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CVR > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is Hypertension?

A

The blood pressure level above which investigation and treatment do more good than harm

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2
Q

What is Grade 1 Hypertension?

A

Systolic Pressure 140-159

Diastolic Pressure: 90-99

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3
Q

What is Grade 2 Hypertension?

A

Systolic Pressure 160-179

Diastolic Pressure 100-109

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4
Q

What is Grade 3 Hypertension?

A

Systolic Pressure >180

Diastolic Pressure >110

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5
Q

What are the classes of drugs used to treat Hypertension?

A
  1. ACE Inhibitors
  2. Angiotensin/Angiotensin II Blockers
  3. Beta Blockers
  4. Calcium Channel Blockers
  5. Diuretics
  6. Alpha Blockers
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6
Q

What is Angina?

A

Mismatch between myocardial oxygen supply and demand–> results from Ischaemia

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7
Q

What is the difference between stable, unstable and variant angina?

A

Stable- No change in symptoms in previous weeks, associated with obstructive coronary disease
Unstable- Abrupt pattern change in symptoms, associated with plaque rupture
Variant- Usually stress-related, patients develop coronary spasm

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8
Q

What are the symptoms of Angina?

A
  1. Retrosternal discomfort
  2. Pressure-like heart pain
  3. Occurs with exertion, relieved by rest
  4. Pain may radiate down arm
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9
Q

What are the classes of drugs used to treat Angina?

A
  1. Nitrates
  2. Beta Blockers
  3. Calcium Channel Blockers
  4. ACE Inhibitors
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10
Q

What is Heart Failure?

A

Heart failure is the pathological state in which the heart is unable to pump enough blood for the needs of metabolising tissues

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11
Q

What is Heart Failure with Reduced Ejection Fraction?

A

Heart failure where the patient has systolic dysfunction–> Impaired Contractile Function

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12
Q

What is Heart Failure with Preserved Ejection Fraction?

A

Heart failure where the patient has diastolic dysfunction–> Impaired Ventricular Filling due to stiffness or hypertrophy

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13
Q

What are the classes of drugs used in the treatment of Heart Failure?

A
  1. Diuretics
  2. ACE Inhibitors
  3. Angiotensin II Antagonists
  4. Hydralazine/Nitrates
  5. Beta Blockers
  6. Inotropes
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14
Q

What is Arrhythmias?

A

Usually associated with structural abnormality of myocardium, Due to Iscahemia, Heart Failure and Hypertrophic Obstructive Cardiomyopathy

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15
Q

What are the classification of Arrhythmias?

A
  1. Classic
  2. Ventricular
  3. Supra-ventricular

In Electrophysiology: Wide vs Narrow QRS Complex

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16
Q

What is Wolfe Parkinson White Syndrome?

A

When the Electrical Impulse Bypasses the AV node

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17
Q

What is important about Long QT Syndrome?

A

Drugs that prolong the QT interval in ECG can precipitate Arrhythmias

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18
Q

What is Brugada Syndrome?

A
  1. ST segment elevation in right heart leads–> Susceptible to Ventricular Tachycardia–> Treat with ICD
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19
Q

What is an ICD?

A

Implantable Cardioverter Defibrillator–> effectively end most episodes of ventricular tachycardia or fibrillation

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20
Q

What are the drugs used in the treatment of Arrhythmias?

A 
Class 1a. Disopyramide, Quinidine, Procainamide
Class 1b. Lignocaine, Mexiletine
Class 1c. Propafenone, Flecainide
Class 2: Beta Blockers
Class 3. Amiodarone, Bretylium, Sotalol
Class 4. Calcium Channel Blockers
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21
Q

How do Class 1a drugs work?

A

Quinidine and similar drugs–> They prolong QT interval and depress conduction that promote re-entry–> Proarrhythmic

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22
Q

How do Class 1b drugs work?

