Cardiology Medications Flashcards Preview

Drugs > Cardiology Medications > Flashcards

Flashcards in Cardiology Medications Deck (30):
1

Name some typical ACE-Is

Ramipril
Enalapril

2

Why do these medications cause a dry cough in 10% of people? How is this remedied?

They prevent breakdown of bradykinin, which accumulates to give these symptoms
Replace with Angiotensin Receptor Block, Candesartan or Losartan.

3

In which people are ACE-I and ARBs inefficacious?

Afro-carribean

4

Drug interactions of ACE-I?

Lithium (sodium and potassium deviations (particularly Na).
mTOR inhibitors
NSAIDs (renal impairement- could accidentally cause an AKI).

5

Other side effects of an ACE-I? Do ARBs have these?

Dizziness, postural hypotension and taste
(metallic) and electrolyte disturbances.

take before bed

Yes

6

How do ACE-I affect potassium? how might this manifest??

hyperkalaemia
tachycardia

7

Are ACE-I prone to hypersensitivity reactions?

In some people they can manifest as a rash

8

Who should you avoid giving ACE-I to?

Afro-Car
Pregnant
Renal stenosis

NB: ACE I's are nephrotoxic (because that is where they are metabolised, and if AKI already present there...), but also they're nephroprotective at the same time due to cardiac remodelling that reduces renal HT.

9

How do Calcium Channel Blockers act?

They bind to L type calcium channels on vascular smooth muscle and cardiac myocytes
These regulate contractions
The channels also regulate pacemaker cells and can decrease contraction through the AV node

10

Two types of CCBs?

Dyhydropyridines: reduce smooth muscle contraction, decreasing afterload and LV force. Does not bind heart
Non-Dyhydropyridine: These slow down AV-conduction, thus having anti-arrythmic effects. Binds to the heart

overall they slow down contractility and conductivity

11

What other conditions can CCBs be used for?

arrthymia
angina

12

Examples of DHPs?

Amlodipine
nifedipine

13

examples of Non-DHPs?

Verapamil
diltiazem

14

Which CCB should you prescribe by brand?

dilitiazem; due to issues with bioavailability

15

Side effects of CCBs?

(reduced oxygen demand)

lowered BP
bradycardia
could precipitate AV block
abdo pain
headache
peripheral oedema

16

Drug interactions of CCBs?

avoid with beta blocker: asystole risk

17

Examples of beta blockers??

Atenolol (beta 1 )
Propanolol (non-selective, therefore both 1 & 2)

18

How do beta blockers act?

They target beta 1: a major cardiac component, blocking norepinephrine released by sympathetic adrenergic nerves

19

Define the following:
Chronotropy:
Ionotropy
Dromotropy
Lusitropy

Components of sympathetic system, describing what hey stimulate
HR
contractility
electrical conduction
Relaxation

20

What other conditions can beta blockers be used for?

arrthymia and UA

21

Common side effects of beta blockers?

bronchospasms, fatigue, bradycardia, hypoglycaemia, acute heart failure aggravation
Sutolol associated with nightmares or vivid dreams!

22

Common contraindications of beta blockers?

interaction with verapamil causing asystole
asthma
HF/ block
uncontrolled diabetes
occluded extremities

23

What are cardiac glycosides?

Digoxin. alters K and Na exchange and inhibits ATP-action, resulting in decreased heart contractility. Positive ionotrope, negative chronotrope. Also inhibits vagal impulse to reduce sympathetic tone

24

When would you prescribe digoxin? Be cautious of what?

Counselling points for digoxin?

Congestive heart failure. Also supraventricular dysrhythmias,particularly atrial fibrillation
V good in v. young and sedentary people (elevations in HR problematic if active).
Narrow TW: caution in elderly and with thyroid disorders
Be very cautious with dosaging. Anorexia, nausea and
vomiting in babies you might see sinus bradycardia


CNS disturbances and dizziness, Visual disturbances
– blurred vision
• Nausea and vomiting
• Skin rashes- usually present together with
eosinophilia

25

What are K channel agonists/activators?

Act by: Dilation of the arterial and venous return in some cases, smooth muscle in the hyperpolarised state relaxes.
• Nicorandil has no direct effect on myocardial contractility.
• Minoxidil is indicated for the treatment of severe hypertension.

26

Prescribing Nicorandil or Minoxidil: what should you warn patient about?

Do not prescribe with...

Flushing and headaches and Dizziness
Salt and water retention
Feeling weak and Mouth ulcers- Nicorandil

• Sildenafil (synergy)

27

What causes hypertension?

Primary : 90-95% of cases, unknown genetic factor likely
Secondary HT: renal disease, endocrine (cushing's), vascular (renal artery stenosis)
Diet
Oestrogens
NSAIDs
Steroids

28

What is bendroflumethiazide?

thiazide diuretic, it's in the name you goon


Bendroflumethiazide is a thiazide diuretic which works by inhibiting sodium reabsorption at the beginning of the distal convoluted tubule (DCT). Water is lost as a result of more sodium reaching the collecting ducts. Bendroflumethiazide has a role in the treatment of mild heart failure although loop diuretics are better for reducing overload. The main use of bendroflumethiazide currently is in hypertension (part of the effect is due to vasodilation).

29

Side effects of diuretics? When prescribing be mindful of what?

low K, hypoantremia, hypomagnesia, hypocalcaemia, headache, thirst, dizziness. Gynecomastia for spironolactone


Be aware that it can lead to inappropriate diuresis. Gynecomastia w spirinolactone. Postural hypotension. Increased AKI risk. Hypokalaemia w digoxin

30

What conditions are diuretics fantastic for??

congestive heart failure
acute pulmonary oedema
ascites
(reduction of pre-load and afterload)