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Cardio > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

what is an inotropic drug?

A

affects contractility of the heart

-alters force/energy of muscular contractions

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2
Q

what is a chronotropic drug?

A

affects HR

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3
Q

outline the classes of anti-arrhythmic drugs

A

classified according to their effects on cardiac action potential

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4
Q

outline cardiac action potential electrophysiology

A
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5
Q

how do class 1 anti-arrhythmics work

A

work by blocking Na channels - slow depoalrisation & conduction

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6
Q

give an example of class 1a anti-arrhythmic drug

A

Quinidine

v rarely used in UK due to adverse effects - may cause prolonged QT

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7
Q

outline 2 class 1b anti-arrhythmic drugs

A
  • lidocaine
  • phenytoin
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8
Q

outline a class 1c anti-arrhythmic drug

in who can this class not be given?

A

Flecainide

MARKEDLY depresses sodium entry into channels

In pts with CAD

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9
Q

adverse affects of class 1?

A
  • class 1 b&cā€“> neurotoxicity
  • negatively inotropic
  • N&V
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10
Q

what are class 2 anti-arrhythmics?

A

beta-blockers

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11
Q

how do beta blockers act? and effects?

A
  • act to reduce sympathetic activity
  • negatively inotropic & chronotropic
  • act on AV node to reduce conduction
  • act on SA node to reduce rate of spontaneous depolarisation
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12
Q

adverse effects of beta blockers?

A
  • postural hypotension
  • bradycardia
  • AV node block
  • bronchoconstriction
  • hypoglycaemia
  • erectile dysfunction
  • insomnia
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13
Q

outline class III anti-arrhythmic drugs

A

amiodarone

sotalol

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14
Q

mechanism of action of class III anti-arrhythmic drugs

A

block K channels - hence cause prolongation of refractory period

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15
Q

adverse effects of amiodarone?

A
  • thyroid dysfunction
  • peripheral neuropathy
  • photosensitivity
  • lung fibrosis
  • hepatitis /cirrhosis
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16
Q

what are class 4 anti-arrhythmics?

A

Non-Dihydropyridine CCBs

17
Q

mechanism of action of non-dihydropyridine CCBs?

A
  • reduce conduction through AV node
  • negative inotropes
  • negative chronotropes
18
Q

adverse effects of non-dihydropyridine CCBs

A
  • bradycardia
  • heart block
  • constipation
  • gum hyperplasia
  • headaches, flushing, peripheral oedema
    • more common in dihydropyridines
19
Q

outline the classification of CCBs

A
  • Dihydropyridines
    • amlodipine
    • nifedipine
  • Non-Dihydropyridines
    • verapamil
    • diltiazem
20
Q

what are the different properties of the classes of CCB

A
  • Dihydropyridine
    • anti-hypertensive properties
  • Non-Dihydropyridine
    • anti-arrhythmic properties
21
Q

what is Digoxin?

A
  • cardiac glycoside
  • Na/K ATPase inhibitor
22
Q

mechanism of action of Digoxin?

A
  • slows AV conduction
  • positive inotrope
23
Q

adverse effects of digoxin?

A
  • causes ECG changes
  • toxicity may cause PR prolongation & lead to arrhythmias
  • hypokalaemia potentiates its effects
24
Q

action of adenosine?

A

acts on SA node to reduce HR, and AV node to slow conduction

used primarily in SVT

25
Q

mechanism of action of atropine?

A

anti-cholinergic

26
Q

mode of action of aspirin?

A
  • cyclo-oxygenase inhibitor
    • inhibits production of thromboxane A2
  • reduces platelet aggregation
27
Q

mode of action of clopidogrel?

A
  • ADP receptor antagonist
  • reduces platelet aggregation
28
Q

mechanism of action of nitrates?

A
  • release NO to relax smooth muscle
  • venodilators
29
Q

outline cardioselective beta blockers

A

Betablockers Act Exclusively At Myocardium

Betaxolol

Acebutelol

Esmolol

Atenolol

Metoprolol

30
Q

what is the stance of cardioselective b-blockers in pts with asthma

A

Cardioselective beta-blockers pose a lesser risk but this risk is invariably dose-dependent. beta blockers should still be avoided in these patients.

31
Q

diabetics and beta blockers consideration?

A

due to the risk of hypoglycaemia, beta blockers may mask the symptoms of a hypo in a diabetic

32
Q

what CCBs are used for treatment of stable angina?

why do they work in preventing angina?

A

ALL

They reduce cardiac rate, contractility and afterload and hence myocardial oxygen demand - preventing angina

33
Q

outline the main difference between dihydropiridine & non-duhydropyridine CCB in terms of where they act

A
  • dihydro- relatively selective for the vasculature
  • non-dihydro- more selective for the heart
    • verapamil MOST cardioselective
34
Q

what must you not co-prescribe with beta blockers?

A

non-dihydropyridine CCB ā€“> may cause bradycardia, asystole etc

Cardio (18 decks)

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