Cardiac Pharmacology 2 (SUDWEEKS) Flashcards

1
Q

All of the following are defects outside the heart that can potentially cause heart failure EXCEPT:

A. Coronary artery diseaes

B. Pulmonary hypertension

C. Diabetes

D. Valve deficiency

E. All of the above are defects outside of the heart

A

D. Valve deficiency

note: valve deficiency is another cause for heart failure but occurs within the heart

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2
Q

Which of the following is used to accelerate cardiac conduction in treating heart muscle failure?

A. Inotropic drugs

B. Chronotropic drugs

C. Dromotropic drugs

D. All of the above

E. None of the above

A

C. Dromotropic drugs

Inotropic = Force

Chromotropic = Rate

Dromotropic = Conduction velocity

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3
Q

Which of the following is used to increase heart rate?

A. Inotropic drugs

B. Chronotropic drugs

C. Dromotropic drugs

D. All of the above

E. None of the above

A

B. Chronotropic drugs

Inotropic = Force

Chromotropic = Rate

Dromotropic = Conduction velocity

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4
Q

Which of the following is used to increase the force of myocardial contraction?

A. Inotropic drugs

B. Chronotropic drugs

C. Dromotropic drugs

D. All of the above

E. None of the above

A

A. Inotropic drugs

Inotropic = Force

Chromotropic = Rate

Dromotropic = Conduction velocity

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5
Q

Beta-blockers:

A. Decrease heart rate

B. Decrease pressure

C. Decrease metabolic demand

D. C and D

E. All of the above

A

E. All of the above

Beta-blockers:

  • decrease heart rate
  • decrease pressure
  • decrease metabolic demand

Diuretics:

  • decrease pressure
  • decrease metabolic demand

Vasodilators:

  • decrease pressure
  • decrease metabolic demand
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6
Q

Diuretics:

A. Decrease heart rate

B. Decrease pressure

C. Decrease metabolic demand

D. C and D

E. All of the above

A

D. C and D

Beta-blockers:

  • decrease heart rate
  • decrease pressure
  • decrease metabolic demand

Diuretics:

  • decrease pressure
  • decrease metabolic demand

Vasodilators:

  • decrease pressure
  • decrease metabolic demand
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7
Q

Vasodilators:

A. Decrease heart rate

B. Decrease pressure

C. Decrease metabolic demand

D. C and D

E. All of the above

A

D. C and D

Beta-blockers:

  • decrease heart rate
  • decrease pressure
  • decrease metabolic demand

Diuretics:

  • decrease pressure
  • decrease metabolic demand

Vasodilators:

  • decrease pressure
  • decrease metabolic demand
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8
Q

Beta-blockers work on which of the following receptors?

A. beta1

B. beta2

C. alpha1

D. alpha2

A

A. beta1

Beta-blockers = “olol”

note: Beta-blockers block sympathetic stimulation of the heart by working on the beta1 receptor. Beta1 receptors are associated with Epi and NE

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9
Q

What do Cardiac glycoside drugs treat and what are the 2 drugs we need to remember?

A

Congestive heart failure

  • Digoxin and Digitalis
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10
Q

Which of the following is a cardiac glycoside used to treat congestive heart failure?

A. Digoxin

B. Tolvaptan

C. Ranolazine

D. Simvastatin

E. Fenofibrate

A

A. Digoxin

Cardiac glycoside = Digoxin and Digitalis

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11
Q

Which of the following is a cardiac glycoside used to treat congestive heart failure?

A. Simvastatin

B. Tolvaptan

C. Ranolazine

D. Digitalis

E. Fenofibrate

A

D. Digitalis

note: cardiac glycosides block the Na+/K+ ATPase

cardiac glycosides = Digoxin and Digitalis

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12
Q

Which of the following blocks the Na+/K+ ATPase?

A. Simvastatin

B. Tolvaptan

C. Ranolazine

D. Digitalis

E. Fenofibrate

A

D. Digitalis

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13
Q

Which of the following is used to block the Na+/K+ ATPase?

A. Beta-blockers

B. Cardiac glycosides

C. ACE inhibitors

D. ANG II blockers

A

B. Cardiac glycosides

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14
Q

Which of the following is used to treat congestive heart failure?

A. Beta-blockers

B. Cardiac glycosides

C. ACE inhibitors

D. ANG II blockers

A

B. Cardiac glycosides

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15
Q

All of the following are used to treat Acute heart failure EXCEPT:

A. Tolvaptan

B. Dopamine

C. Milrinone

D. Nesiritide

E. Ranolazine

A

E. Ranolazine

Acute heart failure tx:

  • Dobutamine
  • Dopamine
  • Inamrinone, Milrinone, Vesnarinone
  • Nesiritide
  • Tolvaptan
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16
Q

All of the following are phosphodiesterase III inhibitors EXCEPT:

A. Inamrinone

B. Milrinone

C. Tolvaptan

D. Vesnarinone

E. All of the above are phosphodiesterase III inhibitors

A

C. Tolvaptan

note: phosphodiesterase III inhibitors all end in “rinone

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17
Q

Which of the following is a catecholamine?

