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Cardiovascular > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q

once adrenaline activates B1 ADRs, what happens?

A

stimulates adenylyl cyclase which inc conc. of cAMP which inc SAN AP frequency (due to inc in CA++)

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2
Q

what happens once Ach binds to M2 muscarinic receptors?

A

inhibits adenylyl cyclase so dec conc of cAMP which dec SAN AP frequency

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3
Q

what determines the pacemaker potential

A

depolarisation

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4
Q

give 2 examples of B-ADR agonists & antagonists

A

. adrenaline & dobutamine

. all beta blockers

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5
Q

what is an example of a partial antagonist

A

propranolol

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6
Q

what conditions do B-ADR agonists treat

A

stimulate sympathetic activity so cardiac arrest or heart failure

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7
Q

what conditions do beta-blockers treat

A

slow down HR etc so arrhythmias-A.fib, tachy etc, heart failure, angina, HT

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8
Q

give 3 common side effects of beta blockers

A

cold extremities, bronchospasm, hypoglycaemia

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9
Q

what is digoxin used for

A

heart failure, A.fib

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10
Q

how do calcium sensitisers work

A

open K+ channels causing vasodilation so red. after load

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11
Q

what are lipids transported by

A

lipoproteins

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12
Q

describe a lipoprotein

A

spherical- hydrophobic core with cholesterol & triglycerides and hydrophilic coat with apoproteins

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13
Q

what are the 4 types of lipoprotein

A

HDL, LDL, very LDL, chylomicrons

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14
Q

why is LDL bad?

A

LDL become oxidised to OXLDL which is taken up by macrophages creating a fatty streak- inflammatory response deposits collagen=atheromatous plaque formed

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15
Q

why is HDL good?

A

HDL accepts excess LDL and brings to liver to be converted to hepatocytes

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16
Q

how does haemostasis occur

A

vascular wall damage exposes collagen & tissue factor > 1y haemostasis (vasoconstriction, platelet adhesion, activation/aggregation of fibrinogen) > activation of blood clotting factors and formation of stable clot

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17
Q

describe 1y homeostasis

A

activated platelets synthesises and release thromboxane A2

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18
Q

what does thromboxane A2 do?

A

causes the release of serotonin binds to vessels= vasconstriciton
causes release of ADP= activating platelets and prompting coagulation of blood

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19
Q

fill in the blanks for the Amplifying Cascade;

fibrinogen > _____ > fibrin >

A

thrombin

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20
Q

what is the aggregative & adhesive factor

A

collagen

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21
Q

give the 4 clotting factors

A

2,7,9,10

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22
Q

how are clotting factors converted to their activated form (2a,7a,9a,10a)?

