Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardio > And more drugs > Flashcards

And more drugs Flashcards

Hyperlipidemia Anti-Arrhythmias Only a couple hyperlipidemia..

1
Q

MOA of statins

A

inhibits rate-limiting step of cholesterol synthesis, which:

  1. upregulates LDL receptors in liver
  2. reduces lipoprotein secretion in liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Statins reduce…

A

LDL (50%)
TG (~37%)

(and increase HDL ~15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Statins are predominately excreted through

A

feces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

-mycin antibiotics, azoles, SSRI’s, CCB’s and grapefruit juice will have drug interactions with these statins:

A

Atorvastatin (lipitor) and Lovastatin

**via CYP3A4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cyclosporine and grapefruit juice are contraindicated with statins because they inhibit:

A

p-glycoprotein mediated intestinal absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

HMG CoA Reductase Inhibitors adverse effects: (7)

A 
mild GI distress
increased liver enzymes
sleep disturbance, memory loss
teratogenic 
myalgia without CPK rise
myositis with CPK rise
rhabdomyolysis with CPK rise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Statin which will have no effect on TG

A

lovastatins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do bile acid sequestrants interrupt recycling of cholesterol?

A

bile negatively charged bile acids in the gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Group of antilipemic drugs that are non-systemic

A

bile acid sequestrants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Group of antilipemic drugs that are safe for use in patients with liver disease

A

bile acid sequestrants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What side effects may limit use of bile acid sequestrants?

A

GI bloating
constipation
possible increase in TG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bile acid sequestrants prevent the absorption of what drugs?

A

digoxin
beta blockers
thyroxine
coumadin

(these should be taken an hour before or 3-4 hours after BAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MOA of ezetimibe (zetia):

A

inhibits absorption of cholesterol in small intestine by 50%, which reduces delivery of cholesterol to liver

this results in upregulation of LDL receptors and increased clearance of LFL from plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ezetimibe (zetia) localizes to:

A

brush border of small intestinal epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Excretion of ezetimibe (zetia):

A

biliary (78%) and renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Effect of ezetimibe (zetia) on LDL, HDL, TG:

A

lowers LDL by ~18%
increased HDL by ~5%
lowers TG by ~11%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Drug interactions associated with ezetimibe (zetia):

A
  1. bile acid sequestrants (decrease absorption of ezetimibe by up to 80%)
  2. cyclosporine (3-4 fold increase in ezetimibe levels)
  3. fibrates (when combined, may increase biliary cholesterol excretion and increase risk of gallstones)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most significant side effect associated with ezetimibe (zetia):

A

increased liver enzymes when co-administered with a statin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MOA of fibric acid derivatives

gemfibrozil and fenofibrate

A

serves as ligand for ligand-activated PPAR-alpha nuclear receptor, which then causes:

  1. supresses transcription of ApoCIII (which increases LPL)
  2. increased ApoA1 synthesis
  3. increases PL transfer protein activity
  4. increased FA oxidation (reduces TG synthesis)
  5. increased biliary cholesterol excretion via increased cholesterol 12a hydroxylase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q 
Effects of fibric acid derivatives on:
VLDL
TG
HDL
LDL
A

VLDL: reduced
TG: reduced by up to 50%
HDL: increased (~15%)
LDL: unchanged/-/+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Side effects of fibric acid derivatives:

A 
GERD, diarrhead
increased liver enzymes
gallstones
teratogenic/embryocidal in animals
    pregnancy category C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Side effect specific to fenofibrate (tricor):

A

reversible increase in creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gemfibrozil reduces metabolism of what drugs?

