Drugs Cardio

Question 1

Example of ACE inhibitors?

Answer 1

lisinopril or ramipril

Question 2

when are ace inhibitors used?

Answer 2

hypertension and heart failure

Question 3

side effects of ace inhibitors?

Answer 3

dry cough, postural hypotension, NEVER USE IN PREGNANCY (due to fatal renal damage), renal failure

Question 4

Example of ARBs and when would they be used?

Answer 4

losartan, hypertension and heart failure

Question 5

why are beta blockers used in the treatment of stable angina?

Answer 5

they decrease the myocardial requirement of O2, counter the sympathetic activity associated with pain, and increase the time in diastole (decrease heart rate) which improves the perfusion of the left ventricle

Question 6

what are beta blockers used to treat?

Answer 6

stable angina (as explained before)
hypertension - reduced CO and renin release from the kidney 

heart failure - surpassed the sympathetic nervous system and RAAS (triturate - start low go slow)

Question 7

what is the effect of calcium channel blockers?

Answer 7

interact with L-Type calcium channels
these mediate:

1. upstroke of the action potential in SA/AV Nodes - can reduced rate and conduction through the AV
2. Phase 2 in ventricular AP - reduced force of cardiac contraction

Question 8

Give an example of a calcium channel blocker.

Answer 8

Dihydropyridines - amlodopine

rate limiting - verapamil

Question 9

side effects of calcium channel blockers

Answer 9

caution when even with beta blockers
headaches
constipation

Question 10

what category of drugs is benzofluazide?

Answer 10

thiazide diuretic

Question 11

uses for thiazide diuretics?

Answer 11

hypertension

Question 12

side effects of thiazide diuretics?

Answer 12

impotence

hypokalaemia - leading to fatigue and arrhythmias

Question 13

what category of drugs does furosemide below to?

Answer 13

loop diuretics

Question 14

when are loop diuretics used?

Answer 14

heart failure

Question 15

side effects of loop diuretics?

Answer 15

hyperglycaemia in diabetics - due to the fact that it causes K to be lost

increased uric acid - leading to gout

Question 16

give an example of a potassium sparing diuretic and what they are used to treat

Answer 16

spironolactone - oedema, heart failure, used to prevent hypokalaemia

Question 17

where do the 3 types of diuretic act upon the nephron?

Answer 17

Loop diuretics: blocks the sodium/potassium/chloride transporter in the ascending loop of Henle, potassium-wasting

Thiazide diuretics: blocks the sodium/chloride transporter in the distal tubule, potassium-wasting

Spironolactone: blocks the aldosterone receptors in the cortical collecting duct. This causes a decrease in sodium and water reabsorption and decreases potassium secreting (therefore is potassium-sparing)

Question 18

what is the proper name for a statin and give an example

Answer 18

HMG-CoA reductase inhibitors

simvastatin

Question 19

when are statins used?

Answer 19

hypercholesterolemia diabetes
angina
MI

vibrates are sometimes used in hyperlipidaemia and low HDL cholesterol

Question 20

how do statins work?

Answer 20

Statins inhibit an enzyme called HMG-CoA reductase, which controls cholesterol production in the liver.
The medicines actually act to replace the HMG-CoA that exists in the liver, thereby slowing down the cholesterol production process

Question 21

give examples of ant platelet drugs used

Answer 21

aspirin, clopidogrel

Question 22

when are anti platelets used?

Answer 22

angina, MI, CVA/TIA (stroke)

used when a patient is at risk of an MI or CVA

Question 23

the main side effect of anti-platelets?

Answer 23

haemorrhage anywhere

Question 24

examples of anti-coagulant drugs?

Answer 24

Heparin IV - fast acting
Warfarin oral - slow acting

rivaroxaban can also be given orally

(they are vitamin K antagonists)

Question 25

when are anti-coagulants used?

Answer 25

DVT, PE, NSTEMI, AF basically anywhere that is at risk of developing a embolism

Question 26

what are the side effects of anti-coagulants?

Answer 26

haemorrhage anywhere reversed by vitamin K LMWH - can lead to osteoporosis

Question 27

give examples of organic nitrates and when they are used

Answer 27

isorbide nitrate GTN they are used in agina and acute heart failure

Question 28

possible side effects of nitrates?

Answer 28

Hypotension, headache | you can build up a tolerance to them so must have a nitrate free period

Question 29

when is digoxin used?

Answer 29

good for use in AF as it blocks AV conduction and produces a delay also used in heart failure when the patients are remaining symptomatic even after other drugs

Question 30

how does digoxin work?

Answer 30

blocks the aloha subunit of Na/K ATPase channel - and art competes wth K so can be dangerously unbalanced in hypokalaemia it increases vagal activity to the heart, but also shortens the refractory period in atrial and ventricular myocytes

Question 31

give an example of fibrinolytic therapy and when it is used

Answer 31

streptokinase - STEMI, PE, CVA

Question 32

side effects of fibrinolytics

Answer 32

haemorrhage, therefore avoid in recent haemorrhage, trauma, bleedinf tendencies and peptic ulcers