WK 2: Cardiorespiratory Flashcards
3 main DDx for chest pain
ACS
PE
dissection
medications for angina (5)
- BB /Ca antagonist
- nicorandil
- short acting nitrate
- aspirin
- lipid lowering drug
beta blockers=
negative inotrope and negative chronotrope
inotrope=
contraction force
chronotrope=
HR
B1 in
heart
B2 in
lungs
heart specific BB
bisprolol
metoprolol
lung and peripheral arteries BB
amlodipine
propanolol
what is special about carvedilol
also blocks adrenoreceptors
adverse features of BB
- dizziness, fatigue, impotence
- hypotension
- bradycardia/ heart block
- masks hypoglycaemia
- impotence
adverse features of calcium channel blockers (4)
headache
reflex tachycardia
peripheral oedema
constipation
nitrates=
prodrugs converted into NO
how do nitrates work
vasodilator in veins more than arteries decreasing preload
which areas do nitrates have a preferential effect for
areas of ischaemia
oral nitrates metabolised via
first pass
sub-lingual nitrates used because
bypass first pass
why don’t you prescribe nitrates at regular intervals
as need a nitrate free period at night as body becomes tolerant
SE of nitrates (5)
- hypotension
- headache,
- facial flushing,
- reflex tachycardia
- tolerance
aspirin MOA
inhibits COX 1 preventing thromboxane from working
aspirin effect on COX-2
requires higher quanities to be anti-inflammatory
SE of aspirin
GI irritation
bronchospasm
ischaemic ECG changes
ST depression
T wave inversion
New heart blocks
Arrhythmias
NSTEMI management (6)
Morphine Oxygen - only if hypoxic Nitrates aspirin antithrombin therapy