A

statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Gemfibrozil is a good drug choice for patients with…

unlike fenofibrate

A

renal disease (extensively metabolized by liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
MOA of niacin: (5)
1. inhibits mobilization of FFA from adipocytes 2. reduced hepatic TG synthesis 3. reduces ApoB synthesis and secretion (VLDL) 4. Enhanced ATP cassette-mediated transfer of cholesterol from macrophage to HDL 5. Enhances LPL (promotes conversion of VLDL to LDL)
26
``` Niacin's effects on: HDL LDL TG Lp(a) ```
HDL: increased (via increased plasma ApoA1) LDL: reduced TG: reduced Lp(a): reduced *unique feature
27
Side effects of niacin:
1. flushing 2. increased liver enzymes, hepatitis, failure 3. GI irritation and activation of peptic ulcer disease 4. hyperuricemia/gout 5. retinal detachment 6. cystoid macular edema 7. myositis 8. skin dryness, etc 9. insulin resistance, hyperglycemia *SMUGGLED (skin flushed, myositis, uric acid, GI, glu, liver, eyes, dry skin)
28
Effects of N3FA:
``` low TG antiplatelet antiarrhythmic reduced BP reduced CAD* ```
29
MOA of N3FA:
reduced hepatic TG synthesis by reducing SREBP increased FA ox via PPAR-alpha activation
30
Effects of N3FA on: HDL LDL TG
HDL: none LDL: none TG: lowers
31
N3FA is a formulation of ___ and ___
EPA | DHA
32
Class I antiarrhythmics | Examples?
Na channel blocker | lidocaine, procaine
33
Class II antiarrhythmics | Examples?
beta blocker | propranolol, metoprolol
34
Class III antiarrhythmics | Examples?
K channel blocker | amiodarone, sotalol, ibutilide
35
Class IV antiarrhythmics | Examples?
Ca channel blocker | verapamil, diltiazem
36
Phase IV depol of the SA node is slowed by
``` vagal activity (ACh) digoxin ```
37
Phase IV depol of the SA node is accelerated by
``` sympathetic activity class II drugs ```
38
Phase 0 depol is slowed by
``` Ca channel blockers class IV drugs ```
39
The cell is hyperpolarized by:
adenosine
40
Class II drugs are used for:
``` symptomatic PVC's reducing arrhythmia's post-MI (*survival) reducing enhanced automaticity angina HTN ```
41
Class I drugs are used to treat: | how?
enhanced automaticity blocking NA channels in the fast-conducting ventricular cells reduces membrane responsiveness =slower recovery
42
Class I drugs bind to Na channels in the _____ and ______ states
open and inactivated
43
Class I drugs result in decreased rate of rise of phase ___ depol
0
44
Procaineamide is a class ___; its dissociation rate is ___ sec and it slows conduction at ___ rates.
IA >1 sec slow
45
Lidocaine is a class ___; its dissociation rate is ___ sec and it slows conduction at ___ rates.
IB <1 (rapid!) fast rates (and ischemia)
46
Flecanide is a class ___; its dissociation rate is ___ sec and has a ______ effect on conduction
IC >10 sec (very slow) pronounced
47
Side effects of procainamide:
drug induced lupus (more likely in slow metabolizers) | tosades de pointes (especially if drug accumulates, as in renal failure)
48
Procainamide has little effect on:
SA and AV nodes
49
EP effects of procainamide:
1. prolongs AP duration 2. suppresses ectopic PM activity in partially depol cells 3. reduced conduction velocity
50
Lidocaine preferentially binds to
Na channels in partially depolarized cells to suppress abnormal automaticity
51
Lidocaine is effective for use in (atrial/ventricular) arrhythmias
ventricular
52
How does lidocaines dissociation rate affect its regulation of HR?
because of its rapid dissociation, cells can recover between APs at a NORMAL HR; thus it blocks at high HR
53
Lidocaine distributes into
fat tissue
54
Side effects of lidocaine:
CNS, agitation, confusion, seizures
55
Flecainide is contraindicated in patients with
structural heart disease proarrhythmic in: - LV dysfunction - CHD - sustained VT
56
