Drugs used in Cardiology

Question 1

where does Abciximab take affect?

Answer 1

Irreversibly binds Gpiib/iia glucoprotein receptors on platelets.
Inhibits platelet aggregation.

Question 2

Adenosine - which channel does it affect?
How long is the half life?

Answer 2

Potassium channel activator.

8-10 seconds

Question 3

When is adenosine used?

Answer 3

causes sinus node arrest
- to terminate SVT / VT

Question 4

what are the 4 main side effects of adenosine?

Answer 4

anxiety
bronchospams
chest tightness
facial flushing

Question 5

what is the mechanism of action of Amiodarone?

Answer 5

Prolong refractory period -> QT interval

Question 6

What is the main use of Amiodarone?

Answer 6

Control SVT
Recurrent VT or HOCM

Question 7

what is the half life of Amiodarone?

Answer 7

26-126 days

Question 8

what is the onset time of Amiodarone?

Answer 8

PO = <3 weeks
IV = <3 hours

Question 9

which two drugs can be potentiated by Amiodarone?

Answer 9

Digoxin
Warfarin
(protein binding can displace these)

Question 10

what are the key side effects of Amiodarone?

Answer 10

1. arrhythmias: torsades
2. ataxia
3. hepatitis (reversible)
4. thyroid dysfunction
5. metallic taste
6. slate grey appearances
7. pulmo fibrosis
8. reversible corneal deposits (90%)

Question 11

when are ACEi contraindicated?

Answer 11

in bilateral renal artery stenosis

(caution in severe renal disease)

Question 12

Why do ACEi cause cough?

Answer 12

They inhibit the breakdown of bradkinin

Question 13

when are ARBs contraindicated?

Answer 13

In patients with poor renal blood flow
1. Renal artery stenosis
2. Cardiac failure
3. Hypovolaemia

Question 14

what is the half life of Flecanide?

Answer 14

16h

Question 15

What are the two main side effects of Flecanide?

Answer 15

Vertigo
Vsual disturbances

Question 16

when is Flecanide the drug of choice?

Answer 16

WPW
AF

Question 17

what is Flecanide used to treat?

Answer 17

1. ventricular arrhythmia
2. chemical cardioversion of acute atrial arrhythmia

Question 18

digoxin MOA

Answer 18

slow conduction at AV node

Question 19

what conditions is Digoxin used for?

Answer 19

Flutter
AF

Question 20

When would you choose Digoxin over Bisoprolol for AF?

Answer 20

heart failure

Question 21

How is Digoxin excreted?

Answer 21

renally
- accumulates in renal impairment

Question 22

what is pulsus bigeminus?

Answer 22

a single ectopic beat, following each regular heartbeat

Question 23

what 3 abnormalitites are seen on ECG in pateints taking Digoxin?

Answer 23

‘reverse tick’
1 degree HB
pulsus bigeminus

Question 24

which 3 electrolyte imbalances predispose to digoxin toxicity?

Answer 24

Hypokalaemia
hypomagnesaemia
hypercalcaemia

Question 25

name 5 toxic effects of digoxin:

Answer 25

anorexia arrhythmia (HB) diarrhoea nausea / vomiting yellow vision (xanthopsia)

Question 26

HMG-CoA reductase inhibitors do what?

Answer 26

inhibit synthesis of cholesterol

Question 27

when is cholesterol synthesised?

Answer 27

night time. - fasting, - high hepatic blood flow

Question 28

what is HMG-CoA reducatse inhibitors MOA?

Answer 28

reduces LDL increases cholesterol clearance increases HDL

Question 29

what are the targets for total serum cholesterol + LDL?

Answer 29

serum = <5 LDL <3

Question 30

2x MOA of Nicorandil

Answer 30

1. k+ channel opener -> arterial vasodilation 2. component of vaso dilitation -> venous relaxation

Question 31

What is Nicorandil used for?

Answer 31

It is an Anti-anginal agent

Question 32

Side effects of nicorandil

Answer 32

Transient headache flushing dizziness

Question 33

What is the recognised potential side effect of Clopidogrel?

Answer 33

neutrophilia

Question 34

What electrolyte disturbances are associated with thiazide diuretics?

Answer 34

Hyponatremia Hypokalaemia Hypomagnesaemia

Question 35

Side effects of Thiazide duiretics include

Answer 35

Gout - reduced tubular clearance if urate. Tranisently impaired insulin release. Postural hypotension

Question 36

Rare side effects of Thiazide duiretics

Answer 36

Agranulocytosis Pancreatitis Thrombocytopenia Photosensitive rash

Question 37

what are the five pillars of HFrEF Pharmacotherapy

Answer 37

ACEI, ARB (~artan) MRA (spiro / eplerenone) Neprilysin inhibitor (Sacubitril-valsartan) SGLT2i (~flozin)