Quiz2.Hyperlipidaemia,absorp,HF,massspec Flashcards
What is aspirin?
An irreversible COX enzyme inhibitor
What is abciximab?
A glycoprotein 2b/3a receptor antagonist which decreases platelet aggregation
Give three examples of ADP receptor agonists
Clopidogrel, ticagrelor, prasugrel
How do statins exert their effect?
- inhibit HMG-coA reductaae
-which leads to a decrease in cholesterol synthesis in the liver
Give an example of a bile acid sequestrant and explain how they work
Colestyramine is a bile acid sequestrant and it works by
-binding to bile acid
-which prevents enteropathic cycling
-which reduces hepatic cholesterol
What is exetimibe and how does it work?
Exetimibe is a selective cholesterol re absorption inhibitor.
It works by
-reducing delivery of cholesterol to liver therefore less uptake
-therefore increased LDL clearance
What is 1st line prevention for CVD?
Atorvastatin 20mg once daily
What is measured for ALL patients starting a statin?
- Thyroid function
- Full lipid profile
- Liver function test
- Renal function
SOME patients will require creatinine kinase testing
What are some statin interactions and why do they occur?
Statins are prone to toxicity:
- clarithromycin and grapefruit juice and enzyme inhibitors therefore can increase statin levels causing myalgia
- simvastatin capped at 20mg when given with diltiazem or amlodipine
Which drug admini method does not require passing of biological membrane?
IV
What characterises the symptoms of chronic heart failure?
They are slow and insidious in their onset
What are clinical features of left sided HF?
Pulmonary oedema and able oedema
What are clinical features of right sided HF?
Peripheral cyanosis, elevated JVP
How are ions separated in a mass spectrometer?
Via a mass to charge ratio
What are 4 tests done in HF diagnosis?
- Natriuretic peptides
- ECG
- Echocardiogram
- Chest X-ray (to look for left ventricular dysfunction)
What are the two treatment branches for HF? What would you prescribe for each of these?
Symptom relief and prevention of progression.
For symptom relief- diuretics, ionotropes, vasodilators
For prevention of progression- ACEi, BB/ARB, aldosterone antags, ARNIS
Give an example of an ARNI
Entresto- sacubitril and valsartan
How do loop diuretics work? Give an example
Furosemide is a loopD and it works by inhibiting exchange of sodium potassium and chloride ions in the thick segment of the ascending loop of Henle
How do thiazide and thiazide like diuretics work?
They work by inhibiting exchange of sodium and chloride ions in the distal convoluted tubule eg bendroflumethiazide
How do carbonic anhydrase inhibitors work?
Eg acetazolomide
- Inhibit carbonic anhydrase
- leads to renal loss of bicarbonate
- therefore urine is alkalised and inc diuresis
How does spironolactone work?
Spironolactone, eplerenone are potassium sparing diuretics eg aldosterone antagonists.
-work by inhibiting reabsorption of Na+ in distal convoluted tubule and collecting tubule.
What is mannitol?
Mannitol is a osmotic diuretic
- increases osmolarity of the tubular fluid
- therefore increasing urinary volume
What is the link between entresto and ACEi/ARBS?
ACEi/ARB should be discontinued 36 hours before starting entresto due to angiodema risk
