Medications for valve disease

Question 1

What are the indications for Beta blockers?

Answer 1

Ischaemic heart disease
Chronic heart failure, 
Atrial fibrillation
Supraventricular tachycardia
Hypertension

Question 2

What are the contraindications for beta blockers

Answer 2

Asthma (bronchospasm) or obstructive airway disease
Peripheral lund disease
Heart failure
reynauds
Low BP/slow HR

Question 3

How do Beta blockers work?

Answer 3

B1 adnrenoreceptor is in heart and kidneys
B2 adrenoreceptor is in lungs and skeletal muscle arteries

Pacemaker cells in heart have B1 receptors. If stimulated, HR and contractility increases, increasing BP

Question 4

What are the side effects of beta blockers

Answer 4

Bradycardia (tired/dizzy)
Cold extremities,
hypotension,
bronchoconstriction

Question 5

Name some types of beta blockers

Answer 5

Bisoprolol
Atenolol/tenormin
Propanolol (non-selective)

Question 6

What are the indications for calcium channel blockers

Answer 6

Hypertension (IHD)
stable angina
Supraventricular arrythmias (SVT, AF, atrial flutter)
Reynauds

Question 7

What are the contraindications for calcium channel blockers?

Answer 7

Poor left ventricular function
AV nodal conduction delay
Unstable angina
Severe aortic stenosis

Question 8

How do calcium channel blockers work?

Answer 8

They block T and L type calcium channel blockers.

L type calcium channels found on smooth muscle cells, calcium causes muscle to contact, narrowing vessels, Also causes cardiomyocytes to contract harder.

T type channels stimulate pacemaker cells.

Question 9

What are the side effects for calcium channel blockers?

Answer 9

PEripheral oedema, flushing, headache, dizzziness from hypotension

Question 10

What are nitrates indications?

Answer 10

Acute angina/chest pain fopr ACS, prophylaxis of angina, IV use for pulmonary oedema

Question 11

What are contraindications for nitrates>

Answer 11

Severe aortic stenosis, hypotension, anaemia, glaucoma

Question 12

How do nitrates work?

Answer 12

Nitrates form nitric oxide, which increase synthesis of cGMP, reduces calcium entering channels and binding to calmooduin, causing smooth muscle cell relaxation, and so vasodilation. This reduces venous pooling, and thus preload, reducing myocardial o2 demand

Question 13

What are the side effects of nitrates?

Answer 13

Flushing, headaches, tolerance, reflex tachycardia

Question 14

Name some nitrates

Answer 14

Glyceryl trinitrate

Isosorbide trinitrate

Question 15

Name come calcium channel blockers

Answer 15

Dihydropyridine (amlodipine, felodipine)

Non-dihydropyridine (diltiazem, verapamil)