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MD3001 > PHARMACOLOGY > Flashcards

PHARMACOLOGY Flashcards

1
Q

What shrinks the window for coronary flow?

A
  • shortening diastole
  • increased ventricular end-diastolic pressure
  • reduced diastolic arterial pressure
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2
Q

Define angina.

A

chest pain due to inadequate supply of oxygen to the heart

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3
Q

What 3 factors can bring on angina?

A
  • exercise
  • cold
  • excitement
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4
Q

What are the two classes of ischaemia causing angina, and what types of angina do they each include?

A

DEMAND ISCHAEMIA
chronic stable angina

SUPPLY ISCHAEMIA
unstable angina
Printzmetal (variant) angina

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5
Q

What are the causes for each of the 3 types of angina?

A

STABLE ANGINA
fixed narrowing of the coronary arteries

UNSTABLE ANGINA
thrombus around a ruptured atheromatous plaque without complete occlusion of vessel

VARIANT ANGINA
coronary artery spasm

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6
Q

What are the two main actions of beta blockers on the heart?

A
  • slowing the heart

- anti-dysrhythmic

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7
Q

What are the 3 clinical uses of calcium-channel antagonists?

A
  • treatment of pain in angina
  • antidysrhythmic
  • treatment of hypertension
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8
Q

What are the main side-effects of calcium-channel antagonists?

A
  • headache
  • constipation
  • ankle oedema
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9
Q

What are the types of angina targeted by organic nitrates?

A
  • stable angina

- unstable angina

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10
Q

What are organic nitrates used for other than management and prophylaxis of angina?

A
  • acute heart failure

- chronic heart failure

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11
Q

Explain the mechanism of action of nicorandil.

A

activates potassium-ATP channels –> hyperpolarisation of vascular smooth muscle
+ nitrovasodilator actions

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12
Q

Give the name of two inhibitors of F-type Na+ channels used as anti-anginals.

A
  • ivabradine

- ranolazine

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13
Q

Give 6 factors affecting drug distribution.

A
  • cardiac output and blood flow
  • plasma protein binding
  • lipid solubility
  • degree of ionization
  • pH of compartments
  • capillary permeability
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14
Q

What would cause hypoalbuminemia? What would be the consequences on free drug levels?

A
  • burns
  • renal disease
  • malnutrition
  • hepatic disease

increase in free drug level

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15
Q

What three factors affect capillary diffusion?

A
  • surface area
  • time
  • nature of capillary (continuous, fenestrated, discontinuous
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16
Q

Name 4 types of specialized barriers to drug distribution.

A
  • blood brain barrier
  • chronic abscesses
  • lung infection
  • placenta
17
Q

What types of drugs would you respectively find in extracellular fluid? plasma? total body water?

A

ECF
large water-soluble molecules

PLASMA

  • highly plasma-bound molecules
  • highly charged molecules
  • very large molecules

TOTAL BODY WATER
small water-soluble molecules

18
Q

How would you calculate the steady state plasma concentration?

A

rate of drug administered/clearance

19
Q

How would you calculate the apparent volume of distribution of a drug?

A

total amount of drug in body / blood plasma concentration of drug

20
Q

What are the two assumptions of the single compartment model of distribution?

A
  • rapid mixing of drug in plasma

- drug in plasma in rapid equilibrium with drug in extravascular tissues

21
Q

What are the factors that influence the volume of distribution of a drug?

A
  • height
  • weight
  • age
  • fluid accumulation
  • accumulation of fat
22
Q

What are the three goals of hypertension treatment?

A
  • reduce arterial BP to recommended targets
  • reduce the risk of end-organ damage
  • reduce the risk of mortality due to CV disease
23
Q

When are anti-hypertensive drugs indicated in people wit stage 1 hypertension?

A

one of:

  • target organ damage
  • established cardiovascular disease
  • renal disease
  • diabetes
  • CV risk of 20% or greater
24
Q

What is the BP treatment target for over 80yrs olds?

A

< 150/90mmHg

25
Q

Name 3 ACE inhibitors and 3 ARBs used in treatment of hypertension.

A

ACE INHIBITORS

  • ramipril
  • lisinopril
  • captopril

ARBs

  • amlodipine
  • felodipine
  • lercanidipine
26
Q

What is the aim of treatment of heart failure?

A
  • relieve symptoms
  • improve exercise tolerance
  • reduce incidence of acute exacerbations
  • reduce mortality rates
27
Q

What are the 5 device therapies available for heart failure?

A
  • pacing
  • cardiac resynchronisation therapy
  • implantable cardiac defibrillator
  • coronary revascularisation
  • heart transplant
28
Q

What is step 1 of treatment of chronic heart failure?

A

diuretics if fluid overload + ACE inhibitors or ARBs + beta-blocker

29
Q

What are Digoxin side-effects?

A

GI upset, dizziness, conduction abnormalities, blurred or yellow vision

MD3001 (9 decks)

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