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FINALS - CARDIO > Meds > Flashcards

Meds Flashcards

1
Q

mechanism of ACEi

A

inhibit angiotensin 1 –> angiotensin II

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2
Q

name of ACEis

A

-pril eg lisinopril

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3
Q

SE ACEi (3)

A

cough // angioedema // hyperkalaemia

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4
Q

what conditions are ACEi contraindicated in (3)

A

pregnancy // renovascular disease // aortic stenosis

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5
Q

what K levels would indicate seeking advice before starting ACEi

A

> 5

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6
Q

interactions with ACEi (1)

A

high dose diuretic –> hypotension

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7
Q

what needs to be monitored after changing or increasing ACEi

A

U+E’s

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8
Q

what creatine and potassium rise is OK in ACEi

A

serum up to 30% and K up to 5.5

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9
Q

what would significant renal impairment after starting ACEi indicate

A

bilateral renal artery stenosis

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10
Q

mechanism of ARBs

A

block angiotensin II at angiotensin receptor

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11
Q

exampls of ARBs

A

-sartan, losartan, candesartan

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12
Q

when are ARBs used

A

2nd line to ACEi - usually if patient develops a cough

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13
Q

cautions (1) and SE (2) of ARBs

A

caution - renovascular disease // SE - hypotension + hyperkalaemia

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14
Q

what is an iontropic effect on the heart

A

increases contractility –> increased CO

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15
Q

what are the 2 main classes of CCBs + what do they do

A

dihydropyridines (relax blood vessels) eg nifidpine, amlodipine // non-dihydropyridines (highly negatively inotropic) eg verapamil or dilitiazem

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16
Q

mechanism verapamil

A

highly negatively inotropic

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17
Q

indications verapamil

A

angina, hypertension, arrhythmia

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18
Q

interaction verapamil

A

do not give with BB as can cause heart block

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19
Q

SE and cautions with verapamil

A

HF!! // constipation // hypotension // bradycardia // flushing

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20
Q

indications for diltiazem

A

angina or hypertension

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21
Q

interactions dilitiazem

A

BBs –> HF

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22
Q

SE and cautions diltiazem

A

hypotension // bradycardia // HF // ankle swelling!!!

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23
Q

indication nifidepine, amlodipine, felodipine (dihydropyridines) (3)

A

hypertension // angina // reynaulds

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24
Q

why are dihydropyridines more likely to cause ankle swelling

A

peripheral vascular smooth muscle dilated

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25
Q

SE and cautions dihydropyridines

A

flushing // headache // ankle swelling

26
Q

SE nifedipine

A

reflex tachycardia

27
Q

what is the rate control drug of choice in Afib

A

BB

28
Q

SE of BBs (5)

A

bronchospasm // cold peripheries // fatigue // sleep disturbance // ED

29
Q

contraindications BB (3)

A

uncontrolled HF // asthma // sick sinus

30
Q

what drug should BB never be given with

A

verapamil –> bradycardia / heart block / HF

31
Q

mechanism of loop diuretics

A

inhibit NaKCl in ascending thick loop of henle –> reduce absorption of NaCl

32
Q

what dosing adjustment may be required for kidney patients on loop diuretics

A

increasing doses so a sufficient concentration in kidneys is achieved

33
Q

main indications for loop diuretics

A

HF or resistant hypertension

34
Q

SE loop diuretics

A

hyponatraemia // hypokalaemia + magnesia // alkalosis // otoxic // hypocalcaemia // AKI // gout

35
Q

mechanism of thiazide diuretics

A

inhibit NaCl in distal convuluted tubule

36
Q

what is lost in thiazide diuretics

A

K + na

37
Q

common side affects of thiazides (6)

A

dehydration // hyponatraemia, hypokalaemia, hypercalceamia // gout // reduced glucose tolerance // impotence// pancreatitis

38
Q

what drug does potassium sparing diuretics need to be given with caution

A

ACEi –> hyperkalaemia

39
Q

examples of potassium sparing diuretics

A

amiloride (usually with another diuretic // spironolactone

40
Q

what type of drug is amiodarone

A

class III antiarrhythmic (for atrial, nodal, and V tach)

41
Q

mechanism of amiodarone

A

blocking K channels which lengthens AP

42
Q

how should amiodarone be administered and why

A

into central veins as can cause thrombophlebitis

43
Q

what drugs does amiodarone interact with (2)

A

p450 inhibitors eg warfarin –> increased INR // increases digoxin

44
Q

how is amiodarone monitored

A

TFT and LFT every 6 months

45
Q

SE of amiodatone (7)

A

thyroid issues // corneal depositis // liver + pulmonary fibrosis // peripheral neoropathy // photosensitive // gray appearance // bradycardia + lengthen QT

46
Q

when is adenosine indicated

A

sinus tachycardia

47
Q

when should adenosine be avoided

A

asthmatics –> bronchospasm

48
Q

mechanism of adenosine

A

agonsit of A1 receptor in AV node –> increased efflux of K –> hyperpolarisation

49
Q

how should adenoise be administered

A

large cannula (short half life)

50
Q

SE adenosine (3)

A

chest pain // bronchospasm // transient flusing

51
Q

mechanism of statin

A

inhibits HMG -CoA reductase (RLS in cholesterol synthesis)

52
Q

contraindications for statins (2)

A

macrolides eg erythromycin and clarithromycin // pregnancy // (watch LFTs as well)

53
Q

who gets statins

A

everyone with CVD or with a 10 year CVD risk >10%

54
Q

statin dose for primary CVD prevention

A

atorvatatin 20mg

55
Q

statin dose for secondary CVD prevention

A

atorvastatin 80mg

56
Q

effect of nitrates

A

vasodilating (+ reduce venous return –> reduce ventricular work)

57
Q

indication for nitrates

A

angina + acute heart failure

58
Q

SE nitrates

A

hypotension, tachycardia, headache, flushing

59
Q

what dosing advice is given for isosorbide nitrate

A

have 10-14 nitrate free hours // ie take second dose after 8 hours

60
Q

when is nicorandil indicated + what is the mechanism

A

angina (K channel activator –> vasodilation)

61
Q

SE nicorandil

A

GI + anal ulcers // headache and flushing

62
Q

contraindications nicorandil

A

left ventricular failure

FINALS - CARDIO (17 decks)

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