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Cardio > pharmacology > Flashcards

pharmacology Flashcards

1
Q

sympathetic stimulation on cardiac rate and force

A

through Gs, B1-adrenoceptors > increase SA node action potential frequency ad heart rate
- cardiac muscle hypertrophy

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2
Q

parasympathetic stimulation

A

acetylcholine activate M2 cholinoceptors in nodal cells
Gi protein
may cause arrhythmias

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3
Q

valsalva manoeuvre

A

activates aortic baroreceptors

used in supraventricular tachycardia or aortic stenosis

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4
Q

massage of bifurcation of carotid artery

A

stimulates baroreceptors in the carotid sinus

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5
Q

pacemaker potential

A

modulated by the funny current

  • hyperpolarization
  • cAMP
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6
Q

block of HCN channels

A

decreases the slope of the pacemaker potential and reduces heart rate

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7
Q

Ivabradine

A

selective blocker of HCN (funny) channels
used to slow heart rate in angina
does not work in AF
acts on SA node

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8
Q

b-adrenoceptor agonists

A

dobutamine, adrenaline and noradrenaline

increase force, rate and cardiac output and O2 consumption

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9
Q

b-adrenoceptor antagonists

A 
non-selective (b1 or b2) or cardioselective (b1)
propranolol- non-selective
atenolol, bisoprolol, metoprolol- selective 
- arrhythmias
- angina 
- HF
- Hypertension
side effects: asthma, fatigue, HF
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10
Q

non-selective muscarinic ACh antagonist - on the heart

A

atropine- increase HR, no change in BP, used in severe bradycardia
digoxin- HF

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11
Q

Organic nitrates in angina

A

GTN or ISMN

side effects: headaches, hypotension

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12
Q

Calcium channel blockers

A

block the opening of L-type channels > limiting calcium concentration
reduce conduction through AV node
reduce force of contraction
selective for smooth muscle preferred for hypertension

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13
Q

ACE inhibitors

A

Blocks angiotensin I becoming angiotension II
used in hypertension and heartfailure
lisinopril
good for kidneys in diabetes
bad for kidneys in renal artery stenosis
side effects: cough, angioneurotic oedema

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14
Q

two types of CCB

A

Dihydroperidines- amlodipine

rate limiting calcium antagonists- verapamil, diltiazem

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15
Q

ARBs

A 
angiotensin II receptor blockers
eg losartan 
used in hypertension and heart failure 
good for kidneys 
no cough
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16
Q

Angiotensin II hormone

A

constricts blood vessels = increase in BP

stimulates salt and water retension in the body = increase BP

17
Q

Alpha blockers

A

block alpha adrenoceptors to cause vasodilatation
used in hypertension and prostatic hypertrophy
eg doxazosin
side effect: postural hypotension

18
Q

Mineralocotoid antagonist

A

block aldosterone receptor
used in heart failure and resistant hypertension
eg spironolactone
side effects: hyperkalaemia, renal impairment

19
Q

anti anginal vasodilators

A

Nitrates (isosorbide), nicorandil (K ATP channel opener), calcium antagonists (amlodipine)

20
Q

anti anginal slow heart rate drug

A 
beta blockers
calcium antagonists (diltiazem, verapamil), Ivabradine
21
Q

anti anginal drugs- metabolic modulator

A

ranolazine

22
Q

What is the role of calcium in a normal cardiac action potential

A

slow influx causes a plateau in the myocardial action potential- prolongs contraction of cardiac myocytes

23
Q

prolong QT segment on ECG

A

hypocalcaemia

24
Q

what is the role of rapid influx of sodium ions in normal cardiac action potential

A

depolarisation of the cardiomyocytes

triggered by pacemaker cells within the sinoatrial node

25
Q

what is the role of an efflux of potassium ions in normal cardiac action potential

A

repolarisation of cardiomyocytes
occurs in two steps:
Directly after depolarisation, there is a transient period of repolarisation followed by the plateau
After this plateau, complete repolarisation occurs as more potassium channels are opened

26
Q

ECG changes due to hypokalemia

A

U waves- a deflection immediately following T wave
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT

27
Q

Bifid P waves

A

the p-wave has 2 peaks, found in left atrial enlargement

28
Q

Inverted T-waves

A

found in myocardial ischaemia

29
Q

Delta waves

A

slurred upstrokes of the QRS complex, found in Wolff-Parkinson-White syndrome

30
Q

Pathological q-waves

A

large q-waves, found in current or prior myocardial infarction

Cardio (16 decks)

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