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Drug Profiles > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Examples: loop diuretics

A

furosemide, bumetanide

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2
Q

loop diuretics - how do they work?

A

inhibits Na, Cl, K reabsorption in ascending loop of henle

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3
Q

indications: loop diuretics

A

pulmonary oedema due to LVF. Chronic heart failure. Kidney impairment. resistant hypertension

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4
Q

Contra-indications: loop diuretics

A

electrolyte imbalance. renal dysfunction. Gestational hypertension

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5
Q

Side effects: loop diuretics

A

dehydration, hypotension, any low electrolyte state, tinnitus

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6
Q

Interactions: loop diuretics

A

NSAIDs (reduce diuretic efficiency), corticosteroids (enhance hypokalaemia), aminoglycosides (enhance ototoxicity/nephrotoxicity)

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7
Q

Examples: thiazide diuretic

A

bendroflumethiazide

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8
Q

bendroflumethiazide - how does it work?

A

inhibits NaCl transporter in distal tubule. Inhibit Na reabsorption and so also decrease H2O reabsorption

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9
Q

Indications - bendroflumethiazide

A

hypertension. oedema secondary to heart failure. prophylaxis of Ca containing renal stones.

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10
Q

Contra-indications - bendroflumethiazide

A

electrolyte imbalance. renal dysfunction. pregnancy. Addison’s disease. Gout.

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11
Q

Side effects: bendroflumethiazide

A

cardiac arrhythmias due to hypokalaemia and hyponatraemia. Male impotence. Thrombocytopenia.

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12
Q

Interactions - bendroflumethiazide

A

NSAIDs (reduce diuretic efficacy). B-blockers (potentiate hyperglycaemia). Corticosteroids (enhance hypokalaemia) ACEi, lithium, digoxin, theophylline

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13
Q

examples: potassium sparing diuretics

A

spironolactone, amiloride

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14
Q

potassium sparing diuretics: how does it work?

A

competitive antagonists that either compete with aldosterone for intracellular cytoplasmic receptor sites or directly block Na channels. Prevents Na reabsorption and K/H ion secretion

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15
Q

Indications: potassium sparing diuretics

A

hypokalaemia. oedema from hepatic cirrhosis, congestive heart failure, Conn’s syndrome

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16
Q

Contra-indications: potassium sparing diuretics

A

severe renal impairment, hyperkalaemia, volume depletion, Addison’s disease, pregnancy

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17
Q

Side effects: potassium sparing diuretics

A

GI problems, dizziness, hypotension, urinary issues, skin rash

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18
Q

Interactions: potassium-sparing diuretics

A

aldosterone antagonists, digoxin, lithium, cyclosporins, ACEi, NSAIDs

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19
Q

Examples: Beta blockers (class II anti-arrhythmic)

A

atenolol, propanolol, bisoprolol

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20
Q

Beta blockers - how does it work?

A

block epinephrine/adrenaline from binding to B-receptors. Reducing heart contraction force, conduction speed, more perfusion. Reduce renin secretion caused decreased blood pressure

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21
Q

Indications - beta blockers

A

angina, ACS, chronic heart failure, AF, supraventricular tachycardia, hypertension (2nd line), panic disorder, anxiety

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22
Q

Contra-indications: beta-blockers

A

asthma, caution in COPD, heart failure, heart block, unstable angina, sick sinus syndrome

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23
Q

Side effects: beta-blockers

A

fatigue, headache, nausea, sleep disturbance, male impotence, liver damage, can mask hypoglycaemia

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24
Q

Interactions: beta-blockers

A

Ca channel blockers (verapamil/diltiazem), bradycardia

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25
Q

Examples: calcium antagonists

A

Diltiazem, amlodipine

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26
Q

Calcium antagonists - how does it work?

A

reduced calcium relaxes smooth muscle –> lowers pressure. Lower cardiac conduction rate, contractility and afterload. Less oxygen demand.

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27
Q

Indications - calcium antagonists

A

hypertension, stable angina, cardiac arrhythmias, cerebral vasospasm

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28
Q

Contra-indications: calcium antagonists

A

poor LV function (heart failure), AV conduction delay (heart block), unstable angina, severe aortic stenosis

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29
Q

Side effects: calcium antagonists

A

ankle oedema, headaches, flushing, palpitations, constipation

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30
Q

Interactions: calcium antagonists

A

beta blockers, cyclosporins, digoxin, theophylline

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31
Q

Examples: ACEi

A

ramipril, losartan

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32
Q

ACEi - how does it work?

A

Reduce RAAS activity. block the conversion of angiotensin I –> angiotensin II, lowering arteriolar resistance and increasing venous capacity. Reduces aldosterone. Reduces preload.

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33
Q

Indications: ACEi

A

hypertension. Reduce stroke and MI risk. Chronic heart failure. Diabetic nephropathy

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34
Q

Contra-indications: ACEi

A

renal artery stenosis, acute kidney injury, pregnancy

35
Q

Side effects: ACEi

A

persistent dry cough, hypotension, hyperkalaemia, angioedema

36
Q

Interactions: ACEi

A

NSAIDs, potassium elevating drugs

37
Q

Examples: nitrates

A

isosorbide mononitrate

38
Q

Nitrates - how do they work?

