Flashcards
Cardiac Drugs
Cards in this deck (59)
- 1What are the types of medication for heart conditionsACE inhibitors
ARBs(angiotensin-2 antagonists)
Anticoagulant
Antiplatelet
Beta Blockers
Calcium channel blockers
Cholesterol lowering (statins)
Diuretics
Nitrates - 2examples of beta blockersatenolol
bisoprolol
metoprolol
labetalol - 3mechanism of beta blockerssblock adrenergenic receptors (B1 and B2 esp)
Sympathetic nervous system activity is reduced which means the heart rate and strength of contraction are reduced
Blood vessels dilate except arteries to the brain
Skeletal muscle contracts - 4function of beta blockersto slow heart rate-reduce the amount of work the heart has to do
to reduce cardiac output=reduction in blood pressure - 5what conditons are treated with beta blockersangina, heart failure, MI(secondary prevention), arrhythmia like atrial fibrillation, hypertension
- 6beta blocker side effectsbradycardia, heart block, hypotension, bronchospasm, fatigue, coldness of extremities, sleep disturbance with nighmares
- 7caution in use of beta blockersHx of asthma, bronchospasm, obstructive airways disease
In diabetes may mask symptoms of hypoglycaemia - 8how do calcium channel blockers work?reduce the force of contraction in the heart muscle
dilate coronary arteries=increased blood supply to heart muscle - 9Two types of calcium channel blockerdihydroperodine
non dihydroperodine - 10examples of dihydroperodine ccbsamlodipine, felodipine, nifedipine
- 11examples of nondihydroperidineverapamil, diltiazem
- 12dihy ccbs are used forangina and hypertension
- 13non dihy ccbs are used forarrythmias, hypertension and angina
nb also slow heart rate - more selective for cardiac tissue - 14what does angiotensin 2 do to BPIncrease=potent vasoconstrictor
- 15how is angiotensin 1 converted into angiotensin 2angiotensin converting enzyme (ACE)
- 16ACE inhibitors likeRamipril, lisinopril, perindopril
- 17use ACE inhibitors forheart failure, hypertension, prevention of cardiac events post MI, diabetic nephropathy
- 18ACE inhibitor side effectsdry cough, angioedema, hyperkalemia
- 19ACE inhibitor cautionprofound first dose hypotension
if concomitant treatment with potassium sparing diuretics=increased risk of hyperkalemia
renal function carefully monitored
NSAIDs=++risk of renal damage
elderly - 20Angiotensin 2 receptor antagonist mechanismprevents angiotensin 2 from working by blocking the receptors=no vasoconstriction
- 21examples of ARBsLosartan, telmisartan, valsartan
- 22What are nitrates for?Vasodilation - dilate coronary arteries to increase blood supply to the heart muscle
also dilate vascular smooth muscle
which leads to the reduction in venous return
which means left ventricle doesn't have to work so hard
which means the heart muscle demands less oxygen - 23what are nitrates used forangina
- 24what is anginapain due to lack of blood in heart muscle
- 25examples of nitratesglyceryl trinitrate=rapid onset spray
isosorbide mononitrate=immediate release tabs or long acting formulations - not suitable for acute attacks - 26side effects of nitratesthrobbing headache with gtn
dizziness, drowsiness, hypotension, n&v
Nitrate free period every 24hr to prevent tolerance - 27what are statinsanti-lipid medications that inhibit hmg-coa reductase
which inhibits cholesterol biosynthesis in the liver
which lowers cholesterol and lipoprotein serum concentrations - 28what is LDL and HDLlow density lipoprotein
high density lipoprotein - 29what are statins used forhypercholesterolaemia and hypertriglycerideaemia
- 30examples of statinsrosuvastatin
atorvastatin
simvastatin - 31statins notable side effectsMuscle pain=?muscle damage (rhabdomyolysis=rapid break down of skeletal muscle)
interactions are many
NB for no grapefruit
clarithromycin=increased risk of toxicity - 32What are diureticsincrease urine production in the kidneys promoting removal of salts and fluids from the body
- 33what are the two types of diureticloop and thiazide
- 34What are loop diuretics forpromote diuresis and reduce oedema
=symptomatic relief of heart failure - 35examples of loop diureticsfurosemide po and iv
bumetanide - 36side effects of loop diureticslow potassium
low sodium
low BP
ototoxicity with IV furosemide - 37mechanism of thiazide diureticspromote diuresis, reduce circulating blood volume
which reduces blood pressure - 38examples of thiazide diureticsbendroflumethiazide
indapamide - 39side effectsdehydration
erractic blood glucose
gout
electrolyte imbalance - 40cautions for thiazide diureticshypOkalemia
elderly
impaired renal function
thiazides can exacerbate diabetes and gout - 41mechanism of antiplatelet medicationreduces platelet aggregation=less risk of a clot in the arterial system
- 42antiplatelets are used forprevent recurrence of stroke and other in hx TIA and stroke
DAPT for prevention of artherothrombic events in ACS patients
secondary prevention in established cardiovascular disease - 43examples of antiplateletaspirin
clopidogrel
ticagrelor - 44antiplatelet side effectsbleeding
gastro protect with PPI - 45Anticoagulants used forprevention of VTE
treatment of PE and DVT - 46examples of anticoagulantswarfarin NB for INR
LMWH
dabigatran
rivaroxaban
apixaban
endoxaban - 47what is warfarinvitamin k agonist
- 48what is INRinternational normalised ratio
the ratio of time taken for the blood to form a clot compared to a standard - 49what is lmwhlow molecular weight heparin
- 50how is lmwh administered and whySubcut
given for VTE prophylaxisis for post op, pregnancy, cancer, sepsis, copd, heart failure - 51what affects drug choice in hypertensionage
type 2 diabetes
ethnic origin - 52antihypertensives fordiabetics, ckd, established cvd and multiple risk factors
- 53how do you treat hypertension?ACE inhibitors reduce peripheral resistance and blood volume
Calcium channel blockers dilate vasculature=lower peripheral resistance
Thiazide diuretics reduce circulating blood volume(ie reduce cardiac output)
Beta Blockers reduce the rate that blood leaves the heart (reduce cardiac output) - 54Heart failure treatmentFirst line
ACE inhibitors
Beta Blockers - 55symptom relief for heart failureloop diuretics
- 56what is covered by the term coronary heart disease?disorders caused by inadequete myocardial blood supply-usually artherosclerosis of coronary arteries
- 57what is acute coronary syndromeunstable angina and evolving myocardial infarction
- 58drugs used in acute myocardial infarctionmorphine for pain
oxygen
antiplatelet for clot prevention and plaque prevention
beta blockers to lower heart rate, bp and myocardial contractility
vasodilators like nitrates IV
LMWH
fibrinolytics - 59secondary prevention of MIbeta blockers
aspirin
ACE inhibitors
Statins