A

an enzyme with VitK Reductase cofactor

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23
Q

what do ECGs show

A

cardiac rate, rhythm, chamber size, electrical axis of heart

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24
Q

when does an electrode generate an upward deflection on ECG

A

when depolarisation moves toward +ve electrode

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25
what is isopotential
flat line- no electrical activity
26
what are the 3 limb leads
right arm-left arm right arm- left leg left arm-left leg
27
what are the 3 augmented leads
aVR, aVF, aVL
28
what is unique about the aVR ECG recording
it is upside down
29
True/False... | Limb leads & augmented leads are horizontal
false... they are VERTICAL chest leads are HORIZONTAL
30
what do each of the 6 chest leads represent
V1 &V2: septal V3& V4: anterior heart V5 &V6: lateral aspect of heart (e.g. LV)
31
P wave...
atrial depolarisation- <0.12s
32
QRS complex...
ventricular depolarisation- <0.1sec
33
T wave...
ventricular repolarisation
34
QT interval...
depolarisation & repol of Vs
35
ST segment...
systole
36
TP segment...
diastole
37
PR interval...
AV node delay- (-0.12-0.2sec)
38
what does ST depression show
ischaemia
39
what does ST elevation show
infarction
40
how to place chest leads
V1 next to sternal angle on right
41
What are signs of a normal axis of heart
lead 1: +ve deflection | aVF: +ve deflection
42
signs of left axis deviation
lead 1: +ve deflection | aVF: -ve deflection
43
signs of right axis deviation
lead 1: -ve deflection | aVF: +ve deflection
44
extreme right axis deviation
lead 1: -ve deflection | aVF: -ve deflection
45
how do you analyse a rhythm strip
1. Patient details 2. Check date & time of ECG 3. Check calibration of ECG paper 4. Determine axis 5. Workout rate and rhythm a. Is electrical activity present? b. Is rhythm regular? c. HR? (300 divided by no of big boxes between 1 QRS and next) d. Is P-wave present? e. What is PR interval like f. Is there a QRS after p-wave g. QRS duration normal (< 3 small squares) 6. Look at individual leads for ST or T wave changes
46
what are the 4 anti-cholesterol drugs
statins, fibrates, PCSK 9 inhibitors, ezetimibe
47
give examples, used for what, 2 side effects and action of statins
- simvastatin, atorvastatin - hyperlipidaemia, angina, CVA - risk of MI, renal failure - HMG co-enzyme A reductase inhibitors (rate limiting step of cholesterol synthesis= inc in LDL receptors)
48
give an example of a fibrate?
bexafibrate
49
what is the suffix of PCSK 9 inhibitors & an example
occumab | - evolocumab
50
how do PCSK 9 Inhibitors work
inc no of LDL receptors
51
how does ezetimibe work
inhibits cholesterol absorption by converting it to bile salts
52
which anti-cholesterol drug is best to treat familial hypercholesterolaemia
PCSK 9 inhibitors
53
what are the 4 drug sub-groups to treat hypertension
diuretics beta-blockers vasodilators mineralocorticoid antagonists
54
what are the 2 types of diuretics
thiazide and loop
55
how do diuretics work
block Na re-absorption so inc urine output
56
give an example of a loop diuretic and a thiazide diuretic
loop=furosemide | thiazide= bendroflumethiazide
57
beta blockers can be non-selective and...
cardioselective
58
how do beta blockers work
selective: block binding of adrenaline to either B1 OR B2 ADRs= lower HR, contractility etc so low BP non-selective: same but block B1 & B2
59
what is the main side effect of b-blockers
cold extremities
60
what are 4 vasodilation drugs to reduce BP
ca-channel inhibitors ACEI alpha blockers ARBs (angiotensin receptor blockers)
61
give 2 examples of Ca-channel blockers
Diltiazem, verapamil
62
how do Ca-channel blockers work
block Ca channels reducing AP and electrical conduction to heart (slower HR), also cause vasodilation
63
what is a common side effect of Ca-channel blockers
ankle oedema
64
what is an example of an alpha blocker and how does it work
Doxazosin | blocka a-ADRs= vasodilation
65
give an example of an ACEI & ARB and how they work
Lisinopril (suffix=pril), Losartan blocks conversion of angiotensin 1 > angiotensin 2 so no aldosterone= more Na+ leaving system so less water retention which means less volume in system= lower BP
66
True/False.. | You can give pregnant women ARBs/ACEI
False.. | do not give these to pregnant women/ renal dysfunction pts
67
Spironolactone is an example of what drug group
Mineralocorticoid Antagonists
68
how do mineralocorticoid antagonists act
block aldosterone receptor
69
what type of drugs are given for anti-anginas treatment
vasodilators, slow HR medicine, metabolic modulators
70
what are 2 types of vasodilators for anti-anginas tx
nitrates, nicorandil
71
give 3 examples of nitrates
GTN, isosorbide, mononitrate
72
what types of drug slow HR
b-clockers, Ca channel blockers, ivabridine
73
True/False... | Ivabradine acts on AVN
False.. | acts on SAN
74
how does renolazine (metabolic modulator) act
dec Ca load on heart
75
what type of drugs are given in MI
anti-thrombotic drugs; anti platelet drugs, anticoagulants, fibrinolytic
76
what is a side effect of ivabradine
altered vision
77
name 3 anti-platelets
aspirin, clopidogrel, ticagrelor
78
name 3 anticoagulants
warfarin, heparin, DOACs
79
what is the difference between anti platelets, anti coagulants & fibrinolytics
in their action; anti-platelets: inhibit platelet agglutination and hence thrombus formation- effective in arterial circulation anti-coagulants: suppress synthesis of clotting factors by binding to antithrombin-3/ inhibiting vitK reductase fibrinolytic: dissolve formed clot
80
give an example of a fibrinolytic
streptokinase
81
what is the biggest risk for anti-thrombotic drug
haemorrhage
82
what are the 4 classes of anti-arrhythmic drugs
``` class 1: Lignocaine, Quinidine, flecainide class 2: non-selective b-blocker class 3: amiodarone, sotalol class 4: verapamil (Ca-channel blocker) ```
83
what is the no1 non-selective beta blocker
propanolol
84
how do class 1 anti-arrhythmic drugs work
block Na+ channels reducing the current
85
how do class 3 anti-arrhythmic drugs work
AP prolongation
86
what 2 drugs are given for anti-fibrillation
b-blocker, digoxin
87
how does digoxin work
delays conduction between atria and ventricles
88
vomiting, yellow vision, bradycardia, arrhythmias are all part of which drug toxicity
digoxin
89
what 7 drugs are given in heart failure?
``` ACEI, ARBs BBs mineralocorticoid antagonists diuretics digoxin Neprilysin Inhibitors (Nis) ```
90
how does Nis act
blocks angiotensin 2 binding to its receptor
91
what is the first line tx for inc TGAs
fibrates- agonist of receptor which inc lipase which hydrolyses TAGs
92
what are fibrinolytic used for
open occluded arteries- opposes coagulation cascade

Cardiovascular (12 decks)

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