Pharmacology 5

  • Created by: evepoag
  • Created on: 19-10-22 17:50
Name 3 acute coronary syndromes?
ST-elevation myocardial infarction (STEMI)
Non-ST-elevation myocardial infarction (NSTEMI)
Unstable angina
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How is atherosclerosis initially developed?
Cholesterol accumulates on the arterial wall, where it is phagocytosed. The macrophage produces paracrine that attract more smooth muscle cells, which creates a 'fatty streak'
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How is atherosclerosis then developed?
Fibrous scar tissue forms around the cholesterol, thickening the arterial wall and narrowing the artery lumen
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Describe the final stages of atherosclerosis
Calcified scar tissue is formed. If the endothelial tissue is damaged, platelets stick to the area and form a clot. If blood flow in the coronary blood vessel is stopped, a heart attack results
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What are some common drugs in atherosclerosis?
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What do anti-platelets do?
They prevent the formation of 'blood clots' in the arterial circulation
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Name some common anti-platelets
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What are Percutaneous Coronary Interventions?
Minor procedures to open blocked arteries
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What should be given post Percutaneous Coronary Intervention (PCI)?
Aspirin with dual therapy
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What are Glycoprotein IIb/IIIa Inhibitors?
They are a type of anti-platelet antagonist used for at-risk patients undergoing a PCI.

They prevent platelet formation by blocking the glycoprotein IIb/IIa receptors on the platelet's membrane to inhibit fibrinogen from binding
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What does fibrinogen do?
Fibrinogen is converted into fibrin which helps form clots
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What are glycoprotein IIb/IIIa inhibitors used in conjunction with?
Aspirin and heparin
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Why are thrombolytic drugs given?
For the treatment of myocardial infarction
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How do thrombolytic drugs work?
They active plasminogen which forms plasmin. Plasmin degrades fibrin and breaks up thrombus/blood clot
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What does thrombolytic drugs usually end in?
- ase
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When should thrombolytic drugs NOT be given?
- after a haemorrhagic stroke in the last 6 months
- active bleeding
- peptic ulceration
- recent trauma
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What nursing considerations should be taken into account when on thrombolytic drugs?
Monitor closely for bleeding
Regular NEWS assessment
Daily bloods
Patient education about concordance
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What are statin-modifying drugs?
They inhibit an enzyme involved in cholesterol synthesis, thereby decreasing cholesterol levels, and increasing HDL (good cholesterol) levels
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What are some contra-indications of statin therapy?
Active liver disease, high alcohol intake, pregnancy
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What can statins cause?
Rhabdomyolysis (muscle tenderness/pain)
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What are nitrates prescribed for?
Prophylaxis and treatment of chest pain
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What do nitrates do?
They are vasodilators that act on smooth muscle to relax and depress muscle
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What is a common nitrate used in cardiology?
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What is another word for chest pain?
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What is aortic stenosis?
Aortic stenosis is the narrowing of the aorta
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When can nitrates not be used?
If patient is hypotensive
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What is digoxin and what is it used for?
Digoxin is a cardiac glycoside

It is used to reduce conductivity within the AV node and therefore decrease myocardial contraction, slowing heart rate
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What cardiac conditions does digoxin usually treat?
Atrial fibrillation (AF) and heart failure
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What is ejection fracture?
It is the percentage of blood that is pumped out of the heart during each beat
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What is a normal EF?
more than 50%
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What EF % indicates reduced EF?
below 40%
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If a patient has heart failure but a normal ejection fracture, what is this called?
Heart Failure with preserved Ejection Fraction
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Name 6 drugs used in heart failure management
1. Diuretics
2. ACE inhibitors
3. ARBs
4. ARNIs
5. Beta-blockers
6. MRAs
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What are diuretics used for?
Reduce congestion and fluid retention
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Name the 2 types of diuretics
1. Loop
2. Thiazide
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What are ACE inhibitors, ARBs and ARNIs all?
'Protective' medications used to protect and improve the function of the heart muscle
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Describe the renin-angiotensin system
(split in 2 cards)
A drop in BP and fluid volume, causes renin to be released from the kidneys.
Angiotensin is produced from the liver. Renin from the kidney and angiotensin from the liver form angiotensin I.
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Describe the renin-angiotensin system
ACE acts on angiotensin I to form angiotensin II. This causes vasoconstriction of the blood vessels. Angiotensin II stimulates the release of aldosterone.
Aldosterone acts on the kidneys to stimulate reabsorption of sodium chloride and water
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What are Angiotensin Receptor Neprilysin Inhibitors (ARNI)s for?
They are used in heart failure with reduced ejection fracture
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What do ARNIs do?
In the RAAS system, vasoconstriction increases blood pressure and sodium

