pharm 2 lecture learning concepts

Outline erythrocyte function

outline normal erythrocyte formation and regulation

Define anaemia

explain the terms macrocytic, microcytic, normocytic, hypochromic and normochromic and how they relate to different subtypes/common causes of anaemia

Recognise the key signs symptoms of anaemia and explain how such symptoms relate to the pathophysiology of this condition

Explain the pathophysiology of and treatments for:
 Iron deficiency anaemia

Explain the pathophysiology of and treatments for:

Vitamin B12 and/or folic acid deficiency anaemia

Explain the pathophysiology of and treatments for:

 Anaemia of chronic renal disease

Describe the anatomy of the heart

Pulmonary circuit
Systemic circuit

Identify the layers of the heart wall

Describe valves of the heart

Describe the blood flow through the heart

Describe the coronary circulation

Describe the conducting system of the heart

• Describe a cardiac action potential

Explain the electrical and mechanical events of the cardiac cycle

Define cardiodynamic variables

Explain the factors affecting cardiac output, HR and stroke volume

Describe the structure and function of the 5 types of blood vessels

Explain the mechanisms that regulate blood flow through arteries, capillaries and veins

Discuss the movement of fluid between capillaries and interstitial fluid

List the roles of cholesterol within the body

Describe the classification and characteristics of:
 TGs, chylomicrons, VLDL

Describe the classification and characteristics of:
LDL and HDL

Explain the endogenous & exogenous cholesterol sources &
pathways including the ‘reverse transport’ of cholesterol

liver makes cholesterol (de novo) - (endogenous) and we consume it in non plant based food in our diets (exogenous)

Describe the etiology of primary & secondary dyslipidaemia

 List the physical symptoms of dyslipidaemia

 Describe the mechanism of action, common adverse effects and interactions of drugs used to treat dyslipidaemia: statins

 Describe the mechanism of action, common adverse effects and interactions of drugs used to treat dyslipidaemia:
fibrates

 Describe the mechanism of action, common adverse effects and interactions of drugs used to treat dyslipidaemia: ezetimibe,

 Describe the mechanism of action, common adverse effects and interactions of drugs used to treat dyslipidaemia:
bile acid binding resins,

 Describe the mechanism of action, common adverse effects and interactions of drugs used to treat dyslipidaemia:
niacin

 Describe the mechanism of action, common adverse effects and interactions of drugs used to treat dyslipidaemia: PCSK9 inhibitors

 Describe the mechanism of action, common adverse effects and interactions of drugs used to treat dyslipidaemia:
omega 3 fatty acids

what is atherosclerosis

define:
Atheroma
Arteriosclerosis
Arteriolosclerosis
Atherogenic
Atherogenesis

Define:
Acute coronary syndrome
Coronary artery disease
Coronary ischaemic disease

 Explain the link between cholesterol, atherosclerosis & heart disease

 Recognise the risk factors for atherosclerosis

 Describe the process of plaque formation

 Describe the development of unstable fibrous plaques

Identify the consequences of atherosclerosis occurring in different vessels around the body

What is Haemostasis

What is meant by the vascular phase in haemostasis.

explain primary haemostasis

explain secondary haemostasis 

 The coagulation cascade - final common pathway in hemostasis

Fibrinolytic Phase of Haemostaisis (thrombis removal)

anticoagulation factors

Recognise factors that contribute to thrombosis & the different clinical presentations for thrombi around the body

arterial vs venous thrombi

Explain the process of fibrinolysis

Describe the mechanism of action, common adverse effects
and interactions of antiplatelet drugs:
 COX inhibitors (aspirin)

Describe the mechanism of action, common adverse effects
and interactions of antiplatelet drugs:
P2Y12 antagonists (clopidogrel, prasugrel, ticagrelor)

Describe the mechanism of action, common adverse effects
and interactions of antiplatelet drugs, including: phosphodiesterase inhibitors (dipyridamole)

Describe the mechanism of action, common adverse effects
and interactions of antiplatelet drugs:
glycoprotein IIb/IIIa inhibitors (abciximab, tirofiban)

Explain the intrinsic coagulation pathway and the laboratory tests used to monitor it

Explain the extrinsic coagulation pathway and the laboratory tests used to monitor it.

Describe the mechanism of action, common adverse effects and interactions of anticoagulant drugs
 Including: Vitamin K antagonists (warfarin),

Describe the mechanism of action, common adverse effects and interactions of anticoagulant drugs; indirect thrombin inhibitors (heparin, enoxaparin, fondaparinaux)

Describe the mechanism of action, common adverse effects and interactions of anticoagulant drugs; direct thrombin inhibitors (dabigatran)

Describe the mechanism of action, common adverse effects and interactions of anticoagulant drugs; factor Xa inhibitors (rivaroxaban, apixaban)

Recognise the factors that may influence INR during warfarin therapy

Describe the mechanism of action, common adverse effects and interactions of fibrinolytic drugs

Tissue plasminogen activator (t-PA) analogues
alteplase & tenecteplase

Explain purpose of & regulators involved in the fibrinolytic cascade

Haemostatic and Reversal Agents

Describe the mechanism of action, common adverse effects and interactions of reversal agents: tranexamic acid

Describe the mechanism of action, common adverse effects and interactions of reversal agents:
vitamin K

Describe the mechanism of action, common adverse effects and interactions of reversal agents:
protamine

Describe the mechanism of action, common adverse effects and interactions of reversal agents:
idarucizumab

Recognise situations where reversal of an antiplatelet or anticoagulation medication may be required

NOAC reversal agents
(novel)

what do you give to reverse warfarin

what do you give to reverse enoxoparin?

what do you give to reverse heparin?

Explain the role of blood products in managing complications of antiplatelet
& anticoagulant drugs

Recognise situations where reversal of an antiplatelet or anticoagulation medication may be required

Haemophilia A
vs
Haemophilia B

Explain the pathophysiology of IHD (angina & myocardial infarction)

Recognise the importance of the local heart vasculature and the factors that decrease myocardial oxygen supply

Unstable Angina

variant angina

Stable Angina

outline classification of myocardial infarctions (STEMI, NSTEMI)

Describe triggers for angina (factors that increase myocardial oxygen requirements)

Recognise the symptoms of angina and myocardial infarction and understand how they develop with regard to the pathophysiology

Describe the major classes of medications
used in the management of IHD:

antihypertensives

MOA of beta-blockers

Beta Blockers Drug Interactions

MOA of calcium channel blockers

AEs Calcium Channel Blockers

explain the mechanism of action, common adverse effects and interactions of:
nitrates

explain the mechanism of action, common adverse effects and interactions of nicorandil

explain the mechanism of action, common adverse effects and interactions of ivabradine

explain the mechanism of action, common adverse effects and interactions of perhexiline

Briefly describe the surgical procedures used in the management myocardial infarction

Goals of treatment of ischaemic heart disease

Management of atherosclerosis & ischaemic heart disease