Pharmacology Flashcards
What is Ramipril?
- Anti-hypertensive
- Limits angiotensin-II mediated LV remodelling in CF
What is Furosemide?
- Potent diuretic
- Indicated with CF fluid overload
What is Digoxin?
- Positive inotrope
- Indicated for systolic CF
Why are K levels important to monitor/manage in cardio patients?
- Determine cells membrane potential + electrical excitability (via Na/K ATPase)
- Hyper/po kalaemia = serious impact on normal cardiac rhythm by disruption of phase 3
What is the MOA of Ramipril?
ACE inhibitor - prevents angiotensin II generation
What is the ADR of Ramipril?
Hyperkalaemia
- blocks ang-II/aldosterone-mediated Na re-uptake from urine in CT
- Na re-uptake normally drives K+ secretion into urine
What is the MOA of Furosemide?
Blocks Na/K/Cl symporter in ascending LOH
What is the ADR of Furosemide?
Hypokalaemia
- Traps Na+ in urine = drives K+ secretion into urine
What is the MOA of Digoxin?
Blocks Na/K/ATPase which increases [Ca] in cardiomyocytes = + inotropy
What is the ADR of Digoxin?
Hyperkalaemia
Competes with K+ so prevents it entering into cells = increases serum K
What is the normal serum K?
3.7 - 5.2
What is seen on the ECG for Hyperkalaemia?
- Peaked T waves
- Prolonged QRS
- Eventual loss of P waves
- Bradycardia
- Asystole
Increasied serum K = depressed electrical excitability
How is Hyperkalaemia treated?
Ca glutamate Insulin Glucose Salbutamol Resonium
What is seen on the ECG for Hypokalaemia?
- Large P waves
- T wave flattering/inversion
- ST depression
- U waves
- Prolonged PR interval
- Predisposition to re-entrant arrhythmias
Reduced serum K = hyper electrical excitability
How is Hypokalaemia treated?
Oral or IV K