In the NP system, ARNIs block the action of neprilysin, which prevents the breakdown of natriuretic peptides. These peptides lower sodium and thereby lower blood pressure.
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What are MRAs also known as?
Potassium sparing diuretics
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What MRAs used for?
Preventing fluid retention and improving heart function
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What are beta-adrenergic blocking agents used for?
Beta-blockers block the beta-1 receptors, that release stress hormones adrenaline and noradrenaline

By doing this, they slow the heart rate and reduces the force at which blood is pumped around the body
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What receptors do beta-blockers block?
Adrenergic receptorsW
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What two body systems can beta-blockers affect?
Renal and liver function
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What are sodium-glucose cotransporter-2 (SGLT2) inhibitors?
They are used for treating type 2 diabetes by helping kidneys lower blood glucose levels
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What 2 other drugs can be used in conjunction with other cardiac drugs?
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What do ACE inhibitors do?
They inhibit activity of the angiotensin-converting enzyme

This enzyme causes vasoconstriction which increases blood pressure. ACE inhibitors make blood vessels relax and widen which lowers BP and improves blood flow to heart
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What do calcium-channel blockers do?
CCBs reduce the amount of calcium entering cells of the heart and blood vessel walls.

As a result, the blood vessels relax and heart muscle receives more oxygenated blood, which lowers blood pressure and treats angina
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Where do loop diuretics act?
On the Loop of Henle in the kidney
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How do loop diuretics work?
They inhibit or block ions and water being reabsorbed from the renal filtrate back into the bloodstream. As water and sodium are not reabsorbed, they stay in the filtrate and are lost in the urine
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What is important to remember about sodium and water?
Where sodium goes, water goes!
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Why might someone feel dizzy on loop diuretics?
The sudden loss of fluid may cause the person to become hypovolaemic, which affects blood pressure
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Why can electrolyte imbalances be found in loop diuretic treatment?
Diuresis causes water AND electrolytes to be lost
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What is a common risk of loop diuretics?
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What is VERY important to do when on loop diuretics?
Monitor electrolytes (U+E)
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What is the formula for blood pressure?
Blood pressure = cardiac output X systemic vascular resistance
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What does angiotensin II cause?
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If you block angiotensin II with an ACE inhibitor, what happens?
blood pressure will be reduced as blood vessels are less constricted
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So what is the very important therapeutic outcome of ACE inhibitors?
Lowers blood pressure
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What do ACE inhibitors also reduce?
Fluid and sodium retention
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The angiotensin converting enzyme is found in the lungs and is involved in the breakdown of bradykinin. When ACE inhibitors are used, what happens to bradykinin?
Bradykinin builds up in the lungs, causing a cough
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When using ACE inhibitors, what should you monitor?
Renal function and electrolytes
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Aldosterone is a hormone which helps to increase blood pressure and cardiac output.

What effect does aldosterone have on the kidney?
It increases sodium and water reabsorption from the renal tubules and increases potassium excretion
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What is another drug class name for mineralocorticoid receptor antagonists?
Aldosterone antagonists
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What are the functional units of the kidneys called?
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A heart rate of below what should prompt further investigation, especially when giving digoxin?
60 beats per minute
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Other cards in this set

Card 2


How is atherosclerosis initially developed?


Cholesterol accumulates on the arterial wall, where it is phagocytosed. The macrophage produces paracrine that attract more smooth muscle cells, which creates a 'fatty streak'

Card 3


How is atherosclerosis then developed?


Preview of the front of card 3

Card 4


Describe the final stages of atherosclerosis


Preview of the front of card 4

Card 5


What are some common drugs in atherosclerosis?


Preview of the front of card 5
View more cards


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