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Cardiac Flashcards

1
Q

Use for Primary HTN

A

thiazides
Ace inhibitors
Angiotensin receptor blockers

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2
Q

HTN with HF

A

diuretic, ace inhibitor, and arb (only use beta blockers in compensated HF)

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3
Q

HTN with DM

A

ace inhibitors and angiotensin receptor blockers

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4
Q

HTN in pregnancy

A

hydrazine, nifedipine, methyldopa, labetalol

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5
Q

Dihydropyridine calcium channel blockers work on?

A

vascular smooth muscle

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6
Q

Amlodipine, clevidipine, nifedipine, nimodipine

A

dihydropyridine calcium channel blockers

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7
Q

nondihydropyridine calcium channel blockers

A

work on the heart

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8
Q

dilitazem, verapamil

A

nondihydropyridine calcium channel blockers

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9
Q

-“dipine”=

A

Dihydropyridine calcium channel blockers

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10
Q

MOA of calcium channel blockers

A

block voltage gated L type calcium channels of cardiac and smooth muscle

(Class 4 will decrease conduction velocity and increase EP and increase PR interval)

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11
Q

Use all Dihydropyridines except nimodipine for:

A

HTN, angina, raynaud phenomenon

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12
Q

nimodipine used for

A

subarachnoid hemorrhage

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13
Q

nondihydropyridines used for

A

HTN, angina, a fib/flutter, and to prevent SVT

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14
Q

SE of dihydropyridines

A

cardiac depolarization, av block, hyperprolactinemia, constipation

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15
Q

SE of nondihydropyridines

A

peripheral edema, flushing, dizziness, gingival hyperplasia

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16
Q

Hydralazine works by:

A

increased cGMP; which works to vasodilator arterioles > veins ; decreases afterload

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17
Q

Hydralazine is used for HF when given with?

A

nitrate

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18
Q

Hydralazine avoids reflex tachycardia with?

A

beta blockers

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19
Q

SE: of hydralazine

A

SLE like symptoms, increase HR, and fluid retention

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20
Q

1 drug for HTN emergency =

A

nitroprusside

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21
Q

NItroprusside works by:

A

increase cGMP–> by releasing NO and can cause Cyanide toxicity

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22
Q

Nitrates examples:

A

nitroglycerin, isosorbide dinitrate, isosorbide mononitrate

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23
Q

MOA of nitrates:

A

dilate veins> arterioles; which decreases preload

**Will also see a decrease in EDV, BP, ejection time, and MVO2

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24
Q

Nitrates work on EDV and BP by:

A

decreases MVO2

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25
Q

Beta blockers work on contractility and BP by:

A

MVO2

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26
Q

Inhibits late phase of sodium current –> decreases diastolic wall tension and oxygen consumption

A

ranolazine

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27
Q

use for angina due to other therapies; that doesn’t affect the HR or contractility?

A

ranolazine

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28
Q

Inhibit NA/K ATPase; which indirectly inhibits the Na/Ca exchanger which increases calcium

29
Q

increases calcium means increasing contractility; also + ionotrophy ; which stimulates vagus nerve and decreases the HR

30
Q

digoxin SE:

A

blurry yellow vision

31
Q

HMG COA reductase inhibitors MOA:

A

prevent mevalonate synthesis

32
Q

Which lipid lowering agents decrease LDL?

A

HMG COA reductase inhibitors; bile acid resins, ezetimibe

33
Q

Which lipid lowering agents increase HDL?

34
Q

Which lipid lowering agents decrease triglycerides?

A

fibrates, omega 3 FA

35
Q

Which lipid lowering agent increases LFTs?

36
Q

Statins cause increased or decreased mortality in CAD patients?

37
Q

SE of statins:

A

statin induced myopathy ; esp with vibrates or niacin

38
Q

examples of bile acid resins:

A

cholestyramine, colestipol, colesevelam

39
Q

Bile acid resins MOA:

A

prevent intestinal reabsorption of bile acids

40
Q

SE of bile acid resins

A

decrease absorption of other drugs and fat soluble vitamins

*** cholestyramine can bind C. difficle

41
Q

MOA: prevent cholesterol absorption at the small intestine brush border

42
Q

can be used when a patient cannot handle statins?

43
Q

MOA of fibrates:

A

upregulate LPL which increase TG clearance;

use PPAR gamma to decrease hepatic LDL and increase LPL activity which will ultimately decrease TG and increase HDL

44
Q

Fibrates SE:

A

myopathy and cholesterol gallstones

45
Q

Inhibit lipolysis in adipose tissue:

46
Q

SE of Niacin:

A

red flushed, face

  • can be decreased with NSAIDS
47
Q

Class 3 K+ channel blockers drugs:

A

amiodarone, ibutilide, dofetilide, sotalol (AIDS)

48
Q

Increase AP, increase ERP Increase QT interval

A

Class 3 K+ channel blockers drugs:

49
Q

Use for A-fib/flutter, V-tach

A

Class 3 K+ channel blockers drugs:

For Vtach ( use amiodarone or sotalol)

50
Q

Sotalol has more risk of _________ and amiodarone has a less risk of _________.

51
Q

You must check what with amiodarone?

A

PFTS, LFTS, TFTS

52
Q

Adenosine MOA:

A

increases K+ out of cells which hyper-polarizes and then decreases intercellular calcium

53
Q

Adenosine indications:

A

diagnose and terminate SVT

** effect is blunted by theophylline and caffeine

54
Q

Magnesium use:

A

torsades and digoxin toxicity

55
Q

Class 2 Anti arrhythmic: Beta blockers

A

metoprolol, propanolol, esmolou, atenolol, timolol, carvedilol

56
Q

decrease SA / AV node activity by decreases cAMP and decreasing calcium current which also decreases slope of phase 4

A

Class 2 Anti arrhythmic: Beta blockers

57
Q

SE of Class 2 Anti arrhythmic: Beta blockers

A

impotence, COPD exacerbation, can masks signs of hypoglycemia

** beta blockers can cause unopposed alpha 1 agonism if given alone for pheochromocytoma or cocaine toxicity

58
Q

Class 1 (Sodium channel blockers) action of what phase?

A

Phase 0; by decreasing slope

59
Q

Class 1A: drugs?

A

quinidine, procainamide, disopyramide

60
Q

Class 1B: drugs?

A

lidocaine and mexiletine

61
Q

Class 1C: drugs?

A

flecainide, propafenone

62
Q

Class 1A MOA:

A

prolong the AP, prolong the QT (causes torsades de pointes) , increases effective refractory period

63
Q

Class 1A SE:

A

reversible SLE like symptoms ( esp. procainamide) , cinchonism ( esp. quinidine) and heart failure (disopyramide)

64
Q

Class 1A used for?

A

atrial and ventricular arrhythmias

65
Q

Class 1B MOA

A

decerase AP duration

66
Q

Class 1B used for?

A

best for: ventricular arrhythmias that are post MI

67
Q

Class 1C MOA

A

prolong ERP in AV node and accessory bypass tracts

68
Q

Class 1C used for?

A

use for SVTS ; CONTRAINDICATED POST MI ;

69
Q

Mneumonic for Class 1 anti-arrhythmics (Sodium) channel blockers

A

1 A Double Quarter Pounder

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Pharm (9 decks)

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