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Flashcards in cardiovascular drugs Deck (97)
1

what treatment would you give for a hypertensive patient under 55

A
then A + C
then A + C + D
Then ABCD or alpha blocker or extra diuretic

2

how do you treat someone over 55 with hypertension

C
then A + C
then A + C + D
( D = thiazide like diuretic)

3

ramipril

ACE inhibitor

4

lisonopril

ACE inhibitor

5

losartan

Angiotensin receptor agonist - ARB

6

aliskiren

Renin inhibitor

7

amlodipine

Calcium channel blocker(dihydropyridine like)

8

lercanidipine

Calcium channel blocker (dihydropyridine like)

9

indapamide

thiazide like diuretic

10

bendroflumethiazide

thiazide like diuretic

11

bisoprolol

B blocker

12

atenolol

B blocker

13

doxazosin

alpha blocker

14

Potassium sparing diuretic/ aldosterone antagonist

spironolactone

15

dry cough, dizziness, headaches, tiredness

ACE inhibitor

16

dizziness, headaches, leg pain

ARBs

17

flushes, headaches, ankle oedema, dizziness

Calcium blocker

18

raised potassium and blood sugar levels

thiazide like diuretic

19

furosemide

loop diuretic

20

candesartan

ARB

21

carvedilol

B blocker

22

side effect of loop diuretics

gout

23

digoxin

AF

24

opiates

reduce anxiety and preload

25

nitrates

preload and afterload

26

dobutamine

beta 1 agonist
increases myocardial contractility
acute reversible heart failure

27

dopamine

increases renal perfusion and BP, improves contractility
acute heart failure and cardiogenic shock

28

adrenaline

increases contractility

29

ivabradine

anti angina
reduces heart rate by blocking funny channels

30

ranolazine

anti angina
inhibits Na
thereby reducing heart workload

last resort

31

Nirocandil

vasodilator for angina

activation of K channels
hyperpolarises smooth muscle

32

what type of angina is demand ischaemia

chronic stable

33

which drugs are vasodilators

organic nitrates
nicorandil
Ca antagonists

they reduce preload and afterload

34

which drugs slow down the heart

ivabradine
B blockers

35

what are the two types of Ca blocker

dihydropyridine derivatives
rate limiting

36

verapamil and diltiazem

rate limiting ca blocker
can impair AV conduction

37

amlodipine and lercanidipine

dihydropyradine derivatives ca blocker

use in variant angina or alongside beta blocker

38

head aches, constipation, ankle oedema

ca antagonist

39

which ca antag is used as an antidysrhythmic

verapamil

used in SVTs

40

what ca antag are used in hypertension

amlodipine or lercanidipine

41

how do organic nitrates work

metabolised to NO and relaxes vascular smooth muscle
reduces preload
dilates coronary vessels
esp in variant angina
may dilate collaterals

42

isosorbide mononitrate

used long before exertion
angina pectoris
dilates blood vessels

43

intravenous GTN

unstable angina
acute heart failure

44

headaches and postural hypotension

organic nitrates

45

sublinguinal GTN

just before exercise

46

isosorbide mononitrate with hydralazine

chronic heart failure

47

headaches, flushing, dizziness

nicorandil

48

what is a class 1 antidysrhythmic

blocks fast sodium channels

49

what is a class 2 antidysrhythmic

blocks Beta adrenergic receptors

50

what is a class 3 antidysrhythmic

potassium channel blocker
prolongs the duration of action potential repolarisation

51

what is a class 4 antidysrhythmic

blocks Ca channels

52

what other two drugs are used to treat dysrhythmia but don't fit into the Vaughn-Williams classification

digoxin and adenosine

53

where do thiazide like diuretics act

DCT

54

where does spironolactone act

collecting tubule

55

dry cough, dizziness, tiredness, headaches

ACE inhibitors

56

back/ leg pain, dizziness, headache

angiotensin receptor antagonist (ARB)