A

Lignocaine–> Treatment for Ventricular arrhythmias associated with AMI and cardiac surgery by acting on ischaemic myocardium

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23
Q

What are the side effects of Lignocaine?

A
  1. Drowsiness
  2. Paresthesia
  3. Seizure activity
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24
Q

How do Class 1c drugs work?

A

They block the fast Sodium Channels–> Treatment for both SVT and Ventricular Arrhythmias (in life threatening situations)

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25
Q

What is the Major Side Effect of Flecanide?

A

Proarrythmic–> only given by electrophysiologist

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26
Q

What is the side effect of Propafenone?

A

Exacerbation of lung disease due to partial beta blocking action

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27
Q

How do Class 3 drugs work?

A

They slow depolarisation, prolonging the action potential duration–> Used in life threatening cases of both SVT and Ventricular Arrhythmias

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28
Q

What are the side effects of Class 3 drugs?

A
  1. Thyroid Disorder
  2. Photosensitivity
  3. Liver damage
  4. Pulmonary Alveolitis
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29
Q

What is the side effect of Bretylium?

A

Hypotension

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30
Q

When is Bretylium used?

A

In ICU setting in patients who have recurrent and refractory ventricular tacharrhythmias

31
Q

How does Sotalol work in the treatment of Arrhythmias?

A

Non-specific Beta Blocker that prolongs depolarisation–> used to treat ventricular arrhythmias

32
Q

What is the main side effect of Sotalol?

A

Prolong QT interval
Heart Block
Heart Failure
Bronchoconstriction

33
Q

How does Digitals (Digoxin) work in the treatment of Arrhythmias?

A
  1. Increases Central Vagal Activity

2. Slows conduction through the AV Node and Bundle of His

34
Q

How do ACE Inhibitors work?

A
  1. They inhibit the formation of Angiotensin II
  2. Reduce the Breakdown of Bradykinin
  3. Inhibit RAAS–> Decrease Retention of Fluid–> Decrease Blood Volume
35
Q

What are the Side Effects of ACE Inhibitors?

A
  1. Cough
  2. Renal Failure
  3. Hyper Kalaemia
36
Q

What are examples of ACE Inhibitors?

A

Ramipril, Enalapril

37
Q

How do Beta Blockers work?

A

They block the Beta adrenoreceptors, Causing Decreased Heart Rate and Decreased Cardiac Contractility

38
Q

What are the side effects of Beta Blockers?

A
  1. Bronchoconstriction
  2. Negative Inotrophy
  3. Fatigue
  4. Heart Block
  5. Heart Failure
39
Q

What are examples of Beta Blockers?

A

Cardioselective–> Atenolol, Metoprolol

Non-Selective–> Propanolol, Timolol

40
Q

What are the different types of Calcium Channel Blockers?

A

Dihydropyrimidine Calcium Channel Blockers and Non-Dihydropyrimidine Calcium Channel Blockers

41
Q

What are the actions of Calcium Channel Blockers?

A

Dihydropyrimidine–> Causes Vasodilation in smooth muscle

Non-Dihydropyrimidine–> Prevents Supraventricular Tachyarrhythmias

42
Q

What are the Side Effects of Calcium Channel Blockers?

A
  1. Arterial Dilation
    2, Reduced Cardiac Contractility
  2. Heart Block and Bradycardia
43
Q

What are examples of Calcium Channel Blockers?

A

Dihydropyrimidine–> Amlodipine, Vifedipine

Non-Dihydropyrimidines–> Dilitazem, Verapamil

44
Q

How do Diuretics work?

A

Inhibit Na+ reabsorption and thus DecreaseWater retention–> Decrease Blood Volume/ get rid of Fluid–> decrease Blood Pressure

45
Q

What are the side effects of Diuretics?

A
  1. Fatigue
  2. Low Electrolytes
  3. Possible Arrhythmias
  4. Hyperglycaemia
46
Q

What are the 2 types of Diuretics?

A
  1. Loop Diuretics

2. Thiazide Diuretics

47
Q

What is Spirolactone?

