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1. Theme 3 > T3 L14: Treatment for ischaemic heart disease > Flashcards

T3 L14: Treatment for ischaemic heart disease Flashcards

1
Q

What are the 2 main sources of cholesterol?

A

Up taken from the GI tract or produced by the liver

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2
Q

How do statins reduce blood cholesterol?

A

They inhibit the HMG CoA reductase enzyme which causes the liver to express more LDL receptors. The receptors are used to up take LDL cholesterol from the blood by liver cells

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3
Q

What is HMG CoA reductase responsible for?

A

It catalyses the rate determining step in cholesterol synthesis

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4
Q

What is the drug clopidigrel for?

A

Antiplatelet

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5
Q

What type of drug is Ramipril?

A

An ACE inhibitor

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6
Q

What type of drug is Losartan?

A

An angiotensin receptor blocker (ARB)

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7
Q

What is the treatment for acute coronary syndromes like unstable angina, NSTEMI and STEMI?

A

As for stable angina but with antiplatelets because their plaques are unstable and likely to rupture (Aspirin + Clopidogrel)

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8
Q

What is an NSTEMI?

A

Non-ST segment elevation myocardial infarction

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9
Q

What is a STEMI?

A

ST-segment elevation myocardial infarction

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10
Q

What type of drug is Prasugrel?

A

An anti-platelet usually used alongside aspirin (an ADP antagonist that blocks P2Y12 receptors). It’s irreversible

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11
Q

What type of drug is Ticagrelor?

A

An anti-platelet (P2Y12 inhibitor). It’s effects are reversible

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12
Q

How are platelets activated?

A

Endothelial cells are damaged so ADP is released and it acts on P2Y12 receptors to stimulate platelets to express GP2b/3a receptors. Fibrinogen binds to these receptors to cross link different platelets

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13
Q

How does aspirin work?

A

It inhibits COX (cyclo-oxygenase enzyme) irreversibly

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14
Q

How does Clopidigrel work?

A

It’s an ADP antagonist that blocks P2Y12 receptors. Irreversible

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15
Q

How does activation of COX help platelet activation?

A

Through the production of Thromboxane A2

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16
Q

Sweating, tachycardia and cold clammy skin are a marker of what?

A

An overactive sympathetic NS

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17
Q

What causes clammy skin?

A

Constricted vasculature in an effort or raise blood pressure

18
Q

How does an MI cause a decrease in blood pressure?

A

It causes damage and an impaired cardiac output which will cause a lowered BP

19
Q

In which part of the body is low blood pressure detected?

A

The medulla oblongata of the brain

20
Q

What causes sweating, tachycardia and cold, clammy skin symptoms during angina?

A

The heart is damaged during an MI and this decreases cardiac output. The sympathetic NS is activated to counteract the pressure loss

21
Q

Why is oxygen given as a treatment for angina?

A

It minimises further damage

22
Q

What is GTN?

A

Glyceryl trinitrate

23
Q

How does GTN work?

A

It’s a nitrate so it causes vasodilation and this increases blood supply to areas like the heart where the was previously a blockage

24
Q

What is Tenecteplase and what is it used for?

A

An enzyme used as a thrombolytic drug

25
Q

What is the function of plasmin?

A

Break down of fibrin

26
Q

What is the difference between fibrin and fibrinogen?

A

Fibrin is made from fibrinogen. Fibrinogen is converted at the wound into fibrin by the action of thrombin

27
Q

What is the name of factor 1?

A

Fibrinogen

28
Q

What is the function of Thrombin?

A

It converts fibrinogen into fibrin at the site of a wound

29
Q

What is the medical form of heroin called?

A

Diamorphine

30
Q

How are beta blockers used in cardiac treatment

A

They decrease cardiac workload by reducing heart rate, contractility, and arterial pressure. This reduces the O2 demand

31
Q

What is metoprolol and when is it administered?

A

A short-acting beta-blocker administered in a hospital setting because the dosage can easily be adjusted.

32
Q

What is bisoprolol and when is it administered?

A

A long-lasting beta-blocker administered in the community

33
Q

How are ACE inhibitors used in cardiac treatment?

A

They reduce cardiac workload and prevent remodelling development of heart failure

34
Q

What type of drug is Tinzaparin?

A

An anticoagulant (A low molecular weight heparin)

35
Q

What type of drug is Warfarin?

A

An anticoagulant

36
Q

What type of drug is Apixaban?

A

An anticoagulant

37
Q

What type of drug is Rivaroxaban?

A

An anticoagulant

38
Q

What type of drug is dabigatran?

A

An anticoagulant

39
Q

What is the mechanism of action of Digoxin?

A

It inhibits the Na+/K+ ATPase by binding to it. The levels of Na+ inside the cell increase and this causes the inhibition of the Na+/Ca2+ exchanger leading to a build of of Ca2+ inside the muscle cells and therefore a stronger contraction

40
Q

What is Digoxin used to treat?

A

Heart failure (makes contractions stronger)

1. Theme 3 (19 decks)

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