CARDIAC Flashcards
MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics
Sodium channel blockers
SE of procainamide
Lupus-like syndrome
Limiting side effect of Quinidine
Prolongs QT interval
Other side effects of Quinidine
Thrombocytopenic purpura, and CINCHONISM
Major drug interaction with Quinidine
Increases concentration of Digoxin
DOC for management of acute Ventricular arrhythmias
Lidocaine
DOC for digoxin induced arrhythmias
Phenytoin
SE of phenytoin
Gingival hyperplasia
Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents
Class IC (flecainide, propafenone, moricizine)
Class II antiarrhythmics are
B-blockers
Antiarrhythmic that exhibits Class II and III properties
Sotalol
Side effect of sotalol
prolongs QT and PR interval
Used intravenously for acute arrhythmias during surgery
Esmolol
Anti-arrhythmics that decrease mortality
B-blockers
MOA of class III antiarrhythmics
Potassium channel blockers
Class III antiarrhythmic that exhibits properties of all 4 classes
Amiodarone
Specific pharmacokinetic characteristic of amiodarone
Prolonged half-life, up to six weeks
Antiarrhythmic effective in most types of arrhythmia
Amiodarone
SE of Amiodarone
Thyroid dysfunction, photosensitivity, skin (blue smurf syndrome), corneal deposits, liver damage and pulmonary fibrosis
MOA of class IV antiarrhythmics
Calcium channel blockers
Life threatening cardiac event that prolong QT leads to
Torsades de pointes
Agent to treat torsades de pointes
Magnesium sulfate
Drug used supraventricular arrhythmias
Digoxin
DOC for paroxysmal supraventricular tachycardia (PSVT)
Adenosine
Adenosine’s MOA
Activates acetylcholine sensitive K+ channels in SA and AV node
Anti-arrhythmic with <10 second duration of action
Adenosine
MOA of sildenafil (Viagra)
Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP
Drugs used in the management of angina
Aspirin, Nitrates, CCB, and Beta blockers
Aspirin reduces mortality in unstable angina by
Platelet aggregation inhibition
MOA of nitrates
Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles
Nitrate used for acute anginal attacks
Nitroglycerin sublingual tablets
Nitrate used to prevent further attacks
Oral and transdermal forms of nitroglycerin
Nitrate free intervals are needed due to
Tolerance
SE of nitrates
Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation
CCB are DOC for
Prinzmetal’s angina
Beta blockers are used for which type of anginal attack
Classic
MOA of Cardiac glycosides (eg. digoxin)
Indirectly increase intracellular calcium and cardiac contractility by inhibit Na+/K+ ATPase
Digoxin is used in
Atrial fibrillation and CHF
Digoxin toxicity can be precipitated by
Hypokalemia
Antidote for digoxin toxicity
Digibind
Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects
Amrinone and milrinone
SE of amrinone
Thrombocytopenia
Beta 1 agonists used in acute CHF
Dobutamine and dopamine
Diuretics work in CHF by
Reducing preload
Beta blockers work in CHF by
Reducing progression of heart failure (never use in acute heart failure)
Agent used in CHF that is a selective alpha and nonselective beta blocker
Carvedilol
Agent used in acutely decompensated CHF resembling natriuretic peptide
Nesiritide (Natrecor)
