Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

KT > Pharmacology L) Cardio > Flashcards

Pharmacology L) Cardio Flashcards

1
Q

What is acute coronary syndrome?

A

Spectrum of conditions that involve the reduction of blood flow through coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the symptoms of acute coronary syndrome?

A 
Heartburn
Chest pain
Sweaty
Cold / clammy
Nausea and vomiting
Anxiety
Grey pallor
Loss of consciousness
Arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors for ACS?

A 
Hypertension
Hypercholesterolaemia
Family history
Smoking
Male 
Diabetes
Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the GRACE2 score?

A

Predicts the risk of death from an MI after ACS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the treatment aims for ACS?

A

Reduce cardiac ischaemia - revascularisation, thrombolysis, medical management
Reduce myocardial oxygen demand
Prevent recurrent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give examples of drugs used for thrombolysis

A

Alteplase
Reteplase
Streptokinase
Tenecteplase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the contraindications of drug thrombolysis?

A 
Recent bleeding / trauma (1 month)
Bleeding disorders
Haemorrhagic stroke 
Ischaemic stroke / TIA
On warfarin / DOAC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the immediate management for ACS?

A 
Oxygen
Nitrates
Anti-emetics
Antiplatelet bleeding
Fonaparinux / LMWH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What classes of drugs should be given for long-term management and secondary prevention of ACS?

A 
Dual anti platelet therapy - aspirin + clopidogrel / prasugrel / ticagrelor
ACE inhibitors / ARBs
Beta-blockers
Statins
GTN spray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the mechanism of action of aspirin?

A

COX inhibitor

Reduces TXA2 and platelet activation / aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does clopidogrel work?

A

Inhibits ADP binding to PY2 receptor on platelets to prevent activation and aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long should clopidogrel be given for?

A

1 year following NSTEMI
≤1 year following STEMI
BMS 1 month
DES 6-12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the effects of beta blockers?

A

Block sympathomimetic activity by binding to beta receptors
Slow SA node to allow left ventricle to fill completely to lower heart workload
Dilate arteries to lower BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the side effects of beta blockers?

A 
Fatigue
Cold hands / feet
Nightmares / sleep disturbances
Breathing difficulties in asthmatics
Bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give examples of 1st generation (non-selective) beta blockers

A 
Propanolol
Pindolol
Nodalol
Sotalol
Timolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give examples of 2nd generation (selective) beta blockers

A

Atenolol
Acebutolol
Bisoprolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give examples of 3rd generation beta blockers

A

Non selective: carvedilol, labetalol

Selective: nebivolol, betaxolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do ACE inhibitors work?

A

Inhibit production of angiotensin II and inhibit breakdown of vasodilator bradykinin
Prevent cardiac remodelling by reducing preload and after load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the side effects of ACE inhibitors?

A

Postural hypotension
Loss of taste / appetite
Persistent dry cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do statins work?

A

HMG CoA reductase inhibitor to reduce production of cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the target cholesterol levels when on statins?

A 
Total cholesterol ≤5
Non-HDL cholesterol ≤4
LDL cholesterol ≤3
HDL cholesterol ≥1
Triglycerides ≤2.3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the side effects of statins?

A

Muscle pain
Headache
Nausea and vomiting
Abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are nitrates used for?

A 
Relieve or prevent expected chest pain (GTN)
Prevent regular chest pain
Stable angina
Heart failure
Acute coronary syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the function of nitrates in stable angina?

A

Dilate veins and collaterals leading to decreased O2 consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the side effects of nitrates?

A

Flushing
Headache
Dizziness
Postural hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What drugs interact with nitrates?

A

Sildenafil
Vardenafil
Tadalafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the side effects of nicorandil?

A

Dizziness
Headaches
Nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does nicorandil work?

A

Dilates epicardial coronary arteries and coronary microvessels to increase coronary flow
Venodilatation and dilates peripheral arterioles to decrease myocardial O2 requirement

29
Q

What is atrial fibrillation?

A

Rapid atrial rate >300-60 beats per minute followed by a rapid and irregular ventricular beat
AV node restricts conduction so ventricular rate <200bpm

30
Q

What are the symptoms of atrial fibrillation?

A 
Palpitations
Chest pain
Fatigue
Dizziness
Dyspnoea
Syncope
Low exercise tolerance
31
Q

What is persistent AF?

A

Lasts >48 hours after onset but can be cardioverted back to sinus rhythm using electrical or pharmacological cardioversion

32
Q

What is paroxysmal AF?

A

Intermittent, self terminating or recurrent arrhythmia combined with normal sinus rhythm

33
Q

What is permanent AF?

A

Chronic condition present for >48 hours where cardioversion is ineffective or unsuitable

34
Q

What drug therapy should be given in AF?

A

Anticoagulation
Rate control strategy
Rhythm control strategy
Pill in the pocket

35
Q

What drugs can be used for rate control in AF?

