Pharmacology Cheat Sheet
Pressure, Perfusion and Rhythm
Cardiovascular pharmacology for NEET-PG: heart failure four pillars, adenosine and magnesium for arrhythmias, methyldopa in pregnancy, and LDL targets.
MedNext Academy | 3 min read
Pressure, Perfusion and Rhythm
Cardiovascular pharmacology for NEET-PG: heart failure four pillars, adenosine and magnesium for arrhythmias, methyldopa in pregnancy, and LDL targets.
Cardiovascular pharmacology covering antihypertensives, antianginals, heart failure therapy, antiarrhythmics, and lipid-lowering drugs.
High-yield lines
- Renin release is triggered by reduced renal perfusion, reduced sodium chloride delivery to the macula densa, and beta-1 sympathetic stimulation.
- The four pillars of heart failure with reduced ejection fraction are an ARNI, a beta-blocker, a mineralocorticoid antagonist, and an SGLT2 inhibitor.
- Nitrate tolerance develops with continuous exposure and is prevented by a daily nitrate-free interval.
- Adenosine is given as a rapid 6 mg then 12 mg IV push to terminate AV-nodal re-entrant tachycardia, with an ultra-short half-life of about 10 seconds.
- Intravenous magnesium is the drug of choice for torsades de pointes.
- Methyldopa is the drug of choice for chronic hypertension in pregnancy due to its long fetal safety record.
- Spironolactone can cause gynaecomastia, impotence, and dose-limiting hyperkalaemia through its antiandrogenic and progestogenic activity.
- Amiodarone rarely causes torsades despite prolonging the QT interval because it produces homogeneous multi-channel repolarisation.
- In Wolff-Parkinson-White with atrial fibrillation, AV nodal blockers must be avoided as they can accelerate conduction down the accessory pathway.
- Non-selective beta-blockers can cause bronchospasm and are avoided in asthma, while they remain beneficial long-term in chronic stable heart failure.
- Very-high cardiovascular risk patients target an LDL cholesterol below 55 mg/dL with at least a 50% reduction from baseline.
- Sodium nitroprusside can cause cyanide toxicity, treated with sodium thiosulfate, hydroxocobalamin, or sodium nitrite, and must be protected from light.
- Digoxin controls ventricular rate in atrial fibrillation and reduces heart failure hospitalisation but is mortality-neutral.
- Esmolol has an ultra-short half-life of about 9 minutes, useful for perioperative tachycardia and aortic dissection.
Mapped competency codes
- PH1.26
- PH1.27
- PH1.28
- PH1.29
- PH1.30
- PH1.31
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This summary maps to PH6-cardiovascular-pharmacology.
Frequently Asked Questions
What are the four pillars of heart failure therapy?
An ARNI (sacubitril-valsartan), a proven beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor, each independently reducing mortality.
What is the drug of choice for torsades de pointes?
Intravenous magnesium sulfate.
Which antihypertensive is preferred in pregnancy?
Methyldopa, which has the largest body of long-term fetal safety data.
How is adenosine used and why does it work briefly?
Given as a 6 mg then 12 mg rapid IV push, it causes transient complete AV block terminating AVNRT, with a half-life of about 10 seconds.
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