Cardiology Drugs Flashcards by Max Hayden

Loop Diuretic Examples

Furosemide, Bumetanide, Torsemide

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How do Loop Diuretics work?

Act on ascending limp to inhibit Na+/K+/2CL- co-transporter

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Loop Diuretic Indications

Acute Pulmonary Oedema, Heart Failure, Fluid overload due to other causes

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Loop Diuretic Contra-indications

Hypovolaemia, Dehydration, Hypokalaemia/Hyponatraemia

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What disease can Loop Diuretics worsen and why?

Gout - Loop Diuretics inhibit uric acid excretion

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Loop Diuretic Side Effects

Dehydration, Hypotension, Hearing loss/Tinnitus

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What drugs levels are increased by Loop Diuretics?

Lithium, Digoxin, Aminoglycosides

should be careful of this in all diuretics

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Thiazide Diuretic Examples

Chlorthiazide, Indapamide, Metolazone

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How do Thiazide Diuretics Work?

Inhibit the Na+/CL- co-transported in the Distal Tubule

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Thiazide Diuretic Indications

Hypertension, First line if CCBs aren’t tolerated, Third line if ACE + CCB doesn’t work

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Thiazide Diuretic Contra-indications

Hypokalaemia, Hyponatraemia, Gout

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What drug class reduces the effectiveness of Thiazide Diuretics?

NSAIDs

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Potassium Sparing Diuretics Examples

Spironolactone, Amiloride, Eplerenone

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Potassium Sparing Diuretics Indications

Combination therapy with Loop/Thiazide diuretics to reduce potassium loss

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Potassium Sparing Diuretics Contra-indications

Renal impairment, Hyperkalaemia and Hypokalaemia (unpredictable)

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Beta-Blocker Examples

Bisoprolol, Atenolol, Propranolol

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How do Beta-Blockers Work?

Block Beta1-adrenoreceptors (in heart) = reduced contraction and speed of conduction in heart

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Beta-Blockers Indication

Angina/ACS, Heart failure, AF, SVT

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Beta-Blockers Contra-indications

Asthma (bronchospasm), Heart block

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Beta-Blockers Side-Effects

Fatigue, Cold Extremities, Sleep disturbance, Impotence

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Beta-Blocker Interactions

Don’t use with non-dihydropyridine calcium channel blockers = heart failure / asystole

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Non-dihydropyridine Calcium Channel Blocker Examples

Diltiazem, Verapamil

heart

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Dihydropyridine Calcium Channel Blocker Examples

Amlodipine, Nifedipine

vasculature

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How do Calcium Channel Blockers Work?

Decrease Ca2+ entry into cells = Relaxation, Vasodilation, Reduced contractility

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Calcium Channel Blockers Indications

Hypertension, Stable Angina

Calcium Channel Blockers Contra-Indications

Heart failure, AV delay

Calcium Channel Blockers Side Effects

Ankle Swelling, Flushing, Palpitations, Bradycardia

What drugs shouldn't you prescribe Non-dihydropyridine Calcium Channel Blockers with?

Beta-blockers

ACE Inhibitor Examples

Ramipril, Fosinopril, Enalapril

How do ACE Inhibitors Work?

Block conversion of angiotensin I to angiotensin II (which is a vasoconstrictor)

ACE Inhibitors Indications

Hypertension, Heart Failure, Angina/ACS, CKD

ACE Inhibitor Contra-Indications

Renal artery stenosis, AKI, Pregnancy

ACE Inhibitor Side Effects

Dry Cough, Hypotension (after first dose)

ACE Inhibitor Interactions

Potassium-Elevating drugs, NSAIDs (renal failure)

Angiotensin Receptor Blockers Examples

Losartan, Candesartan

Angiotensin Receptor Blockers Indications

Used as an alternative to ACE inhibitors | same contra-indications and side-effects

How do Nitrates work?

Converted to NO = Reduced Ca2+ in vascular smooth muscle cells

Nitrate Indications

Acute angina/ACS Pain, Prophylaxis of angina (long acting)

Nitrate Contra-indications

Aortic stenosis (=collapse), Hypotension

Nitrate Side Effects

Flushing, Headache, Hyoptension

How does Digoxin Work?

Negatively chronotropic + Positively inotropic

Digoxin Indications

AF, Heart Failure

Digoxin Contra-Indications

Heart block, Ventricular Arrhythmia, Renal failure

Digoxin Side Effects

Visual disturbance, Dizziness, Bradycardia

How does Amiodarone work?

Blocks sodium/calcium/potassium channels and Antagonism of a and b-adrenergic receptors

Amiodarone Indications

Wide Range of Arrhythmias

Why do you have to be careful with Amiodarone?

Many serious side-effects and possible interactions

Anti-Platelet Examples

Aspirin, Clopidogrel, Ticagrelor

How does Aspirin work?

Blocks COX = Reduces thromboxane

Anti-Platelet Indications

ACS, Ischaemic stroke, Long term CVD/PVD

Why shouldn't aspirin be given to under 16yrs olds?

Reye's Syndrome (liver and brain)

Aspirin Contra-indications

Under 16yrs, Pregnancy, Peptic ulcer, Gout

Main side-effect of Anti-platelets?

Increased risk of bleeding (especially when combined)

Thrombolytic Examples

Streptokinae, tPA, Alteplase

How do Thrombolytics work?

Catalyse the conversion of plasminogen to plasmin = Dissolves clot

Thrombolytics Indications

Ischaemic stroke, STEMI, Massive PE

Thrombolytics Side Effects

Hypotension, Cardiogenic shock, Serious Bleeding, Arrhythmia

How does Heparin Work?

Inhibits Thrombin and Factor Xa = Prevents clots

What does Low Molecular Weight Heparin specifically work on?

Factor Xa

Name a synthetic compound that is similar to Heparin?

Fondaparinux

Heparin Indications

DVT, PE, ACS

Heparin Side Effects

Bleeding, Heparin-Induced Thrombocytopenia

Oral Anticoagulant Examples

Warfarin, Dabigatran, Rivaroxaban, Apixaban

How does Warfarin work?

Inhibit Vitamin K cofactors: Factors II, VII, IX, X + Protein C, S, Z

How do DOACs/NOACs work?

Inhibit just one Vitamin K cofactor unlike warfarin

Oral Anticoagulants Indications

DVT, PE, AF, Valve replacements

Oral Anticoagulant Contra-indications

Patients at risk of Bleeding, Pregnancy

What system is Warfarin metabolised by?

CYP450 (many interactions)

Why do Antibiotics increase anticoagulation with Warfarin?

They kill gut flora which normally make Vitamin K

What is the main difference between Warfarin and NOACs?

NOACs are less influenced by diet and other medications

Oral Direct Thrombin Inhibitor NOAC Example

Dabigatran

Oral Direct Factor Xa Inhibitor NOAC Example

Rivaroxaban, Apixaban

Statin Examples

Atorvastatin, Simvastatin, Lovastatin

How do Statins Work?

Inhibit HMG Coa Reductase = Decreased cholesterol Also increase LDL clearance from blood

Statins Indications

Prevention of CVD, Hyperlipidaemia

Statins Contra-indications

Hepatic or Renal impairment, Pregnancy

What is the main Side Effect of Statins?

Muscle aches (can rarely = rhabdomyolisis)

What system are Statins metabolised by?

CYP450

Cardiology Drugs Flashcards

(78 cards)