Cardiac Pharm

Question 1

an example of thiazide diuretics

Answer 1

hydrochlorothiazide

Question 2

MOA of thiazide diuretics

Answer 2

Blocks Na+APTase pumps in upper end of ascending loop of Henle and first segment distal tubule. This will prevent sodium from being pumped out of the filtrate. Water will follow the sodium and be excreted as urine. **may cause hypokalemia.

Question 3

an example of loop diuretics

Answer 3

furosemide

Question 4

MOA of loop diuretics

Answer 4

Blocks NA+ATPase pumps along the entire length of ascending loop of Henle; most powerful class of diuretics. **may cause hypokalemia

Question 5

an example of potassium-sparing diuretic

Answer 5

amiloride and/or eplerenone

Question 6

MOA of potassium-sparing diuretics

Answer 6

inhibits the Na+ATPase pumps that are indirectly linked to K+/H+ exchange in the distal tubule

Question 7

MOA of eplerenone

Answer 7

An aldosterone receptor ANTAGONIST. Aldosterone promotes water and Na retention. Blocking an aldosterone receptor leads to diuresis.

Question 8

an example of an osmotic diuretic

Answer 8

mannitol

Question 9

MOA of osmotic diuretic

Answer 9

Pulls water into vasculature for elimination via osmosis. Does not depend on BP.

Question 10

an example of a carbonic anhydrase inhibitor

Answer 10

acetazolamide

Question 11

Examples of vasodilators (hint: there are 4)

Answer 11

Verapamil
Hydralazine
Nitric Oxide
Nitroprusside

Question 12

MOA of verapamil

Answer 12

calcium channel blocker

Question 13

MOA of hydralazine

Answer 13

K+ channel blocker and myosin light chain phosphatase activator

Question 14

MOA of Nitric Oxide

Answer 14

guanylyl cyclase, myosin light chain phosphatase activator

Question 15

What is myosin light chain phosphatase?

Answer 15

A substance that DEPHOSPHORALATES the cardiac cell, causing it to relax

Question 16

What medications are specifically effective in African American patients with htn and HF

Answer 16

hydralazine and nitrates

Question 17

ACE Inhibitor examples

Answer 17

Aliskiren, captopril and lisinopril

Question 18

Example of an Angiotensin II receptor blocker (ARB)

Answer 18

losartan

Question 19

How do ACE inhibitors and ARBs work?

Answer 19

By interfering with the RAAS, causing the body to excrete more urine and decrease blood volume to assist in BP management

Question 20

Advantage of ACE inhibitors

Answer 20

inhibition of ACE reduces the risk of cardiovascular mortality in hypertensive patients. Are NOT contraindicated with patients who have asthma. Will not cause orthostatic hypotension

Question 21

examples of antianginal drugs

Answer 21

propranolol and nitroglycerin

Question 22

MOA of nitroglycerin

Answer 22

Nitroglycerine gets converted to nitric oxide which is a potent vasodilator in the coronary arteries which increases the supply of oxygen.

Question 23

two medications that can be used in the treatment of cardiac arrest

Answer 23

epinephrine and isoproterenol

Question 24

How do epinephrine and isoproterenol act to treat cardiac arrest

Answer 24

they act as beta1 agonists in cardiac tissue, increase the SNS activity of the sinoatrial node that can induce myocardial systole (contractions)

Question 25

what medication prevents the spread of necrosis during an MI

Answer 25

propranolol

Question 26

how does propranolol prevent spread of necrosis in an MI

Answer 26

propranolol acts as a beta1 antagonist which reduces heart rate, reduces work of the heart, reduces anoxia, and reduces the spread of necrosis

Question 27

Another treatment to prevent necrosis, other than propranolol?

Answer 27

treat with fibrolytic drugs that dissolve blood clots (ex. TPA)

Question 28

Examples of fibrolytic drugs

Answer 28

TPA, streptokinase and urokinase

Question 29

MOA of TPA, streptokinase and urokinase

Answer 29

enzymes that catalyze plasmin formation within a clot that leads to fibrolysis… puts pt at risk for widespread bleeding

Question 30

What medication is used to treat dysrhythmias?

Answer 30

amiodarone

Question 31

MOA of amiodarone

Answer 31

amiodarone is a class III potassium channel blocker that is used to control atrial fibrillation and ventricular tachycardia caused by ectopic foci; its effects are also mediated by inhibition of sodium and calcium channels

Question 32

Why is amiodarone a short term treatment?

Answer 32

AMIODARONE CAN CAUSE TOXIC LUNG, HEART, AND LIVER DAMAGE

Question 33

Major negative side effect to ace inhibitors and the causation of it

Answer 33

ACE inhibitors also inhibit the enzyme that metabolizes the inflammatory mediator bradykinin > bradykinin along the respiratory airway stimulates an inflammatory condition > stimulates mucous secretion > stimulates a chronic cough

Question 34

Pro to bradykinin metabolization

Answer 34

bradykinin is beneficial to the heart because it stimulates fibrolysis that reduces the progression of cardiac remodeling > prolonged life in pts with cardiac failure

Question 35

What is the first line of treatment of patients with fluid overload

Answer 35

diuretics combines with ace inhibitors and/or arbs

Question 36

MOA of eplerenone

Answer 36

aldosterone receptor antagonist

Question 37

Usage of eplerenone

Answer 37

reduces symptoms of edema and blocks aldosterone’s role in promoting cardiac remodeling

Question 38

MOA of tolvaptan

Answer 38

an oral vasopressin antidiuretic hormone receptor antagonist

Question 39

What does tolvaptan used for

Answer 39

it is used to treat hyponatremia/hypervolemia that is secondary to end-stage HF.

Question 40

what drug has a positive inotropic effect on the myocardium

Answer 40

digoxin

Question 41

MOA of digoxin

Answer 41

it blocks the Sodium-Potassium ATPase pump > more sodium in the cell > Sodium-Calcium ATPase pump to work in overtime, excreting sodium from the cell > more calcium inside of the cell > stronger cardiac contractions