A

Antagonist of Aldosterone receptor–> used in Heart Failure

48
Q

What are the Side effects of Spirolactone?

A
  1. Hyperkalaemia

2. Gynaecomastia

49
Q

What are the actions of Nitrates in the treatment of Heart Failure/Angina?

A

They vasodilate both arterial and venous smooth muscle

50
Q

What are the Side Effects of Nitrates?

A
  1. Headache

2. Hypotension

51
Q

What are examples of Nitrates?

A
  1. Nitroglycerin (sublingual)

2. Isosorbide Dinitrate (Oral)

52
Q

What are the actions of Hydralazines in the treatment of Heart Failure?

A

Relax the smooth muscle of precapillary resistance vessels–> but must be used together with Nitrates to be effective

53
Q

What are the Positive Inotropes used in the treatment of Heart Failure?

A
  1. Phosphodiesterase Inhibitors (short term increase of cardiac output)
  2. Beta1 Adrenoreceptor Agonists (short term use)
54
Q

What is a positive inotropic effect?

A

Inhibition of Na+/K+ ATPase–> Increase in intracellular Na+–> Increase in Intracytoplasmic Ca2+–> Increase Contractility of the Heart–> Increase Cardiac Output

55
Q

What are the 2 types of drugs used in the treatment of Asthma?

A
  1. Bronchodilators

2. Anti-Inflammatories

56
Q

What are the Bronchodilator Drugs used in Asthma treatment?

A
  1. Beta-2 Adrenoreceptor Agonists
  2. M3 Muscarinic Receptor Antagonists
  3. Xanthines
57
Q

What are the Anti-Inflammatory Drugs used in Asthma treatment?

A
  1. Glucocorticoids
  2. Cromones
  3. Leukotriene Modifiers
58
Q

What are the actions of ß2 Adrenoreceptor Agonists?

A
  1. Cause Bronchodilation by increasing cAMP

2. Inhibits mediator release from Mast Cells

59
Q

What are the Side Effects of ß2-Adrenorecptor Agonists?

A
  1. Tremor
  2. Arrhythmias
  3. Hypokalaemia
  4. Muscle Cramps
60
Q

What are examples of ß2-Adrenoreceptor Agonists?

A

Short-acting–> Salbutamol

Long-Acting–> Salmeterol

61
Q

What are the actions of M3 Muscarinic Antagonists?

A

Inhibit actions af Acetylcholine, causing Bronchodilation and reduced mucus secretions

62
Q

What are the side effects of M3 Muscarinic Antagonists?

A
  1. Dry Mouth

2. Urinary Retention

63
Q

What are examples of M3 Muscarinic Antagonists?

A
  1. Ipratropium

2. Tiotropium

64
Q

What are the actions of Xanthines?

A

Inhibit phosphodiesterase which increase cAMP and cGMP

65
Q

What are the Side Effects of Xanthines?

A
  1. Arrhythmias

2. Nausea

66
Q

What are examples of Xanthines?

A

Theophylline, Aminophylline

67
Q

What are the actions of Glucocorticoids?

A

Inhibits the transcription of Genes coding for the cytokines involved in inflammation

68
Q

What are the side effects of Glucocorticoids?

A
  1. Dysphoina

2. Thrush

69
Q

What are examples of Glucocorticoids?

A
  1. Beclomethasone

2. Budesonide

70
Q

What are the actions of Cromones?

A

Stabilise the Mast Cell and Inhibits Eosinophil accumulation in the lung

71
Q

What are the side effects of Cromones?

A

Cough and Wheezing

72
Q

What are examples of Cromones?

A

Nedocromil

73
Q

What are the actions of Leukotriene Modifiers?

A
  1. Counteract the release of Leukotrienes

2. Inhibit LOX

74
Q

What are examples of Leukotriene Modifiers?

A

LOX Inhibitor–> Zileuton

Leukotriene Receptor Antagonists–> Montelukast

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