Pharmacological Treatment of Cardiovascular Conditions Flashcards
If controlling the rate in regular narrow complex tachycardia fails with IV adenosine, which drug class should be utilised?
Beta blockers
When would digoxin be considered first line for atrial fibrillation RATE control?
When atrial fibrillation is coexistent with heart failure
Lignocaine belongs to which class of antiarrhythmic drugs?
Class Ib
What is the third line treatment for hypertension?
ACE inhibitor + calcium channel blocker + thiazide diuretic
What are the treatments for Wolff-Parkinson-White syndrome?
Sotalol
or
Amiodarone
or
Flecainide
Diltiazem blocks which type of ion channel and whereis it located?
L-type calcium channel
Heart and vasculature
Digoxin blocks which membrane protein?
Na+/K+ ATPase
How does warfarin function?
Blocks gamma carboxylation of factors II, VII, IX and X
According to STEMI and NSTEMI guidlines, what treatment should all patients get regardless of the type of MI?
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Clopidogrel
MONA + C
When a patient has an irregular broad complex tachycardia which treatment is best?
IV magnesium sulphate
Which treatments may be considered if a patient’s chronic heart failure is poorly managed by second line treatments?
Digoxin
Potentially ivabradine if the symptoms are still severe
Name a class IC antiarrhythmic drug
Flecainide
When a patient has a regular broad complex tachycardia, which treatment should considered?
Amiodarone
When is digoxin strongly indicated for heart failure?
When heart failure coexists with atrial fibrillation
In atrial fibrillation which drug should be given to prevent clotting?
Warfarin
Name a thiazide diuretic
Bendroflumethiazide
or
Indapamide
If a person has Wolff-Parkinson-White syndrome they can be treated with sotalol, but not when they have which co-existant condition?
Atrial fibrillation
Which loop diuretic may be used to treat fluid build-up from various causes?
Furosemide
What is the acute treatment for a supra-ventricular tachycardia in a patient with asthma?
Verapamil
When morphine is administered which anti-emetic is also given?
Metoclopramide
When treating the RHYTHM in atrial fibrillation which drugs may be used?
- Amiodarone
- Flecainide
When a patient who has both diabetes and hypertension, what is the first line treatment if they are from African or Caribbean origin?
ACE inhibitor and Calcium channel blocker
Which of the following drugs is an organic nitrate?
- Isosorbide mononitrate
- Digoxin
- Milrinone
Isosorbide mononitrate
Which type of drug class does nicorandil belong?
Potassium channel agonist
In poorly controlled hypertension, after third line treatment, what are the remaining options and indications for when each may be used?
- Spironolactone (aldosterone antagonist) - when K+ <= 4.5mmol/l
- Increased thiazide diuretic dose - when K+ >= 4.5mmol/l
- Alpha or beta blocker - when diuretics are not tolerated or ineffective
Name a renin inhibitor
Aliskiren
Ivabradine is an antagonist of which channel?
HCN
(for funny current)
What is the long term treatment for supra-ventricular tachycardia?
Beta blocker
What is the first line treatment for a caucasian patient > 55 years old with hypertension?
Calcium channel blocker
What is rivaroxiban?
Factor Xa inhibitor
What is the second line treatment for anyone suffering from hypertension?
ACE inhibitor + calcium channel blocker
What is the treatment for bradycardia when there is a chance of asystole?
Atropine
or
Adrenaline
If a patient has Torsades de Pointes and suffers from polymorphic VT, what is the treatment?
Magnesium sulphate IV
Class IA, IB and IC antiarrhythmic drugs are all ________ channel blockers
Sodium
What is the first line treatment for a patient of African or Caribbean origin suffering from hypertension
Calcium channel blocker
When a patient has an irregular narrow complex tachycardia what is the required treatment?
Beta blocker
or
Digoxin
(plus anticoagulant for both)
Which class of drug is digoxin?
Cardiac glyoside
When treating the RATE in atrial fibrillation which drug classes are used?
Beta blocker
Calcium channel blocker
When a patient has a regular narrow complex tachycardia, what is the treatment?
Adenosine IV
Name a class 1a antiarrhythmic drug
Disopyramide
Amiodarone is an agonist of which channel?
Potassium channels
Which class of drug does atropine belong?
Non-selective muscarinic antagonist
Name an alpha I receptor antagonist
- Prazosin
- Doxazosin
Which drug is both a calcium sensitiser and potassium channel agonist?
Levosimenden
What is the second line treatment for a patient with chronic heart failure?
Aldosterone antagonist
or
Angiontensin II receptor blocker
or
Hydralazine + nitrate
Amlodipine blocks which type of ion channel and where is it located?
L-type calcium channel
Vasculature
GTN is used to treat which condition primarily?
Stable angina
Which rate-limiting drug is not used in VT?
Verapamil
Statins work by blocking which enzyme from functioning?
HMG-CoA reductase
Which of the following drugs is a ACE inhibitor?
- Losartan
- Lisinopril
- Bosentan
Lisinopril
What is the difference between heparin and low molecular weight heparin?
Heparin - factor Xa inhibitor via antithrombin III
Low molecular weight heparin - factor Xa inhibitor
What is the mode of action for aspirin?
Blocks COX-1 in platelets
Verapamil blocks which type of ion channel and where is it located?
L-type calcium channel
Heart
What is the first line treatment for a patient with chronic heart failure?
ACE inhibitor and a beta blocker
What is the first line treatment for a caucasian person < 55 years old with hypertension?
ACE inhibitor
Which class of drug is glycopyrronium bromide?
Non-selective muscarinic antagonist
Assuming a patient is being treated with an ACE inhibitor for hypertension, yet they are struggling to cope with a dry cough, what could their medication be changed to?
Angiotensin II receptor blocker
What is the acute treatment for a supra-ventricular tachycardia?
Adenosine IV
What are the drugs which can treat VT?
- Amiodarone
- Lidocaine
- Procainamide
Streptokinase is a drug utilised for which medical procedure?
Thrombolysis
Which drug is a direct thrombin inhibitor?
Dabigatran
Name a class 3 antiarrhythmic drug
Amiodarone