57

flushes, headaches, ankle oedema, dizziness

Ca channel blockers

58

raised potassium and blood sugar levels

thiazide like diuretics

59

what is the treatment plan for heart failure

D A B

NOT C!
(do not want to decrease contractility)
unless co existing angina :) -amlodipine

60

what are the symptoms of heart failure

SOB
swelling
lack of energy
difficulty sleeping
swollen abdomen
cough with frothy sputum
increased urination
confusion

61

what are the main drugs used in chronic heart failure

furosemide
ramipril lisinopril
candersartan
bisoprolol
carvedilol
spironolactone

62

where do loop diuretics act

thick ascending loop

63

what are the 4 effects of angiotensin

vascular growth and hypertrophy
vasoconstriction
salt retention
aldosterone secretion

64

what is the effect of beta blockers

slows heart rate
allows the ventricle to fill more completely
vasodilation- decreased afterload

65

hyperkalaemia, hyponatraemia, nasea, hypotension

aldosterone receptor antagonists (spironolactone, eplerenone)

66

acute gout

loop diuretics

67

what does digoxin do

increased vagal activity
increases contractility by increasing Ca levels

68

what are the initial treatments for acute heart failure

loop diuretics - venodilation and diuresis
opiates - reduce anxiety and preload
nitrates- reduce preload and afterload

69

what are second line treatments for acute heart failure

ionotropes - beta agonists eg dobutamine
dopamine - increases renal perfusion
adrenaline- increases contractility

70

disopyramide

1a sodium channel blocker

used in ventricular dysrhythmia and AF

71

lignocaine

1b sodium channel blocker

prevents ventricular tachycardia and fibrillation after MI

72

flecainide

1c sodium channel blocker

suppresses ventricular ectopics, paroxysmal AF and reccurent tachycardias

73

sotalol

b blocker used in dysrhythmia

74

amiodarone

potassium channel blocker

75

verapamil

calcium channel blocker

76

how do class 1 arrhythmia drugs work

reduce the rate of cardiac depolarisation during phase 1

77

what does use dependant mean

work more effectively if there is high activity eg tachycardia

78

how do b blockers work

reduce cAMP which reduces Ca influx

79

what is the usual ending for arbs

-artan

80

what is the care pathway for pts with hypetension

lifestyle interventions
patient education
annual review of care

if younger than 40 consider specialist referral

if stage 2 hypertension or organ damage then antihypertensive drugs

81

what would you offer a pt with a dry cough after ACE inhib

Angiotensin 2 receptor blocker aka ARB

82

what would you offer someone with resistant hypertension

further diuretic
or alpha blocker or beta blocker

83

what ACE inhibitors would you use in hypertension

ramipril, lisinopril

84

what arb would you use in hypertension

losartan

85

what renin inhibitor would yo use in hypertension

aliskerin

86

what calcium blockers would you use in hypertension

amlodipine, lercanidipine
i.e. dihydropyradine like

87

what diuretics would you used in hypertension

indapamide, bendrofluomethiazide

88

what b blockers would you use in resistant hypertension

atenolol or bisoprolol

89

what alpha blockers would you use in resistant hypertension

doxazosin

90

what loop diuretic would you use in chronic heart failure

furosemide

(gout)

91

what ACE inhibitor would you use in chronic heart failure

ramipril and lisinopril

92

what arb would you use in chronic heart failure

candesartan

93

what B blocker would you use in chronic heart failure

bisoprolol or carvedilol

94

what aldosterone receptor antagonist would you use in chronic heart failure

spironolactone

(hyperkalaemia, hyponatraemia, nausea and hypotension)

95

what Ca inhibitor would you use in chronic heart failure with coexisting angina

amlodipine

96

what is EDRF

endothelin derived relaxing factor
causes relaxation of smooth muscle in the vessel wall

97

what are the 3 main drugs used in angina

nitrates
b blockers
ca antagonists