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Revision Questions: Cardiovascular (Preview)

Sample Questions

  1. List the classes and subclasses of anti-arrhythmic drugs under the Vaughan-Williams system and give an example of a drug in each class.
  2. Why do ACE inhibitors reduce blood pressure?
  3. Which calcium channel blocker does not have any significant effects on the myocardium?
  4. In a hypertensive patient who is taking insulin to treat diabetes mellitus, which class of drugs is to be used with extra caution and advice to the patient?
  5. Differentiate the following classes of drugs used in hypertension in terms of causing potassium changes in the body.
    • ACE-inhibitors
    • Angiotensin II antagonist
    • Loop diuretics
    • Thiazide diuretics
    • Aldosterone antagonists & potassium-sparing diuretics

Sample Answers

  1. Vaughan-Williams classification of anti-arrhythmic drugs
  2. Class Known As Examples
    Ia Fast channel blockers Quinidine, procainamide, disopyramide
    Ib   Lignocaine, mexiletine
    Ic   Flecainide
    II Beta-blockers Esmolol, sotalol
    III   Amiodarone, sotalol
    IV Slow-channel blockers Verapamil, diltiazem
    V   Adenosine, digoxin
  3. ACE-I block conversion of angiotensin I to angiotensin II and also inhibit the breakdown of bradykinin. They reduce the effects of angiotensin II-induced vasoconstriction, sodium retention and aldosterone release.
  4. Diltiazem acts on both cardiac and vascular smooth muscle, but it has less effect on cardiac cells hence may be used safely with beta blockers in hypertension.
  5. Beta-blockers may mask signs of acute hypoglycaemia (eg. tachycardia, tremor). Beta1-selective beta-blockers such as atenolol, metoprolol and bisoprolol are preferable. They produce less bronchospasm, less peripheral vasoconstriction and less alteration to glucose/lipid metabolism.
  6. Potassium changes:
    • ACE-I: hyperkalaemia
    • Angiotensin II antagonist: hyperkalaemia
    • Loop diuretics: hypokalaemia
    • Thiazide diuretics: hypokalaemia
    • Aldosterone antagonists & potassium-sparing diuretics: hyperkalaemia

The full version has many more questions with answers included.

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