Pharmacology Flashcards
Adrenaline activates B2 adrenoceptors in the heart to cause increased heart rate. True/False?
False
Acts on B1 adrenoceptors
Which muscarinic receptor does ACh act on in the heart to cause decreased heart rate?
M2 receptors
Which channels, when blocked, decrease the slope of the SA node action potential?
HCN channels
Name a drug that is a selective blocker of HCN channels and for what heart condition it is mainly used
Ivabradine
Used for angina
Sympathetic stimulation causes a decrease in the duration of systole. True/False?
True
Name a B1 agonist drug used sometimes in heart failure
Dobutamine
Propranolol is a selective B2 receptor antagonist. True/False?
False
It is non-selective
Name a selective B1 antagonist drug
Atenolol
Metoprolol
Give some adverse effects of B-blockers
Aggravate asthma
Aggravate heart failure
Cold extremities
Bradycardia
Fatigue
What are the dangers of digoxin?
It has a low therapeutic ratio and is thus toxic, especially in hypokalaemia
Can cause heart block
What is an indirect effect of digoxin?
Slows AV node conduction to increase refractory period
Name 2 examples of organic nitrates used clinically
GTN tablet/spray
Isosorbide mononitrate
Why is it important to have nitrate-low periods?
Repeated use can develop tolerance and reduce efficacy
Name a renin inhibitor
Aliskiren
Renin inhibitors (aliskiren) can be used in conjunction with an ARB or ACEi. True/False?
False
What are the effects of ACE?
Converts AT I to AT II
Inactivates bradykinin
Name an ACEi used in Tayside
Lisinopril
Name an ARB used in Tayside
Losartan
What are the main differences between ACEi and ARBs?
ARBs do not inhibit bradykinin and do not produce dry cough
What is the main/overall action of diuretics?
Increase Na, Cl and water excretion
Indirectly relax vasculature
What is the undesirable effect of diuretics?
Loss of K+
Name a thiazide diuretic and conditions it is used in
Bendroflumethazide
Mild heart failure, hypertension
Name a loop diuretic and conditions it is used in
Furosemide
Chronic heart failure, acute pulmonary oedema
What are some side effects of diuretics?
Hypokalaemia
Arrhythmias
Gout
Impotence
Name conditions in which amlodipine can be used
Hypertension
Angina
ACEi and ARBs are safe in pregnancy. True/False?
False
NEVER use in pregnancy
Name conditions in which nitrates can be used
Angina
Acute heart failure
Name some antiplatelet agents
Aspirin
Clopidogrel
Name some anticoagulants
Heparin (IV)
Warfarin (oral)
What do fibrinolytics simply do?
Dissolve formed clots
Name a commonly used fibrinolytic
Streptokinase
CV disease is associated with low LDL and HDL. True/False?
False
High LDL and/or low HDL causes CV disease
The bigger the HDL:LDL ratio, the better (in terms of health). True/False?
True
Why is LDL “bad” cholesterol?
Increased LDL is involved in the pathogenesis of atherosclerosis
Why is HDL “good” cholesterol?
HDL accepts excess cholesterol from the plasma membrane of cells (e.g. macrophages) and delivers cholesterol to the liver - reverse cholesterol transport
What are the drugs of choice for reducing LDL (and moderately increasing HDL)? Give examples
Statins - simvastatin, atorvastatin
When and how are statins administered?
Orally at night
What are the 3 components of Virchow’s triad? What do they predispose to?
Abnormal blood flow
Vessel wall injury
Increased coagulability of blood
These predispose to thrombosis
An arterial thrombus is a white thrombus. True/False?
True
What colour is a venous thrombus?
Red
Where do white thrombi commonly lodge?
Brain (detached embolus from left heart)
Where do red thrombi commonly lodge?
Lung (detached embolus from right heart)
How is warfarin administered? How fast is its onset of action?
Oral
2-3 days
What is the main risk with anticoagulant drugs?
Risk of haemmorhage
How might a warfarin overdose be treated?
Vitamin K/clotting factor infusion
Give examples of LMWHs
Enoxaparin
Dalteparin
How is heparin administered?
Intravenously or subcutaenously
How is LMWH administered?
Subcutaneously
Name an oral active inhibitor of Xa
Rivaroxaban
How is aspirin administered?
Oral
How is clopidogrel administered?
Oral
Give examples of fibrinolytic drugs
Streptokinase
Aleplase
Duteplase
How are fibrinolytic drugs administered?
Intravenously
What is the healthy level for Total Cholesterol?
5 or below
What is the healthy level for HDL?
1 or above
What is the healthy level for LDL?
4 or below
What are triglycerides?
Fatty substance similar to LDL
What is the healthy level of Fasting triglycerides? (when you’re asked not to eat for several hours before the test)
1.7 or below
What is the healthy level of non-Fasting triglycerides?
2.3 or below
What is the healthy level of Total cholesterol to HDL cholesterol ratio?
6 or below
