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Respiratory and Cardio > Pharmacology of heart failure and hypertension > Flashcards

Pharmacology of heart failure and hypertension Flashcards

1
Q

How does pulmonary oedema occur in heart failure?

A

Left ventricular dysfunction - fluid backs up into pulmonary capillaries - hydrostatic pressure increases - fluid enters lungs

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2
Q

Acute treatment for pulmonary oedema:

A 
Diamorphine
O2
Diuretic
Nitrates
Ventilatory support
Inotrophic support
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3
Q

What diuretic is used in pulmonary oedema?

A

IV furosamide

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4
Q

What is diamorphine used to do in PO?

A

Relief of anxiety

vasodilation

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5
Q

Nitrates act to

A

Vasodilate

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6
Q

Types of ventilatory support:

A

CPAP

IPPV

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7
Q

CPAP

A

Continuous postive airway pressure

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8
Q

IPPV

A

Invasive positive pressure ventilation

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9
Q

What can be used as ionotrophic support?

A

Dobutamine

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10
Q

Dobutamine =

A

Synthetic catecholamine

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11
Q

Following recover from PO, patient has what?

A

Chronic heart failure

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12
Q

What should a patient be started on after acute PO?

A

Diuretic
Beta blocker
ACEi

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13
Q

What is the aim of treatment for anasarca?

A

Need to induce diuresis

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14
Q

Ways to induce diuresis:

A 
Best rest 
Fluid restriction
Diuretic
Inotrophic support
Mechanical help: dialysis
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15
Q

What should you give to a patient on bed rest?

A

LMWH

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16
Q

Diuretics of choice in HF:

A

Loop

Loop + thiazide

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17
Q

Problems caused by loop diuretics:

A

Hypokalaemia
Hyponatreaemia
Hypercaemia

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18
Q

MoA amiloride:

A

Blocks K+/Na+ exchanger

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19
Q

MoA spironolactone

A

Aldosterone antagonist

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20
Q

1st line treatment for HF:

A

Diuretics
ACEi (or ARB)
Betablocker
MRAs

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21
Q

ARB =

A

Angiotensin II receptor blocker

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22
Q

MRAs =

A

Mineralcorticoid receptor antagonist

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23
Q

Suffix of ARB

A

-sartan

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24
Q

What is ACE escape?

A

Angiotensin II can be made by other enzymes

25
Q

What does ARBs get around?

A

ACE escape

26
Q

Why are ACEis better than ARBs

A

ACE breaks down kinins (vasodilators). Kinins increase

27
Q

What do ACEi and ARB cause?

A

Fall in BP
Rise in K+
Rise in creatinine
Fall in Hb

28
Q

Why does ACEi cause a rise in creatinine?

A

Renal artery stenosis

29
Q

Side effects of ACEi

A

Cough
Rash
Angio-oedema

30
Q

Why may we need MRAs?

A

Aldosterone not totally suppressed by ACEi

31
Q

Name 2 MRAs

A

Spironolactone

Epleronone

32
Q

Side effects of spironolactone:

A

Hyperkalaemia

Gynaecomastia

33
Q

Name a SARA

A

Eplerenone

34
Q

SARA =

A

Selective aldosterone receptor antagonist

35
Q

a1 receptors cause

A

Vasoconstriction

36
Q

What acts on a1 receptors

A

Noradrenaline

37
Q

b1 is found on

A

Cardiac muscle

Kidneys

38
Q

b2 is found on

A

Peripheral vessels
Ciliary body
Bronchodilation
Decrease GI contractility

39
Q

Is sympathetic activation good or bad in HF?

40
Q

Effect of blocking b1 =

A

Decrease in HR
Decrease contractility
Decrease renin release

41
Q

Effect of blocking b2 =

A 
Vasoconstriction of vessels
Bronchoconstriction
Speeds up GI motility
Reduce IOP
Less glucose released, more glucagon
42
Q

How to betablockers help in HF?

A 
Improve myocardial function
Protect myocytes
Slow HR
Anti-ischaemia 
Anti-arrythmic
Ejection fraction improves
43
Q

Examples of non-selective beta blockers

A

Propanolol
Timolol
Nadolol

44
Q

Examples of selective beta blockers

A

Atenolol

Metoprolol

45
Q

What conditions are selective beta blockers prefered for?

A

COPD
Asthma
Diabetes

46
Q

Ivabradine =

A

Inhibits pacemaker current, slows HR

47
Q

Aliskiren =

A

Direct renin inhibitors

48
Q

What enzymes system blocks ANPs?

49
Q

Sacubritil =

A

NEP inhibitor

50
Q

Valsartan =

51
Q

Digoxin is indicated in

A

Atrial fibrilation
Atrial flutter
HF

52
Q

MoA of digoxin

A

Blocks Na+/K+ on cardiac myocytes

Ca2+ moves in

53
Q

4 drugs to avoid in HF

A
  • Calcium antagonists
  • Positive inotrophs
  • Aspirin
  • Statins
54
Q

ABCD of hypertension:

A

ACEi
Beta blockers
Ca2+ blockers
Diuretics

55
Q

MoA of calcium antagonists:

A

Reduce BP

Negative inotrophy

56
Q

Name 2 dihydropyridines =

A

Amlodipine

Nifedipine

57
Q

Name 2 non-dihydropyridines =

A

Verapamil

Diltiazem

58
Q

Doxazosin =

A

Alpha blocker

Respiratory and Cardio (14 decks)

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