Class III drugs will block phase ___, which prolongs the effective refractory period (or the __ on an EKG).
3 QT
57
Prolonging effective refractory period in the slow conducting limb prevents:
re-entry
58
Amiodarone blocks what channels?
K Na Ca beta-adrenergic
59
Amiodarone slows what portions of an EKG?
PR QRS QT (also causes sinus bradycardia)
60
IV amiodarone is used to treat:
life-threatening arrhythmias | used in cardiac resuscitation
61
amiodarone is metabolized via | What does it interact with?
CYP3A4 digoxin warfarin
62
Side effects of amiodarone:
``` pulmonary fibrosis photosensitivity dermatitis corneal halos optic neuritis (possible blindness) hypo/hyperthyroidism muscle weakness hepatitis ```
63
Sotalol blocks what channels?
K | beta (in L isomer)
64
Sotalol is excreted via
kidneys
65
Sotalol is contraindicated in:
``` prolonged QT renal insufficiency Asthma/COPD decompensated CHF 2nd/3rd AV block sinus bradycardia ```
66
Not so awesome sotalol side effect:
torsades de pointe
67
Indicated for acute termination of a-fib or a-flutter
ibutilide
68
"Pure" class II drug
ibutilide
69
Major side effects of ibutilide
transient asystole | torsade de pointes (polymorph V-tach)
70
Antiarrhythmics that block __ channels have torsade de pointes as a side effect
K
71
Drugs that treat v-tach
1. amiodarone 2. lidocaine (IV) 3. procaineamide
72
Sotolol should not be given in the setting of:
acute MI
73
Drugs that block conduction through the AV node are used to control:
rapid supraventricular arrhythmia
74
Drugs that slow conduction through AV node:
1. verapamil (class IV CCBs) 2. propranolol (class II, beta-blockers) 3. digoxin
75
Drugs that will have NO effect on AV node:
procaineamide, lidocaine, ibutilide
76
Effects of class IV drugs:
reduced SA node automaticity | reduced AV node conduction
77
Adverse effects of class IV drugs:
SA/AV block impaired myocardial contractility hypotension
78
Class IV are useful in what type of patients? | Contraindicated in?
can't tolerate beta-blockers normal LV function CHF LV dysfunction Sinus bradycardia AV block
79
Effects of digoxin
increases vagal activity to reduce SA automaticity inhibits Na/K/ATPase, which results in Ca overload
80
Drug that terminates paroxysmal supraventricular tachycardia
adenosine
81
Common adenosine side effects:
chest tightness transient asystole flushing recurrent PSVT without additional trx
82
What drug can be diagnostic for PSVT?
adenosine: if that fixes it = PSVT; | if not, try again
83
Digoxin alone is contraindicated in patients with:
WPW | can induce vfib
84
What drug class inactivates bradykinin?
ACEI
85
Side effects of ACEI's:
``` Hypotension Azotemia (volume-reduced, reduced GFR) Cough (Bradykinin) Angioedema (Bradykinin) Skin rash Dysguesia (“metallic” taste) Hyperkalemia--may affect renal function ```
86
ACEI or ARB's: which is preferred in CHF?
ACEI
87
How do beta blockers affect CHF patients?
short term not so great, but long term increases CO and decreases LVEDP
88
What molecular effects do beta blockers have in CHF?
1. Reverse desensitization 2. Increase receptor number 3. Restore fast signaling modes (contractility) over slow signaling modes (gene expression)
89
Beta blockers approved for CHF
Metoprolol (Lopressor®, Toprol XL®) Carvedilol (Coreg®) Bisoprolol (Zebeta®) ***NOT nebivolol
90
Digoxin will ___ contractility and ___CO
increase | increase
91
ACEI and ARB prevent/reverse the mitogenic effects of AngII, which include:
hypertrophy of cardiac myocytes and vasc smooth musc cardiac and vasc fibrosis atherosclerosis
92
What type of duiretic should you use with ACEI?
K sparing (like spironolactone)
93
Do not give which 3 drugs with digoxin?
quinidine (decr elim) amiodarone (decr elim) verapamil (slowing of HR)

Cardio (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions