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Cardiology > PPT 1 > Flashcards

PPT 1 Flashcards

1
Q

Bendroflumethiazide

A

Thiazide diuretic - blocks Na/Cl reabsorption in the DCT

Oedema and hypertension

Contraindication: diabetes, Addison’s, hypontremia

Can cause hypokalaemia

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2
Q

Indapamide

A

Thiazide ‘like’ diuretic - blocks Na reuptake at DCT (exact mechanism unclear)

Can cause hypokalaemia

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3
Q

Chlortalidone

A

For heart failure, hypertension, ascites and diabetes insipidus

Thiazide ‘like’ diuretic - blocks NaCl reuptake in DCT

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4
Q

Furosemide

A

Loop diuretic - blocks NKCC2 in ascending loop of henle

For oedema and resistant hypertension

Contraindicated in renal failure due to nephrotoxic drugs, severe hypokalaemia and severe hyponatremia

Hypokalaemia can occur with both thiazide and loop diuretics

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5
Q

Bumetanide

A

Loop diuretic

Used for oedema

Inhibits the Na/K ATPase pump and blocks active reabsorption of Cl and Na in the ascending loop

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6
Q

Amiloride

A

K sparing diuretic

Inhibits Na uptake in the DCT

Increases Na excretion and thus reduces K+ and H+ excretion

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7
Q

Spironolactone

A

K sparing diuretic

Competetively inhibits mineralocorticoid receptors in the DCT to promote Na and water loss while sparing K+

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8
Q

Eplerenone

A

K+ sparing diuretic

Aldosterone/ mineralocorticoid receptor antagonist

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9
Q

Propranolol

A

Non-selective beta blocker

Causes vasoconstriction, inhibition of vascular endothelial growth factors and down-regulation of RAAS

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10
Q

Bisoprolol

A

Hypertension and angina

B-blocker - cardioselective B1

*even though it is considered to be cardio-selective, it should still be avaoided in patients with a hx of asthma, bronchospasm or COPD (can be given under specialist supervision)

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11
Q

Atenolol

A

Cardioselective B1 b-blocker

Hypertension, arrhythmias, migraine

Avoid use in hx of asthma, COPD and bronchospasm

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12
Q

Metoprolol

A

Cardioselective B1 blocker

Hypertension, angina, arrhythmias, migraine, hyperthyridism adjunct

Avoid if hx of asthma, COPD and bronchospasm

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13
Q

Carvedilol

A

Beta and alpha 1 blocker

Beta blocker: inhibits exercise induced tachycardia

Alpha blocker: smooth muscle relaxation in vasculature thus lowering peripheral resistance

Hypertension, angina

Avoid in hx of obstructive airway disease and bronchospasm

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14
Q

Amlodipine

A

Dihydropyridine calcium channel blocker

Selective for peripheral vasculature therefore associated with fewer adverse cardiac effects e.g. myocardial depression and conduction anomalies

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15
Q

Felodipine

A

Long acting dihydropyridine calcium channel blocker

Angina and hypertension

Acts primarily on smooth muscle cells

Prevents calcium-dependent myocyte contraction and vasoconstriction - reduces cardiac contractility

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16
Q

Diltiazem

A

Calcium channel blocker - works on the heart and the vasculature

Blocks influx of calcium into cardiac and vascular smooth muscle during depolarisation

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17
Q

Verapamil

A

Calcium channel blocker

Binds to the alpha1 subunit of L-type calcium channels

** check if it works specifically on the heart or peripheral vessels too**

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18
Q

Ramipril

A

ACEi

Hypertension, systemic heart failure, MI prophylaxis

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19
Q

Lisinopril

A

ACEi

Hypertension, short-term post MI, heart failure, renal complications of diabetes

20
Q

Losartan

A

Angiotensin II receptor blocker

Used for chronic hert failure when ACE inhibitors are unsuitable or contra-indicated

21
Q

Candesartan

A

Angiotensin II receptor blocker

Hypertension & heart failure with left ventricular systolic function when ACEi are not tolerated

22
Q

Valsartan

A

Angiotensin II receptor blocker

Hypertension, heart failure when ACEi can’t be used

Contraindications: viliary cirrhosis and cholestasis

23
Q

Doxazosin

A

Selectively inhibits post synaptic alpha-1 receptors on vascular smooth muscle thus decreasing peripheral resistance and reduces blood pressure

Hypertension and BPH (relaxes smooth muscle in the prostate and bladder thus relieving frequency, urgency and weak stream)

24
Q

Tamsulosin

A

Alpha 1A and 1B blocker

For BPH

25
Q

Atorvastatin

A

HMG CoA reductase inhibitor - blocks biosynthesis of cholesterol

Stimulates upregulation of LDL receptors which promotes uptake of LDL by the lier thus lowering levels in the blood

26
Q

Rosuvastatin

A

Competitively inhibits the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase

27
Q

Simvastatin

A

Competitively inhibits the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase

28
Q

Bezafibrate

A

Fibrates act by decreasing serum triglycerides; they have variable effect on LDL-cholestrol

29
Q

Ezetimibe

A

Ezetimibe inhibits the intestinal absorption of cholesterol.

If used alone, it has a modest effect on lowering LDL-cholesterol, with little effect on other lipoproteins

30
Q

Unfractioned heparin

A
31
Q

Dalteparin

A

Factor IIa and Xa inhibitor (preferentially inactivates Xa)

Low molecular weight heparin

32
Q

Fondaparinux

A

Fondaparinux sodium is a synthetic pentasaccharide that inhibits activated factor X

33
Q

Warfarin

A
34
Q

Apixaban

A

Xa inhibitor

35
Q

Rivaroxaban

A

Xa inhibitor

36
Q

Dabigatran

A

Dabigatran etexilate is a direct thrombin inhibitor with a rapid onset of action

37
Q

Alteplase

A
38
Q

Tenecteplase

A
39
Q

Beriplex

A

made up of blood clotting factors II, IX, and X

40
Q

Idarucizumab

A

Idarucizumab is a humanised monoclonal antibody fragment that binds specifically to dabigatran and its metabolites, thereby reversing the anticoagulant effect

41
Q

What is ambulatory blood pressure?

A

BP measured during activities of daily life - measured for up to 24hrs

42
Q

Normotensive ABPM

A

Daytime average below 135/85mmHg

43
Q

Stage 1 hypertension

A

ABPM daytime average 135/85mmHg or higher

44
Q

Stage 2 hypertension

A

ABPM daytime average above 150/95mmHg

45
Q

What should happen to blood pressure at night?

A

Should dip - if the difference between daytime readings and night time readings of BP are <10% further investigation is needed

46
Q

ABPM daytime average below 135/85mmHg and clinic blood pressure persistently above 140/90mmHg

A

White coat hypertension

47
Q
A

Cardiology (8 decks)

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