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drugs Flashcards

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1
Q

under 55 not black HTN

A

give them ACEi

ramipril

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2
Q

over 55 htn

A

give CCB
amlodipine
nifedipine

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3
Q

under 55 black htn

A

CCB
amlodipine
nifedipine

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4
Q

e.g of CCB

A

amlodipine

nifedipine

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5
Q

e.g of ACEi

A

ramipril

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6
Q

SE of ACEi

A

dry cough - bradykinin accumulation

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7
Q

2nd line of HTN over 55

A
    • CCB

2. CCB+ ACEi

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8
Q

3rd line

A

A+C+D

add thiazide like duiretic (indapamide)

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9
Q

4th line

A

A+C+D+ more D
or a diff D
or add an alpha or beta blocker

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10
Q

what is it called when you have given ACEi CCB and Diuretic and still cant control HTN

A

resistant HTN

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11
Q

e.g of alpha blocker for resistent HTN

A

doxazosin

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12
Q

e.g of duiretic used in HTN mangaement

A

thiazide like duiretic = indapamide

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13
Q

when would you use ARB in HTN management

A

instead of ACEi if contraindicated

e.g candesartan

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14
Q

e.g of ARB

A

candesartan

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15
Q

what is an aldsoterone antagonsit used for

A

increase sodium and water excretion and potassium retention in DCT -
used in fluid – ascites oedema in liver cirrohoiss = SPIRONOLACTONE
chronic heart failure - alongside BBs or ACEi or ARB
in conns

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16
Q

what is an example of aldosterone antagonist

A

spironolactone

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17
Q

side effect of aldosterone anatgonist

A

hyperkalcaeimiea – arrythmias

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18
Q

CI of aldosterone antagonists

A

hyperkalcaemia

Addisons (low cortisol)

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19
Q

e.g of a alpha blocker

A

doxazosin

tamulosin

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20
Q

what does alpha blockers do

A

block alpha 1 adreno receptors in smooth muscle inducing relaxation == vasodilation
reduced resistance to bladder outflow

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21
Q

what condition are alpha blockers used in

A

benign prostatic hyperplasia
tamulosin (alpha 1 antagonist)
AND resistant hypertension(doxazosin only)

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22
Q

what does ACEi do

A

blocks ACE so prevents the conversion of angiotension 1 to angiotensin 2. lowers perpipheral vasc resistance - especially efferent glomerular arteriole

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23
Q

side effect of ramipril

A

=ACEi
SE= hypOtension
dry cough
hyperkalaemia as low aldosterone promotes aldosterone secretion

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24
Q

what is an angiotensin receptor blocker

Study These Flashcards
A

blcoks angiotensin 2 action of the AT1 receptor = reduces periph vasc resistance
reduces aldosterone lever
promotes sdium and water excretion lowering venous preload

25
when are ACEi and ARBs used
``` HTN CHF - ACEi first ARBs next IHD Diabetic neuropathy and CKD with proteinuria ```
26
side effect of ARBs
renal failure - renal artery stenosis
27
CI of ARBs and ACEi
renal artery stenosis AKI pregnacny
28
betablocker examples
bisoprolol (B1) atenolol (middle) propanolol (non selective)
29
what do beta blcokers do (b1)
block the b1 adrenergic receptor located in heart reduces force of contraction and speed of conduction releives cardiac ischaemia prolongs AV node refractory period reduces renin secretion by b1 recep in kidney
30
when BB used
``` IHD - 1st line - improves angina prognosis CHF - 1st line AF-1st line SVT - HTN - when CCBs and ACEi inapp ```
31
SE of BB
headache | nausea
32
contraindication of BBs
asthma - blocks b2 airway receptors - broncho spasm therefore chose cardioselectvie BBs
33
what antiarythmic class is BBs
class 2
34
whats a calcium cahnnel blocker 2 types
dihydropyridines | non dihydropyridines
35
e.g of ccbs
dihydropyrodines - nifedipine = vascualr selective | non dihydropyridines - verapamil - heart selective
36
what does verapamil do
supress cardiacc conduction of heart. blocks calcium channels reducing heart rate and oxygen demans
37
what does nifedipine do
decreaes calcium entry uno vascualrr and cardiac cells - vasodilation = lowers bp
38
SE of ccb
``` ankle oedema (due to vasodilation) headache ```
39
when is CCB CI
``` unstable angina aortic stenosis (severe) ```
40
what class antiarthymic is CCB
4
41
what is adenosine
1st line of supraventric tachycardias (AF and ATRIAL FLUTTER) stable angina = 2nd line activates adenosine receptors in heart - slows sinus rhymthim
42
what is SE of adenosine
bradycardia
43
who CI in adenosine
assthma and COPD as broncho spasm
44
what is amiodarone
blocks K Na Ca channels prolonging repolarization anatgonises alpha and beta adreno receptors interferes with AV nodal conduction
45
when is amiodarone used
``` tachyarrythnmias AF Atrial flutter SVT VT refractory VF (when electriccal defib inapporporiate) ```
46
SE of amiodarone
hypOtension
47
what is an example of a fibrolytic drug
alteplase
48
what does alteplase fo
catayses conversoion of plasminogen to plasmin - dissolves fibrinous clots == allows reperfusion
49
when would u use alteplase
1st line in ISCHAEMIC stokes WITHIN 4.5hrs actue STEMI within 12hrs with antiplatelets and anticoag 2nd line to PCI massive pulmonary embolism
50
SE of alteplase
bruising | N+V
51
CI of alteplase
recent haemorrage trauma or surgey bleeding disorders HAEMORRHAGIC STROKE (hence CT scan first)
52
what is digoxin
negatively chronotropic positive inotropic indirectily increased vagal tone inhib Na/K ATPase causeing Na to accumulate increasing contractile force
53
when use digoxin?
atrial fib and flutter 2nd line to BB and CCB severe Heart failure 3rd to ACEi BB etc
54
nitrates examples
glycerol trinitrate = short acting
55
what are nitrates
converted to nitric oxide -- increases cGMP synth - reduces smooth muscle intracell Ca = relaxation venous and arteral vasoldilation
56
when is nitrate used
stable angian and ACS angina prophylaxis pulmonary oedema - plus furosemide and oxygen
57
what is furosemide
loop diuretic
58
SE of nitrates
flushing headache hypotension
59
who is CI for nitrate use
severe aortic stenosis - cardiovascualr collapse as cant comp for the dilated vasculature

2a RRS (26 decks)

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