Cardiovascular Pharmacology Flashcards: ACS, Hypertension & Heart Failure

What class is atorvastatin and what is it used for?

Statin → lowers cholesterol; prevents cardiovascular disease

What class is ramipril and what is it used for?

ACE inhibitor → treats hypertension, heart failure, post-MI

Atorvastatin + ramipril together suggest what?

Cardiovascular disease risk (HTN + dyslipidaemia ± IHD)

What is a common adverse effect of ACE inhibitors?

Dry cough

What is a serious adverse effect of ACE inhibitors?

Angioedema (airway emergency)

When do ACE inhibitor side effects occur?

Cough → days-weeks | Angioedema → anytime

What are key prehospital medications for ACS?

Aspirin, GTN, oxygen (if hypoxic), opioid, antiemetic

What are GTN contraindications?

SBP <90-100 mmHg, PDE-5 use, bradycardia/RV infarct

What is an aspirin contraindication?

Allergy or active bleeding

What is the mechanism of GTN?

↑ Nitric oxide → vasodilation → ↓ preload → ↓ O₂ demand

In ACS, which is the priority: aspirin or GTN?

Aspirin

Why is aspirin more important than GTN?

Treats clot (reduces mortality); GTN only relieves pain

What class is candesartan?

ARB → hypertension/heart failure

What class is metoprolol?

Beta-blocker → HF, AF, HTN

What class is spironolactone?

Aldosterone antagonist → heart failure

What is digoxin used for?

Heart failure and atrial fibrillation

These drugs together suggest what condition?

Chronic heart failure

What is a likely past history in an HF patient?

HF, AF, hypertension

What is the mechanism of beta-blockers?

↓ HR, ↓ contractility, ↓ BP (β1 blockade)

What is the mechanism of digoxin?

↑ Ca²⁺ (↑ contractility) + ↑ vagal tone (↓ HR)

What are the effects of digoxin?

Negative chronotropic, positive inotropic, negative dromotropic

What are causes of digoxin toxicity?

Renal failure, low K⁺, drug interactions

What are signs of digoxin toxicity?

Nausea, vision changes, bradycardia, arrhythmias

What do SOB + crackles + oedema + low SpO₂ indicate?

Acute heart failure (pulmonary oedema)

What is the prehospital treatment for acute HF?

Oxygen, CPAP, GTN, ± diuretics

What is the mechanism of tenecteplase?

Breaks down fibrin clots (plasmin activation)

What is a major risk of tenecteplase?

Severe bleeding (intracranial)

What is the mechanism of heparin?

Inhibits thrombin & factor Xa

What is the mechanism of clopidogrel?

Blocks ADP → ↓ platelet aggregation

What is the role of diuretics in HF?

↓ preload via fluid removal

What is the role of ACE inhibitors in HF?

↓ RAAS → ↓ BP & fluid retention

What is the difference between ARBs and ACE inhibitors?

Same effect, no cough

What is the effect of aldosterone antagonists?

↓ Na⁺/water, ↑ K⁺

What is the HF drug sequence mnemonic?

Pril → Olol → Sartan → ± Digoxin

What are first-line HTN drugs?

ACEi, ARBs, CCBs, Thiazides

What is the key ACS rule for paramedics?

Aspirin saves lives, GTN relieves pain