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Pharmacology > Antiarrhythmic - Diuretics - Hyperlipidemia > Flashcards

Antiarrhythmic - Diuretics - Hyperlipidemia Flashcards

0
Q

Polymorphic ventricular tachycardia, often displaying waxing and waning QRS amplitude in ECG

A

Torsades de Pointes

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1
Q

Two arrhythmogenic mechanisms

A
  1. Abnormal automaticity

2. Abnormal conduction

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2
Q

What are the different class of antiarrhythmic drugs based on Singh Vaughan Williams Classifications

A

Class 1: Sodium channel blockers
Class 2: Beta-adrenoceptor blockers
Class 3: Potassium channel blockers
Class 4: Calcium channel blockers

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3
Q

What portion of the cardiac action potential does the Class 1 antiarrhythmic drugs act on?

A

Phase 0

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4
Q

Class 1A antiarrhythmic drug that has a lupus like syndrome side effects

A

Procainamide - used for atrial and ventricular arrhythmias, especially after MI

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5
Q

A class 1A antiarrhythmic drug that has a marked antimuscarinic effects

A

Disopyramide

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6
Q

Antiarrhythmic drug that is also used in malaria with a side effect of having cinchonism and autoimmune reactions (ITP)

A

Quinidine - reduces clearance of digoxin

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7
Q

Treatment for class 1A overdose

A

Sodium lactate - reverse drug induced arrhythmias

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8
Q

Antiarrhythmic drugs that reduces AP duration, selectively affects ischemic or depolarized Purkinje and ventricular tissues. Have little effect on the ECG

A

Group 1B antiarrhythmic drugs

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9
Q

Drug of choice for ventricular arrhythmias post-myocardial infarction. It is also the least cardiotoxic among conventional anti-arrhythmic drugs

A

Lidocaine

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10
Q

Antiarrhythmic drug that has a powerful depressants of sodium current. Can markedly slow conduction velocity in atrial and ventricular cells

A

Group 1C antiarrhythmic drugs

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11
Q

Anti arrhythmic drug used for refractory arrhythmias, contraindicated for post MI arrhythmia

A

Flecainide

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12
Q

Class IA drugs used for WPW syndrome

A

Procainamide and Amiodarone

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13
Q

Class 2 antiarrhythmic drugs act on what phase of action potential?

A

Phase 4 - AV node is particularly sensitive to blockers

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14
Q

Class 2 antiarrhythmic drug used for post - MI prophylaxis against sudden death and thyrotoxicosis

A

Propranolol - slowed pacemaker activity

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15
Q

Beta-blocker lacking local anesthetic effect

A

Timolol

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16
Q

Beta-blocker with low lipid solubility

A

Atenolol

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17
Q

Antiarrhythmic drug that acts on phase 3, hallmark is prolongation of the AP duration, ECG: increAse in QT interval

A

Class 3 antiarryhythmic drugs - blockade of potassium that are responsible for the repolarization of the AP

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18
Q

Class 3 antiarrhythmic drug used for treatment and prophylaxis of atrial fibrillation

A

Dofetilide - side effects: Torsades de pointes

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19
Q

A beta-blocker that has class 3 properties, used for ventricular arrhythmia and atrial fibrillation

A

Sotalol

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20
Q

Class 3 antiarrhythmic drug used for refractory arrhythmias, most efficacious of all antiarrhythmic drugs.

A

Amiodarone - it has group 1, group 2 and 4 effects

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21
Q

Toxicity results to pulmonary fibrosis, paresthesias, tremors, thyroid dysfunctions, corneal deposits, and skin deposits

A

Amiodarone toxicity

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22
Q

Group of drugs effective in arrhythmias that must traverse calcium dependent cardiac tissues (AV node). ECG: PR interval is consistently increased

A

Class 4 antiarrhythmic drugs

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23
Q

Why are dihydropyridine calcium channel blockers not useful as antiarrhythmics?

A

Dihydropyridine CCBs evoke compensatory sympathetic discharge which facilitates arrhythmias rather than terminating them

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24
Q

Class 4 antiarrhythmic drug used for Reynaud’s phenomenon

A

Diltiazem

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25
Q

Site of active sodium and chloride pump out of the lumen of the nephron via Na/Cl carrier

A

Distal convoluted tubule

27
Q

It is a miscellaneous antiarrhythmic drug of choice for paroxysmal supraventricular tachycardia

A

Adenosine

28
Q

Major site for sodium chloride and sodium bicarbonate reabsoption (60-70%)

A

Proximal convoluted tubule

29
Q

Carbonic anhydrase inhibitor drug used for glaucoma,

A

Acetazolamide - SE: hyperchloremic metabolic acidosis (NAGMA)