A

stimulates guanylate cyclase which decreases intracellular Ca. Relaxation of muscle cells and dilation of blood vessels. VASODILATION of vessels by donating NO.

39
Q

Indications - nitrates

A

angina. ACS. pulmonary oedema. left ventricular heart failure

40
Q

contra-indications: nitrates

A

severe aortic stenosis, hypotension, electrolyte imbalance, Wolf-Parkinson-White syndrome

41
Q

Side effects: nitrates

A

flushing, headaches, light-headedness

42
Q

interactions: nitrates

A

phosphodiesterase inhibitors, viagra, tri-cyclic antidepressant

43
Q

Examples: cardiac glycosides

A

digoxin

44
Q

Cardiac glycosides - how does it work?

A

inhibits Na/K ATPase pumps, increased myocyte contraction, increased parasympathetic tone. decreased heart rate, increased contraction force

45
Q

Indications: cardiac glycosides

A

congestive heart failure, AF, flutter

46
Q

Contra-indications

A

electrolyte imbalance, 2nd degree heart block, ventricular arrhythmias, renal failure

47
Q

Side effects: cardiac glycosides

A

bradycardia, GI effects, blurred vision

48
Q

Interactions: cardiac glycosides

A

loop/thiazide diuretics, amiodarone, calcium channel blockers, NSAIDs

49
Q

Examples: anti arrhythmic drugs (class III)

A

amiodarone

50
Q

anti-arrhythmic drugs - how does it work?

A

bind to and block potassium channel channels that are responsible for phase 3 repolarization. prolongs action potential and refractory period.

51
Q

Indications - anti-arrhythmic agents

A

dysrhythmias

52
Q

Contra-indications- anti-arrhythmias

A

heart block, thyroid dysfunction

53
Q

Side effects: anti-arrhythmic agents

A

hepatitis, photosensitivity, colour loss, thyroid problems

54
Q

Interactions: anti-arrhythmias

A

digoxin, diltiazem, verapamil

55
Q

What drug class is aspirin?

A

NSAID

56
Q

aspirin: how does it work?

A

irreversibly inhibits COX. Stops formation of arachidonic acid –> thromboxane. Decreased platelet aggregation

57
Q

Indications: aspirin

A

ACS, acute ischaemic stroke, AF, fever

58
Q

Contra-indications: aspirin

A

children under 16 (Reye’s syndrome), pregnancy, peptic ulcer disease, gout

59
Q

Side effects: aspirin

A

bronchospasm, tinnitus, GI haemorrhage

60
Q

Interactions: aspirin

A

anticoagulants

61
Q

Examples: antiplatelet agent

A

clopidogrel, ticagrelor

62
Q

antiplatelet - how does it work?

A

adenosine diphosphate receptor antagonist. Decreased platelet aggregation

63
Q

Indications: anti-platelet

A

ACS, preventing coronary artery stent occlusion, CVD, AF

64
Q

Contra-indications: anti-platelet

A

active bleeding, renal/hepatic impairment, haemophilia

65
Q

Side effects: anti-platelet

A

bleeding, GI upset, thrombocytopenia

66
Q

interactions: anti-platelet

A

cytochrome p450 inhibitors, aspirin, heparin, warfarin, NSAIDs

67
Q

Examples: tissue plasminogen activator

A

heparins (enoxaparin)

68
Q

Tissue plasminogen activator - how does it work?

A

inhibits thrombin and factor Xa. UFH activates anti-thrombin, inactivate Xa. LMWH directly inhibit

69
Q

Indications: tissue plasminogen activator

A

VTE, DVT, PE, ACS

70
Q

Contra-indications: tissue plasminogen activator

A

clotting disorders, severe hypertension, trauma/invasive surgery, renal impairment

71
Q

Side effects: tissue plasminogen activator

A

bleeding, injection site reactions, heparin induced thrombocytopenia

72
Q

Interactions: tissue plasminogen activator

A

antiplatelets, anticoagulants, nicotine, antihistamines

73
Q

Examples: anticoagulants

A

warfarin, rivaroxaban

74
Q

Anticoagulants - how does it work?

A

rivaroxaban = factor Xa inhibitor. inhibits vitamin K reductase so theres no vitamin K reactivation. Coagulation factor synthesis

75
Q

Indications - anticoagulants

A

DVT, PE, preventing embolic complications in AF

76
Q

Contra-indications - anticoagulants

A

pregnancy, haemorrhagic risk, liver disease

77
Q

Side effects - anticoagulants

A

bleeding, alopecia

78
Q

interactions - anticoagulants

A

alcohol. cytochrome p450 inhibitors (omeprazole, ciprofloxacin, erythromycin). cytochrome p450 inducers (phenytoin, carbamazepine, rifampicin)

79
Q

Examples: statins

A

simvastatin

80
Q

statins - how does it work?

A

inhibit HMG-CoA reductase. Clears LDLs and reduced triglyceride levels, increases HDL levels

81
Q

Indications - statins

A

primary/secondary cardiovascular disease prevention, primary hyperlipidaemia

82
Q

Contra-indications - statins

A

pregnancy, liver disease, renal disease

83
Q

Side effects - statins

A

headache, GI issues, myopathy, rhabdomyolosis, high liver enzyme levels, hyperglycaemia

84
Q

Interactions - statins

A

cytochrome p450 inhibitors (amiodipine)

Drug Profiles (3 decks)

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