Cardiac Pharm - Stuff Tom Can't Remember Flashcards
Digoxin Toxicity
Symptoms
Nausea Vomiting Diarrhea Hyperkalemia Blurry yellow vision Arrhythmias (DADs) AV Block
List drug classes indicated in use in Primary (Essential) HTN
Thiazides
ACE Inhibitors
Angiotensin II Receptor Blockers
Dihydropyridine Ca2+ channel blockers (nifedipine)
What is Beck’s Triad? What do these symptoms indicate?
- Hypotension
- Increased JVP (distended neck veins)
- Distant, muffled heart sounds
Indicates acute cardiac tamponade!
What is Kussmaul’s sign? What does it indicate?
Increase in JVP on inspiration instead of a normal decrease.
Seen in constrictive pericarditis, restrictive cardiomyopathies, RA or RA tumors.
What is pulsus paradoxus? What does that indicate?
Decrease in systolic BP by >10mmHg during inspiration.
Indicates cardiac tamponade, asthma, obstructive sleep apnea, pericarditis.
How are each of the three types of hyponatremia treated?
Hypovolemic hyponatremia – saline injection
Euvolemic and Hypervolemic hyponatremia – Vaptams may be used (ADH receptor antagonists)
What valvular defect presents with a holosystolic murmur?
Mitral regurgitation (intensity of murmur constant through systole)
What valvular defect presents with a midsystolic murmur (crescendo-decrescendo)?
Aortic stenosis
What valvular defect presents with a blowing diastolic murmur?
Aortic regurgitation
What valvular defect presents with a holosystolic machine like murmur?
PDA
What is the general MOA for fibrates?
Activate PPAR-alpha to induce HDL synthesis.
Activate LPL to clear more triglycerides from the blood.
List all of the Class I Anti Arrhythmics we discussed
Procainamide Quinidine Lidocaine Mexiletine Flecainide Propafenone
What kinds of arrhythmias are indicated for Class IA anti-arrhythmics?
Atrial and ventricular arrhythmias
What kinds of arrhythmias are indicated for Class IB anti-arrhythmics?
Lidocaine is used for arrhythmias post MI
Ventricular tachycardia and fibrillation
What kinds of arrhythmias are indicated for Class IC anti-arrhythmics?
Supraventricular arrhythmias in otherwise normal hearts
What kinds of arrhythmias are indicated for Class II anti-arrhythmics?
Preventing recurrent infarction and sudden death after MI
Exercise induced arrhythmias
Atrial fibrillation
Atrial flutter
AV node reentry
What kinds of arrhythmias are indicated for Class III anti-arrhythmics?
Amiodarone
Recurrent ventricular tachycardia or fibrillation
Atrial fibrillation
DOC for out of hospital Cardiac arrest
Dronedarone currently used for atrial fibrillation/flutter
What kinds of arrhythmias are indicated for Verapamil?
Supraventricular arrhythmias
Reentry arrhythmias involving the AV node
Slowing ventricular rate in atrial fibrillation/flutter
What is the indication for adenosine?
Converting paraoxysmal supraventricular tachycardia to sinus rhythm
What drugs might you use to convert A fib or paraoxysmal supraventricular tachycardia to sinus rhythm?
Adenosine
Amiodarone
Flecainide
What drugs might you use to maintain sinus rhythm in A fib or paraoxysmal supraventricular tachycardia?
Amiodarone
Dronedarone
Flecainide
Propafenone
What drugs might you use for ventricular rate control in A fib or paraoxysmal supraventricular tachycardia?
Diltiazem or Verapamil
Propranalol or Esmolol
What would you use to treat ventricular tachycardia in a patient without heart disease?
Amiodarone
Lidocaine
What are the indications of spironolactone?
Primary or secondary hyperaldosteronism
Cirrhosis of the liver
Could be used with K+ wasting diuretics to prevent hypokalemia
Dabigatran
MOA
Oral anti-IIa (thrombin) agent
Riveroxiban
Apixiban
MOA
Oral anti-Xa agents
Bivalirudin
Hirudin (Refludan)
Argatroban
MOA
IV Anti-IIa (thrombin) agents
Icatibant
MOA
Indication?
B2 (bradykinin) receptor antagonist
Used for angio-neurotic edema
What is Dressler Syndrome?
Autoimmune pericarditis that occurs weeks to months after an MI
What are some big lab manifestations of DIC?
Thrombocytopenia
Shistocytes and fragmented RBCs on peripheral smear
Prolonged PT and APTT
Decreased fibrinogen level
What are the primary murmurs heard in HOCM?
First, you’d hear a crescendo-decrescendo systolic murmur due to outflow tract obstruction of the aortic valve.
If the HOCM gets bad enough, you may get mitral regurgitation (holosystolic murmur) as well.
