cardio pharmacology

Question 1

what drugs are given to a patient with stable angina?

Answer 1

• beta blockers
• nitrates
• calcium channel antagonists
  statins

Question 2

what is the function of beta blockers?

Answer 2

reduce heart rate- negatively chronotropic and inotropic

Question 3

what is the function of nitrates?

Answer 3

• primary venodilators

- dilate systemic veins to reduce venous return, so reduce work of heart and O2 demand

Question 4

what is the function of calcium channel antagonists`?

Answer 4

• primary arteriodilators
• dilate systemic arteries- so reduce after load on heart, so less energy required to produce the same CO, so less work on heart and O2 demand

Question 5

what is the function of statins?

Answer 5

• HMGCoA inhibitors

- reduce LDL levels in blood

Question 6

what is the function of aspirin?

Answer 6

irreversible inactivation of cyclooxygenase 1

Question 7

what 2 drugs are involved in dual anti platelet therapy for ACS?

Answer 7

aspirin and P2Y12 inhibitors

Question 8

what 5 drugs are used in the secondary prevention of ACS?

Answer 8

• aspirin
• P2Y12 inhibitors
• statins
• ACE inhibitors
• beta blockers

Question 9

name an example of a P2Y12 inhibitor

Answer 9

clopidogrel

Question 10

what are the 4 classes of diuretics?

Answer 10

thiazides
loop diuretics
potassium-sparing diuretics
aldosterone agonists

Question 11

name an example of a thiazide

Answer 11

bendroflumethiazide

Question 12

name 2 loop diuretics

Answer 12

furosemide and bumetanide

Question 13

where do thiazides act?

Answer 13

distal tubule of the nephron

Question 14

name a potassium sparing diuretic

Answer 14

spironolactone

Question 15

name 2 nitrates

Answer 15

isosorbide mononitrate, GTN spray

Question 16

what are the 4 classes of the Vaughan Williams classification of antiarrythmic drugs?

Answer 16

• class 1- sodium channel blockers
• class 2- beta adrenoreceptor antagonists
• class 3- prolong the action potential
• class 4- calcium channel blockers

Question 17

give an example of a class 1 Vaughan Williams drug in each category (A, b, c)

Answer 17

a- quinidine
b- lidocaine
c- propafenone

Question 18

give 2 examples of class 2 Vaughan Williams drugs

Answer 18

propanolol, nadolol

Question 19

give 2 examples of class 3 Vaughan Williams drugs

Answer 19

amiodarone, sotalol

Question 20

give 2 examples of class 4 Vaughan Williams drugs

Answer 20

verapamil, diltiazem

Question 21

name 2 ACE inhibitors

Answer 21

ramipril, perindopril, enalapril, trandolapril

Question 22

when are ACE inhibitors clinically indicated?

Answer 22

hypertension, heart failure, diabetic nephropathy

Question 23

what are the adverse affects of ACE inhibitors?

Answer 23

• hypotension
• acute renal failure
• hyperkalaemia
• teratogenic effects in pregnancy
• increase in kinin production

Question 24

what symptoms of increased kinin production do ACE inhibitors cause?

Answer 24

cough, rash, anaphylactoid reactions

Question 25

when are ARB's (angiotensin II receptor blockers) clinically indicated?

Answer 25

hypertension, heart failure, diabetic nephropathy

Question 26

give 2 examples of ARB's

Answer 26

candesartan, valsartan

Question 27

what are the adverse effects of ARB's?

Answer 27

symptomatic hypotension, hyperkaleamia, renal dysfunction, rash, angio-oedema

Question 28

when are calcium channel blockers clinically indicated?

Answer 28

hypertension, IHD, tachycardia

Question 29

what are the 3 classes of calcium channel blockers and what are their effects?

Answer 29

dihydropyridines- affect vascular smooth muscle, peripheral arterial vasodilators phenylalkyamines- negative chronotropic and inotropic effect benzothiazepines- affects both heart and peripheral vascular system

Question 30

name 4 dihydropyridines

Answer 30

- nifedipine - amlodipine - felodipine - lacidipine

Question 31

give an example of a phenylalkylamine

Answer 31

verapamil

Question 32

give an example of a benzodiazepine

Answer 32

diltiazem

Question 33

when are beta blockers clinically indicated?

Answer 33

angina, heart failure, arrhythmias, hypertension

Question 34

what are the adverse affects of beta blockers?

Answer 34

fatigue, headache, sleep disturbance, hypotension, bradycardia, cold peripheries, erectile dysfunction

Question 35

what are the adverse effects of dihydropyridines?

Answer 35

Peripheral vasodilation can cause flushing, headache, oedema and palpitations

Question 36

what are the adverse effects of both verapamil and diltiazem?

Answer 36

Negatively chronotropic effects cause bradycardia

Question 37

what are the adverse effects of verapamil?

Answer 37

Negatively inotropic effects cause worsening of cardiac failure, constipation