A

Beta blocker
Rate-lowering calcium antagonist
Digoxin

36
Q

How can rhythm control be done?

A

Electrically by cardioversion

Chemically using drugs

37
Q

Give examples of pill in the pocket drugs for AF

A

Flecainide

Propafenone

38
Q

Give examples of DOACs

A

Dabigatran
Rivaroxaban
Apixaban
Edoxaban

39
Q

What monitoring should be done when using DOACs?

A

On initiation: renal function, weight, liver screen and clotting screen
Renal function checked annually

40
Q

When can’t DOACs be used?

A

For mechanical valves

41
Q

What is warfarin?

A

Vitamin K antagonist

42
Q

What is digoxin used for?

A

Rhythm control in AF

Only effective for controlling ventricular rate at rest so should only be used as monotherapy if patient is sedentary

43
Q

What are some signs of digoxin toxicity?

A 
Lethargy
Confusion
Vomiting
Loss of appetite
Diarrhoea
Visual changes
44
Q

What are the side effects of amiodarone?

A

Cardiac arrhythmias
Skin sensitivity to sun
Corneal deposits
Thyroid precipitates hypo/hyperthyroidism

45
Q

Give examples of dihydropyridine

A

Amlodipine
Felodipine
Nicardipine
Nifedipine

46
Q

Give examples of non-dihydropyridines

A

Diltiazem

Verapamil

47
Q

How do calcium channel antagonists work?

A

Inhibit calcium ions from entering slow or voltage gated channels in vascular smooth muscle and myocardium

48
Q

What are the side effects of calcium channel antagonists?

A 
Constipation
Facial flushing
Headaches
Ankle swelling
Fatigue
Dizziness
49
Q

What are the points in the CHA2DS2VASc score?

A 
Congestive Hf +1
Hypertension +1
Age ≥75 +2
Diabetes mellitus +1
Previous stroke, TIA or thromboembolism +2
Vascular disease +1
Age 65-74 +1
Female +1
50
Q

What are the points in the HAS-BLED score?

A 
Hypertension +1
Abnormal renal function or liver function +1 or +2
Stroke +1
Bleeding +1
Labile INRs +1
Elderly (>65) +1
Drugs or alcohol +1 or +2
51
Q

What is heart failure?

A

Clinical syndrome characterised by typical symptoms caused by a structural and/or functional cardiac abnormality resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress

52
Q

What are the symptoms of HF?

A 
Dyspnoea
Orthopnoea
Paroxysmal nocturnal dyspnoea
Peripheral oedema
Fatigue
53
Q

What are the signs of HF?

A 
Elevated JVP
Hepatojugular reflux
3rd heart sound
Pulmonary crackles
Peripheral oedema
Laterally displaced apical impulse
54
Q

What are the 2 types of HF?

A

HF with reduced ejection fraction (systolic HF)

HF with preserved ejection fraction (diastolic HF)

55
Q

What are the causes of chronic HF?

A 
Ischaemic heart disease
Acute coronary syndrome	Hypertension
Valve disease
Arrhythmias
Cardiomyopathy
Myocarditis
56
Q

What drugs should be given for HF with reduced EF?

A

ACEi / ARB/ ARNi
Beta blocker
Aldosterone antagnist

57
Q

What is the physiological response to HF?

A

Increase cardiac output
Increase catecholamine release
Activation of renin-angiotensin system
Structural changes

58
Q

What is BNP?

A

Peptide are released by the heart in response to myocardial tension & increased intravascular volume

59
Q

What is Starling’s law?

A

Greater the amount of blood volume (preload) into the ventricle of the heart during diastole, the greater the amount of blood volume ejected out of heart during systolic phase

60
Q

What are the types of diuretics?

A

Loop diuretics
Thiazide-like diuretics
Potassium-sparing diuretics

61
Q

Give examples of loop diuretics

A

Furosemide

Bumetanide

62
Q

What are the side effects of loop diuretics?

A

Fatigue
Dizziness
Electrolyte imbalance

63
Q

Give examples of thiazide-like diuretics

A

Bendroflumethiazide

Metolazone

64
Q

What are the side effects of thiazide-like diuretics?

A

Gout exacerbation

65
Q

Give examples of potassium sparing diuretics

A

Spironolactone

Eplerenone

66
Q

What are the side effects of potassium sparing diuretics?

A

Hyperkalaemia

Gynaecomastia

67
Q

Give examples of ARBs

A

Candesartan
Losartan
Valsartan

68
Q

What are the side effects of ivabradine?

A

Bradycardia
Headache
Dizziness
Vision disturbance

69
Q

What are some lifestyle changes to advise in HF?

A 
•	Monitor fluid intake
Monitor breathlessness &amp; oedema
Smoking cessation
Optimise BP
Optimise diabetes management
Diet &amp; reduced salt intake
Regular exercise
Flu &amp; pneumococcal vaccination

KT (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions