren?

Answer 25

Angio-oedema, hyperkalaemia, hypotension.

Question 26

What as a DDI of direct renin inhibitors?

Answer 26

Any diuretics, particularly furosemide.

Question 27

How does digoxin (cardiac glycoside) work?

Answer 27

Binds to Na/K-ATPase channels, inhibiting them, causing increased intracellular sodium, reversing NCX, and increasing intracellular calcium and inotropy.

Question 28

Name some signs and symptoms of digoxin toxicity

Answer 28

Arrythmia, heart block, visual disturbances, cramps, vomiting, diarrhoea, delirium, confusion and headache.