Cardiac Drugs

Question 1

What are the two major non-DHP CCBs?

Answer 1

Diltiazem

Verapamil

Question 2

What is the MOA of CCB (what type of Ca channels are blocked, and what is the physiological effect)?

Answer 2

• Block L type Ca channels

- Reduces muscle contractility

Question 3

What is the MOA of hydralazine? Use? Side effects?

Answer 3

• Increase in cGMP to cause smooth muscle relaxation, and vasodilation of arterioles
• Used for HTN, CHF
• Lupus-like syndrome

Question 4

What is the MOA of nitroprusside? Use? Side effects?

Answer 4

• Increases cGMP via direct release of NO
• HTN emergency
• Cyanide toxicity

Question 5

What is the MOA of fenoldopam? Use? Side effects?

Answer 5

• Dopamine D1 agonist to cause arteriole vasodilation

- Emergent HTN

Question 6

What is the MOA of NTG? Use? Side effects?

Answer 6

• Vasodilation by increasing NO in vascular smooth muscle, to dilate veins
• Pulmonary edema, angina
• Reflex tach, hypotension, HA

Question 7

What is the MOA of statins? Use? Side effects?

Answer 7

• inhibit HMG-CoA reductase
• Hypercholesterolemia
• myopathy / rhabdomyolysis

Question 8

What is the MOA of niacin? Use? Side effects?

Answer 8

• Inhibits lipolysis in adipose tissue
• Reduce VLDL synthesis
• hyperglycemia and hyperuricemia

Question 9

What is the MOA of cholestyramine? Use? Side effects?

Answer 9

• Bile acid resin; prevents intestinal reabsorption of bile acids
• hypercholesterolemia
• Increase in triglycerides, cholesterol gallstones

Question 10

What is the MOA of colestipol? Use? Side effects?

Answer 10

• Bile acid resin; prevents intestinal reabsorption of bile acids
• hypercholesterolemia
• Increase in triglycerides, cholesterol gallstones

Question 11

What is the MOA of colesevelam? Use? Side effects?

Answer 11

• Bile acid resin; prevents intestinal reabsorption of bile acids
• hypercholesterolemia
• Increase in triglycerides, cholesterol gallstones

Question 12

What is the MOA of ezetimibe? Use? Side effects?

Answer 12

• Prevent cholesterol absorption at small intestine brush border
• Increases LFTs, diarrhea

Question 13

What is the MOA of fibrates (-“fibrate”)? Use? Side effects?

Answer 13

• Upregulate LPL to increase TG clearance via PPARalpha
• Hypercholesterolemia and hypertriglyceridemia
• Myositis (especially with statins)

Question 14

What is the effect on LDL, HDL, and TGs for: statins

Answer 14

LDL = super decrease
HDL = increase
TG = decrease

Question 15

What is the effect on LDL, HDL, and TGs for: niacin

Answer 15

LDL = Decrease
HDL = good increase
TG = decrease

Question 16

What is the effect on LDL, HDL, and TGs for: Bile acid resins

Answer 16

LDL = Decrease
HDL = slightly increase
TG = slightly increase

Question 17

What is the effect on LDL, HDL, and TGs for: ezetimibe

Answer 17

LDL = Decrease
HDL = none
TG = none

Question 18

What is the effect on LDL, HDL, and TGs for: fibrates

Answer 18

LDL = decrease
HDL = increase
TG = super decrease

Question 19

What is the MOA of digoxin? Use? Side effects?

Answer 19

• Blocks Na/K ATPase to increase Ca inside myocytes, and thereby increase contractility
• CHF and a-fib
• Cholinergic s/sx

Question 20

What are the s/sx of digoxin intoxication?

Answer 20

• Halos around lights
• Yellow vision
• arrhythmias

Question 21

What is the treatment for digoxin intoxication?

Answer 21

“Digibind”-(Anti Fc antibody for digoxin)

• Correct metabolic disturbances
• Mg

Question 22

What are the general MOA of class I - IV antiarrhythmics?

Answer 22

1 = Na blocker
2 = beta blocker
3 = K blocker
4 = CCB