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Pharmacology year 1 > SBA summer > Flashcards

SBA summer Flashcards

Antibiotics, CV drugs

1
Q

Bisoprolol, Atenolol, propranolol, metoprolol

what? indication?

A

Beta blockers

First line - AF and IHD (Angina and ACS), CHF (improves prognosis, SVT

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2
Q

MOA for beta-blockers

  • AF
  • HTN
A

propranolol, bisoprolol, atenolol, metroprolol

Beta1 receptor (mainly in heart) BB reduce contraction force and speed of conduction

AF- reduce ventricular rate in AF by prolonging AV node refractory period

HTN - reduce renin secretions from kidneys (B1 receptorrs)

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3
Q

Side effects of BB

A

Fatigue, headaches, nausea, sleep disturbance

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4
Q

Absolute contraindications for BB

which ones selective/non-selective

A

Asthma - Bronchospasms

Atenolol and bisoprolol - realatively B1 receptor selective

Propanolol - not

(kim put on propanolol for headaches)

2nd/3rd degree heart block, unstable HF

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5
Q

BB interaction

A

Non-dihydropyridine CCB

Verapamil and Diltazem

Vera and Dita don’t like Big Boys

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6
Q

Amlodipine, nifedipine, diltiazem and verapamil

what?

Indications?

A

CCB

Amlodipine - first line or 2nd line tx HTN (reduces risk of stroke, MI, and death from CVD)

Symptom control - stable angina

Diltiazem and Verapamil - controls cardiac rate in SVT, AF, Atrial flutter

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7
Q

CCB MOA

A

Amlodipine, Nifedipine, dilitiazem and verapamil

reduce CA2+ into vascular and cardiac cells. reducing intracellular Ca2+ conc

arteriol smooth muscles vasodilate

heart - reduces myocardial conraction, suppress cardiac conduction, reduce O2 demand

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8
Q

CCB selectivity

A

Verapamil - most cardio selective

(Vera wants love)

amlodipine, nifedipine - relatively selective for vasculature

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9
Q

Side effects CCB

A

ankle swelling, flushing, palpitations, constipation

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10
Q

Classes of CCB (3)

A

Dihydropyridines (Nifedipine, Amlodipine) potent Vasodilators

kNifes Are Violent

Phenylalkylamines (verapamil, gallopmil) potent myocardial depressants

Vera wants love

Benzothiazepines (Diltiazen) moderate both

Dita wants violent love

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11
Q

Side effects of CCB

A

Nifedipine, amlodipine (vasodilation) - headaches, ankle swelling, palpitations)

Verapamil (myocardial depression) bradyarrhythmias, AV block

Diltiazem - similar but milder

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12
Q

Contraindications for CCB

A

Pre-existing cardiac conduction disorders (AV block)

symptomatic hypotension

ACS

Verapamil and diltiazem - BB

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13
Q

Where are CCB metabolised

A

metabolised in liver, excreted by kidneys

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14
Q

Isosorbide mononitrate

glyceryl trinitrate

indication

A

GTN spray

acute angina and chest pain ass with ACS

Isosorbide mono (long acting)

prophylaxis for angina where BB or CCB not tol/insuff

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15
Q

Nitrates MOA

A

relax venous capacitance vessels reducing pre-load

thef. reduce cardiac work and O2 demand

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16
Q

Side effects - nitrates

A

vasodilator - flushing, headaches, hypotension,

sustained use can lead to tolerance

give am and lunch time

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17
Q

CI of nitrates

A

severe aortic senosis

hypotension

sildenafil

18
Q

Nicorandil

MOA

Indication

A

vasodilation due to nitrate property

prevention/tx chest pain in stable angina

used if BB/CCB insuff or not tolerated

? cardiology referral if 2 antihypertensives not working

19
Q

Nicorandil S/E

A

vasodilation

Mouth ulcers, flushing, dizzy, headaches, N+V

20
Q

Ramipril, Lisinopril, Perindopril

what?

Indications?

