Coronary (not chronic) Heart Disease Therapeutics Flashcards Preview

Hugh's MD2 Foundation > Coronary (not chronic) Heart Disease Therapeutics > Flashcards

Flashcards in Coronary (not chronic) Heart Disease Therapeutics Deck (21):
1

What are the front line drugs in coronary heart disease?

Beta-blockers

Statins

Angiotension system blockers (ACEi and ARBs)

Anti-platelets

Antianginals

2

How do beta-blockers aid in the treatment of coronary heart disease?

Block sympathetic input > Reduce HR and contractility > Reduce O2 demand > Reduce ischaemia = Symptomatic control

Reduced SNS driven pathological ventricle remodelling = Long term improvement in mortality

3

Which beta-blockers are used in coronary heart disease?

Metoprolol

Atenolol

4

What are the side effects of beta-blockers?

Exercise intolerance

Lethargy

Tiredness

Bronchospasm

Hypotension

Bradycardia

Erectile dysfunction

Vivid dreams

 

5

When are beta-blockers contraindicated?

Hypoglycaemic diabetics as they might mask hypo's

Hyperglycaemic as they disrupt control

6

What cohort of patients with CHD should be on statins?

All of them regardless of LDL levels

7

What are the side effects of statins?

Rare

Myalgia

Rhadomyolysis

Elevated AST and ALT

8

Arrange these statins in order of their potency

Atorva

Rosuva

Simva

Prava

Prava

Simva

Atorva

Rosuva

9

Why are angiotension system inhibitors used in coronary heart disease?

Prevent their stimulation of pathological ventricular remodelling. Enlarged ventricles are more susceptible to CHD (and HF)

10

Which ACEi are used for coronary heart disease?

Perindopril

Ramipril

11

What are the side effects of ACEi?

Dry cough

Hyperkalaemia

Renal impairment

Hypotension

Angioedema

Teratrogen

 

12

What angiotension receptor blockers are used in CHD?

Irbesartan

Candesartan

Olmesartan

13

What dose of aspirin is used in CHD?

75-150mg

14

How does clopidogrel work?

Inhibits ADP necessary for platelet activation

15

When is clopidogrel used?

When aspirin is contraindicated (bleeding risk)

Or on top of aspirin

16

What major drug drug interaction does clopidogrel have?

With PPIs as they block metabolism of its pro-form

17

How are nitrates used in CHD? How do they work?

Symptomatic control

Dilate coronary arteries

18

What are the side effects of nitrates?

Headache

19

Which Ca channel blockers are sometimes used in CHD?

Dihydropyridines eg amlodipine

- vasodilate: peripheral and coronary

No mortality benefit

20

What are the side effects of dihydropyridines?

Hypotension

Peripheral oedema

Flushing

21

Why don't verapamil and diltiazem provide long term mortality benefit?

They don't prevent pathological remodelling