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Cardiovascular System > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What are the common anti hypertensives?

A

Thiazide diuretics, Beta Blockers, Vasodilators (Calcium Antagonists, Alpha blockers, ACEI, ARB

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2
Q

What are the common anti anginal drugs?

A

Beta blockers, calcium antagonists, nitrates, nicorandil

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3
Q

What are the common anti thrombotic drugs?

A

Antiplatelets (aspirin, clopidogrel), anticoagulants (warfarin) and fibrinolytics (streptokinase and tPA)

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4
Q

What are the common anti cholesterol drugs?

A

Statins and fibrates

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5
Q

What is the common anti arrhythmic drug?

A

Digoxin

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6
Q

When is furosemide used?

A

Heart failure (strong diuretic)

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7
Q

What do diuretics do?

A

Block sodium reabsorption in kidneys

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8
Q

When is bendrofluazide used?

A

Hypertension (mild diuretic)

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9
Q

What are the side effects of diuretics?

A

Hypokalaemia (tiredness, arrhhythmias)
Hyperglycaemia (diabetes)
Increased uric acid (gout)
Impotence

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10
Q

What do beta blockers do?

A

Block beta adrenoceptors

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11
Q

What are the two types of beta blockers?

A

Cardioselective (only block beta one adrenoceptors) and non selective beta blockers (block both types of beta adrenoceptors)

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12
Q

When are cardioselective beta blockers used (e.g. atenolol)?

A

Angina, hypertension and heart failure

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13
Q

When are non selective beta blockers used (e.g. propanolol)?

A

Thyrotoxicosis

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14
Q

What are the side effects of beta blockers?

A

Tiredness cold peripheries and heart failure ( worsens heart failure in the short term)

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15
Q

In what type of patient should you NEVER use a beta blocker?

A

Asthmatic

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16
Q

What are the two types of calcium antagonists?

A

Dihydropyridines and rate limiting calcium antagonists

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17
Q

When are dihydropyridines (e.g. amlodipine) used?

A

Hypertension and angina

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18
Q

What is a side effect of dihydropyridines?

A

Ankle oedema

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19
Q

When are rate limiting calcium antagonists used (e.g. verapamil and diltiazem)?

A

Hypertension and angina plus superventricular arrhythmias CAUTION IF GIVEN WITH BETA BLOCKERS

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20
Q

What do alpha blockers do?

A

Block alpha adrenoceptors to cause vasodilation

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21
Q

When are alpha blockers used (e.g. doxazosin)?

A

Hypertension and prostatic hypertrophy

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22
Q

What are the side effects of alpha blockers?

A

Postural hypertension

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23
Q

What do ACEIs do?

A

Prevent angiotensin I from converting to angiotensin II by inhibiting the angiotensin converting enzyme

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24
Q

When are ACEIs used (e.g. lisinopril)?

A

Hypertension and heart failure

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25
When are ACEIs good for kidneys?
In diabetic nephropathy
26
When are ACEIs bad for the kidneys?
In renal artery stenosis
27
What are the side effects of ACEIs?
Cough, renal dysfunction and angioneurotic oedema
28
When should you NEVER use ACEIs?
In pregnancy
29
What do ARBs do?
Block angiotensin II receptors
30
When are ARBs used (e.g. losartan)?
Hypertension and heart failure
31
When are ARBs good for kidneys?
Diabetic nephropathy
32
When are ARBs bad for the kidneys?
Renal artery stenosis
33
What are the side effects of ARBs?
Renal dysfunction
34
When should ARBs NEVER be used?
In pregnancy
35
What do nitrates do?
Cause venodilation
36
When are nitrates used (e.g isosorbide monoritrate)?
Angina and acute heart failure
37
What are the side effects of nitrates?
Headaches, hypotension/collapse
38
When are antiplatelet agents used?
Angina, acute MI, CVA/TIA and for patients at high risk of MI and CVA
39
What are the side effects of antiplatelet agents?
Haemorrhage anywhere, peptic ulcer -> haemorrhage and aspirin sensitivity -> asthma
40
How is heparin administered?
IV only
41
How is warfarin administered?
Orally only
42
Which clotting factors does warfarin block?
2, 7, 9 and 10
43
When are anticoagulants used?
DVT, PE, NSTEMI and atrial fibrillation
44
What is warfarin reversed by?
Vitamin K
45
Which clotting factor does Rivarooxaban inhibit?
Factor X
46
What do fibrinolytic drugs do?
Dissolve formed clots
47
When are fibrinolytic drugs used (e.g. Streptokinase tissue plasminogen activaor (tPA))?
STEMI, PE (selected cases) and CVA (selected cases only)
48
What are the side effects of fibrinolytic drugs?
SERIOUS RISK OF HAEMORRHAGE
49
When should you avoid using fibrinolytic drugs?
Recent haemmorhage, trauma, patients with bleeding tendencies, severe diabetic retinopathy and peptic ulcers
50
What do statins do?
Block HMG CoA reductase
51
When are statins used?
Hypercholesterolaemia, diabetes, angina/MI, CVA/TIA and patients with high risk of MI and CVA
52
What are the side effects of statins?
Myopathy, Rhabdomyolysis renal failure
53
When are fibrates used (e.g. bezafibrate)?
Hypertriglyceridaemia and low HDl cholesterol
54
What is haemostasis?
Arrest of blood loss from a damaged blood vessel. Involves: - local vasoconstriction - adhesion and activation of platelets at site of injury - formation of fibrin
55
What is thrombosis?
Pathological haemostasis - haemotological plug in the absence of bleeding
56
What is an arterial thrombus?
White thrombus - mainly platelets in a fibrin mesh | Forms an embolus if it detaches from its site of origin
57
What is a venous thrombus?
Red thrombus - white head, jeely-like read tail, fibrin rich If it detaches forms an embolus that usually lodges in the lung
58
What are the serine proteases?
Factors IIa(thrombin), VIIa, IXa and Xa
59
What is the process that activates the clotting factors?
gamma - carboxylation of glutamate residues
60
What is an essential cofactor of the carboxylase enzyme that mediates gamma-carboxylation?
Vitamin K - in its reduced form
61
How does warfarin work?
Blocks vitamin K reductase so vitamin K cannot be reduced - carboxylase enzyme cannot function without it - clotting factors not activated (II, VII, IX and X)
62
What is warfarin's onset of action?
Slow (2-3 days) whilst the inactive factors replace active factors that are slowly cleared from the plasma
63
What is the major warfarin warning?
Can be difficult to strike the balance between the desired anticoagulant effect and haemorrhage - low TI
64
How is the effect of warfarin monitored?
Internalised normalised ratio
65
What is the mnemonic for pharmacological treatment for an acute MI?
``` MONA + C M - Morphine (plus anti-emetic) Oxygen Nitroglycerin (SL GTN x 3 for ischaemic pain) Aspirin 300mg and clopidogrel 600mg ```

Cardiovascular System (11 decks)

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