A

ACE inhibitors

1st/2nd line tx of HTN (reduce risk of CVD complications and death)

CHF - 1st line all grades (improves symptoms and prognosis)

IHD - reduce risk following MI

Diabetic nephropathy - proteinuria (kidney protective)

21
Q

ACE inhib MOA

A

Ramipril, Lisinopril, Perindopril

Blocks action of ACE

prevents conversion of angiotensin 1 to 2

Angiotensin 2 vasoconstrictor and stimulates aldosterone secretion

reduced Aldosterone promotes Na+ and H2O secretion this reduces preload (beneficial in HF)

22
Q

Side effects of Ramipril, Lisinopril, Perindopril

A

ACE inhibitors

hypotension, cough, hyperkalemia, headaches

23
Q

Contraindications for ACE I

A

Renal artery stenosis, AKI, pregnant/breast feeding

24
Q

ACE I interactions

A

Potassium supplements

K+ sparing diuretics

NSAIDS (increased risk of renal failure)

monitor U+Es and renal func.

25
Q

Simvastatin, Atorvastatin, pravastatin

what?

indications?

A

Statins

primary prevention CVD

secondary prevention of CVD - first line with lifestyle advice

hyperlipidemia

26
Q

Statins MOA

A

reduce serum chol. levels

inhibit HMG COA reductase

reducing production of chol by liver, and increase LDL chol clearance from blood

slows/reverses atherosclerosis process

27
Q

Statin interactions

A

Statin metabolism reduced by P450 inhibitors therefore increased risk of SE

macrolides, amiodarone

amlodipine - CCB

Grapefruit (inhibits P450)

Check thyroid before starting

28
Q

Side effects of statins

A

Muscle aches - myopathy

headaches/ GI upset

29
Q

Warnings - cautions for statins

A

Hepatic impairment

renal impairment

pregnancy

30
Q

Common side effects of cardiac drugs

swollen ankles:

aching muscles:

GI bleed:

raised liver enzymes:

cold fingers and toes:

headaches:

sleep disturbance:

A

swollen ankles: CCB

aching muscles: Statins

GI bleed: Aspirin

raised liver enzymes: Statins

cold fingers and toes: BB

headaches: Nitrates

sleep disturbance: BB

31
Q

3 steps of angina treatment

A

Step 1 - BB or CCB (ax CV risk +/- statins and antiplatelets)

Step 2 - Add in CCB or BB (pt takes both)

CCB+BB can cause heart block

Add - Amlodipine or Nifedipine

kNifes Are Violent but like Big Boys

Step 3 - add in one of following:

Long acting nitrate

Nicorandil

Ivabradine

Ranolazine

Consider cardiology referral

32
Q

3 Steps for HTN treatment

A

Step 1 - <55yrs ACE I, >55yrs or black CCB

Step 2 - ACEI + CCB

Step 3 - ACE I + CCB + thiazide like diuretic

33
Q

when to give statins

A

at night

34
Q

abx that inhibit cell wall

A

with beta-lactam ring

penicillin

carbapenems eg. meropenem

Cephalosporins

without beta-lactam ring

Vancomycin

35
Q

Abx that inhibit pr- synthesis by targeting ribosomes

A

Macrolides - erythromycin, clarithromycin

Tetracyclines - doxy

Gentamycin

36
Q

Names of macrolides

A

erythromycin

clarithromycin

37
Q

ABx for Campylobacter

A

MC

Macrolides

Erythromycin, clarithromycin

38
Q

ABx that inhibit folic acid metabolism

A

Trimethoprim (E.coli)

Sulfamethoxazole

(co-trimoxazole is combination of both)

39
Q

ABx for C.diff

MOA

A

Metronidazole

inhibits nucleic acid synthesis

40
Q

Antibiotic for salmonella or Shigella

A

CSASH

Ciprofloxacin SAlmonella SHigella

41
Q

MOA and Class

Ciprofloxacin

A

Quinolones

inhibit DNA gyrase

42
Q
A

Pharmacology year 1 (1 decks)

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