30
Q

Site for sodium chloride reabsoption via Na/K/2Cl transporter

A

Thick ascending loop of Henle

31
Q

Site of calcium and magnesium reabsorption

A

Thick ascending loop of Henle

32
Q

Important in maintaining glomerular filtration

A

Prostaglandins

33
Q

Drugs that decreases the efficacy of loop diuretics

A

NSAIDs

35
Q

Site for last tubular sodium reabsoption, reabsorbing (2-5%) of sodiu via channels

A

Cortical collecting ducts

36
Q

Loop diuretic that has synergistic effect with aminoglycosides. Half life of 6 hours used for heart failure and pulmonary edema

A

Furosemide - SIMD: Ethacrynic acid

37
Q

Primary site of acidification of urine, last site of potassium excretion

A

Cortical collecting duct

38
Q

Site of reabsorption of water occurs under the control of antidiuretic hormones (ADH)

A

Medullary collecting duct

39
Q

Calcium is also reabsorbed at this distal convoluted tubule under the control of what hormone?

A

PTH

40
Q

Diuretic used for hyperaldosteronism, SE: gynecomastia, impotence

A

Spironolactone - SIMD: Eplerenone - reduces progression of DM nephropathy

42
Q

Remains in the lumen and holds water by virtue of its osmotic effect. Used for rhabdomyolysis and increased intracranial pressure

A

Mannitol

45
Q

Drugs effective in lowering LDL cholesterol except:

Statins, fibrates, resins, ezetimibe, niacin

A

Fibrates - has no or little effect on LDL concentrations

46
Q

Potassium - sparing diuretic (Na blocker) used for hypokalemia. SE: hyperkalemia, acute renal failure and kidney stones

A

Amiloride

47
Q

An ADH antagonist used for SIADH and hyponatremia

A

Conivaptan

48
Q

Drug used for hypercholesterolemia (high LDL), pruritus in cholestasis. SE: steatorrhea, constipation and malabsorption

A

Cholestyramine - bile acid binding resin

49
Q

Conditioned highly associated with acute pancreatitis

A

Hyperchylomicronemia

52
Q

Drugs most effective in lowering triglycerides and VLDL, increasing HDL

A

Niacin and fibrates

53
Q

It raises triglyceride and VLDL levels and should be avoided in patients with hyoertriglyceridemia

A

Alcohol

54
Q

Has anti-atherosclerotic effects and prevent bone loss. However, had increased risk of myopathy and rhabdomyolysis when used with fibrates

A

Simvastatin - reversible competitive inhibitor of HMG-CoA reductase

55
Q

Drug converted to glucuronide form in the liver, it inhibits NPC1L1 transporter and prevents absorptionof dietary cholesterol and cholesterol that is excreted in bile

A

Ezetimibe - with synergistic effect with Statins in lowering LDL

56
Q

Most effective agent for increasing HDL levels, reduces LDL cholesterol, triglycerides and VLDL. Both vitamin and antihyperlipidemic drug

A

Niacin - aspirin pre-treatment reduces flushing, avoid in patients with peptic ulcer disease

57
Q

90% of bile acids are reabsorbed and returned to the liver for reuse via?

A

Enterohepatic recirculation

58
Q

Synergistic combination for Familial combined hypercholesterolemia?

A

Niacin + Resin or Statin + Fibrate

59
Q

Disadvantage of Statin and Fibrate combination

A

Increased risk of myopathy and rhabdomyolysisw

60
Q

A sterol absorption blocker used for hypercholesterolemia by acting as cholesterol analog

A

Sitosterol

61
Q

Used as an antiarrhythmic drug by depressing ectopic pacemakers, including those caused by digitalis toxicity

A

Potassium ion

62
Q

Drug that activates PPAR-a, increases expression of lipoprotein lipase and apolipoproteins apoA-I and apoA-II. Drug of choice for hyperetriglyceridemia but increased risk for cholesterol gallstones

A

Gemfibrozil - fibric acid derivative

63
Q

Combination of hyperlipidemic drugs that may increase risk of cholithiasis

A

Fibrate + Resin

64
Q

Synergistic combination for familial hypercholesterolemia?

A

Niacin + Statins or Statin + Ezetimibe

65
Q

ADH agonist - act at V1 and V2 ADH receptors used in central diabetes insipidus

A

Desmopressin

67
Q

What would be the blood pH if using both loop diuretics and thiazides?

A

Alkalemia

68
Q

Thiazide diuretic that has synergistic effect with loop diuretics

A

Hydrochlorothiazide

69
Q

Toxicity results to ototoxicity, hypokalemia, dehydration, allergy to sulfa drugs, nephritis and gout

A

Loop diuretic toxicity

74
Q

Site of uric acid transport

A

Proximal convoluted tubules

Pharmacology (11 decks)

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