Pharmacology Flashcards
What is the first line treatment for heart failure and name a side effect of that drug.
ACE inhibitors.
Angioedema is a relatively common side effect to look out for.
Beta blockers, need to start at a low dose as hypotension often occurs at the start of treatment.
What is spironolactone used for?
Long term management of heart failure as a potassium sparing diuretic and for refractory oedema (oedema that is not improved with other drugs)
When would you give a frusemide injection?
In the treatment of acute pulmonary oedema. It is a powerful, high ceiling loop diuretic which also produces a transient venodilation.
What is a high ceiling effect?
If the initial dose is insufficient, increasing doses are likely to have increasing effect.
What is an inotrope?
An agent that alters the force or energy of muscular contractions.
Negative inotropic agents weaken the force of muscular contractions.
Positive agents increase strength of muscular contraction.
What treatment would you give a patient presenting with acute pulmonary oedema?
IV frusemide
IV morphine
Nitrate
72yo man has an acute exacerbation of HF. What is a non-drug therapy which will have an immediate benefit?
Oxygen given at the lowest flow rate that provides adequate Hb sat. Uncontrolled high flow rate may cause hypercapnoea if the patient has COPD.
The use of which drug can exacerbate HF via sodium and fluid retention?
NSAIDs
How does an anticholinergic agent like ipratropium bromide produce bronchodilation?
Blocks vagal tone and reflexes. There are muscarinic receptors on bronchial muscle which are stimulated by acetylcholine and produce bronchoconstriction. The vagus nerve innervates BSM. Activation of vagus releases acetylcholine which activates muscarinic receptors. Block these, produce bronchodilation.
How do you determine the dose of warfarin for a px to take?
INR
What else should you prescribe when initially starting a px on warfarin?
Low molecular weight heparin as warfarin doesn’t act straight away and you don’t want the px to get a DVT.
What 5 drugs cause the biggest trouble at the Northern?
Opioids Anticoagulants Antibiotics Paracetamol Insulins
What are the 5 rights of medication safety?
Right patient Right drug Right dose Right route Right time
Name 6 high risk medications
Anti infectives Potassium and other electrolytes Insulin Narcotics and Neuromuscular blocking agents Chemotherapeutic agents Heparin and other anticoagulants APINCH
