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Flashcards in Cardiac pharmacology Deck (45)
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1

Which cardiac drug is contraindicated in renal artery stenosis?

ACE inhibitors

2

Which drugs would you prescribe in angina?

Beta blockers
Calcium channel antagonists
Nitrates
Nicorandil

3

Which drugs would you prescribe in hypertension?

ACE inhibitors
Beta blockers
Calcium channel antagonists
Diuretics
Spironolactone

4

Which drug is described as the "potassium sparing diuretic"?

Spironolactone

5

Which drugs would you prescribe in cardiac failure?

ACE inhibitors
Beta blockers
Diuretics
Spironolactone

6

Which side effect must you be wary of when using diuretics?

Hypokalaemia

7

Which part of the nephron do thiazide diuretics act on?

Distal tubule

8

How do diuretics work?

Inhibit NaCl absorption - as a result, H2O and NaCl excreted in urine
Blood volume is reduced, and so MABP decreases

9

Why are diuretics particularly useful in oedema?

They reduce blood volume and reduce arterioles and venules, allowing reabsorption of fluid into capillaries

10

Which part of the nephron do loop diuretics act on?

Ascending limb of the loop of henle

11

Which are stronger - loop diuretics or thiazide diuretics?

Loop

12

Which drug would be prescribed first (according to SIGN guidelines) in heart failure?

ACE Inhibitor
Beta blocker

13

Which drug can cause the regression of left ventricular hypertrophy?

ACE inhibitor

14

How do nitrates work?

Venorelaxation - decrease preload, decrease SV, decrease myocardial O2 requirement by reducing workload of the heart
Also causes dilatation of collateral arteries - blood flow redirected to ischaemic areas

15

What effect does NO have on cGMP?

Stimulates the conversion of more GTP to cGMP which stimulates relaxation of vascular smooth muscle

16

Which nitrate can be given to patients for short-term symptom management and prophylaxis before exercise?

GTN

17

Which cardiac drug is it possible to develop tolerance to?

Nitrates

18

What is the most common side effect of nitrates?

Headaches

19

Which chemical conversion do ACE inhibitors prevent?

Angiotensin 1 to angiotensin 2

20

Why do ACE inhibitors cause an irritating dry cough?

They prevent the inhibition of bradykinin - a chemical which irritates the nerve endings

21

What drug are patients converted to if they experience an irritating dry cough with ACE inhibitors?

ARBs e.g. losartan

22

Where do ACE inhibitors have their greatest effect?

Angiotensin sensitive vascular beds e.g. in brain, heart kidney

23

What effects do ACE inhibitors have on the vasculature?

Cause both venous and arteriolar dilatation, reducing preload, afterload and total peripheral resistance

24

Other than dry cough, what is another adverse effect of ACE inhibitors initially?

Hypotension, especially in patients treated with diruetics

25

Which cardiac drugs are contraindicated in pregnancy?

ACE inhibitors and ARBs

26

Why are ACE inhibitors useful in cardiac failure?

They decrease vascular resistance i.e. afterload
Counter inappropriate activation of the RAAS

27

Why are ACE inhibitors useful in hypertension?

Reduced TPR and MABP

28

What does stimulation of the alpha 1 adrencoceptors enhance?

Vasoconstriction

29

Why are beta blockers useful in angina?

Increase window for coronary blood flow by increasing length of diastole (HR overall slowed)
This allows better perfusion of left ventricle
Myocardial O2 requirement reduced - cardiac work load reduced due to decreased HR and SV

30

Why are beta blockers useful in hypertension?

Reducing HR means CO decreased, thus MABP is decreased (MABP = CO x TPR)
Reduces renin release from kidney