A. Dobutamine

B. Dopamine

C. Inamrinone

D. Nesiritide

E. Tolvaptan

A

B. Dopamine

Dobutamine = Beta1 agonist

Dopamine = catecholamine

Inamrinone = phosphodiesterase III inhibitor

Nesiritide = atrial natriuretic peptide agonist

Tolvaptan = vasopressin receptor antagonist

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18
Q

Which of the following is a Beta1 agonist?

A. Dobutamine

B. Dopamine

C. Inamrinone

D. Nesiritide

E. Tolvaptan

A

A. Dobutamine

Dobutamine = Beta1 agonist

Dopamine = catecholamine

Inamrinone = phosphodiesterase III inhibitor

Nesiritide = atrial natriuretic peptide agonist

Tolvaptan = vasopressin receptor antagonist

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19
Q

Which of the following is a vasopressin receptor antagonist?

A. Dobutamine

B. Dopamine

C. Inamrinone

D. Nesiritide

E. Tolvaptan

A

E. Tolvaptan

Dobutamine = Beta1 agonist

Dopamine = catecholamine

Inamrinone = phosphodiesterase III inhibitor

Nesiritide = atrial natriuretic peptide agonist

Tolvaptan = vasopressin receptor antagonist

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20
Q

Which of the following is a phosphodiesterase III inhibitor?

A. Dobutamine

B. Dopamine

C. Inamrinone

D. Nesiritide

E. Tolvaptan

A

C. Inamrinone

Dobutamine = Beta1 agonist

Dopamine = catecholamine

Inamrinone = phosphodiesterase III inhibitor

Nesiritide = atrial natriuretic peptide agonist

Tolvaptan = vasopressin receptor antagonist

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21
Q

Which of the followingm is an Atrial natriuretic peptide agonist?

A. Dobutamine

B. Dopamine

C. Inamrinone

D. Nesiritide

E. Tolvaptan

A

D. Nesiritide

Dobutamine = Beta1 agonist

Dopamine = catecholamine

Inamrinone = phosphodiesterase III inhibitor

Nesiritide = atrial natriuretic peptide agonist

Tolvaptan = vasopressin receptor antagonist

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22
Q

Antianginal drugs include all of the following EXCEPT:

A. Calcium channel blockers

B. Beta-blockers

C. ACE inhibitors

D. Vasodilators

E. Antiplatelet drugs

A

C. ACE inhibitors

Antianginal drugs:

  • Ca2+ channel blockers
  • Beta-blockers
  • Vasodilators
  • Antiplatelet drugs
  • Lipid lowering drugs
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23
Q

Which of the following is antianginal drug that blocks late Na+ and KIR currents?

A. Ranolazine

B. Tolvaptan

C. Aspirin

D. Clopidogrel

E. Tirofiban

A

A. Ranolazine

24
Q

Which of the following is an Antiplatelet drug that blocks the activation of platelets by inhibiting ADP receptor?

A. Ranolazine

B. Tolvaptan

C. Aspirin

D. Clopidogrel

E. Tirofiban

A

D. Clopidogrel

ADP receptor inhibitors = Clopidogrel and Prasugrel

Glycoprotein receptor inhibitors = Abciximab, Eptifibatide, Tirofiban

Blocks late Na+ and KIR currents = Ranolazine

25
Q

Which of the following is an Antiplatelet drug that blocks platelet aggregation by inhibiting glycoprotein receptors?

A. Ranolazine

B. Tolvaptan

C. Aspirin

D. Clopidogrel

E. Tirofiban

A

E. Tirofiban

ADP receptor inhibitors = Clopidogrel and Prasugrel

Glycoprotein receptor inhibitors = Abciximab, Eptifibatide, Tirofiban

Blocks late Na+ and KIR currents = Ranolazine

26
Q

Which of the following is an Antiplatelet drug that blocks platelet aggregation by inhibiting glycoprotein receptors?

A. Ranolazine

B. Abciximab

C. Aspirin

D. Clopidogrel

E. Tolvaptan

A

B. Abciximab

ADP receptor inhibitors = Clopidogrel and Prasugrel

Glycoprotein receptor inhibitors = Abciximab, Eptifibatide, Tirofiban

Blocks late Na+ and KIR currents = Ranolazine

27
Q

All of the following are Antiplatelet drugs that is a GPIIb-IIIa glycoprotein receptor inhibitor EXCEPT:

A. Abciximad

B. Eptifibatide

C. Tirofiban

D. Tolvaptan

E. All of the above are glycoprotein receptor inhibitors

A

D. Tolvaptan

ADP receptor inhibitors = Clopidogrel and Prasugrel

Glycoprotein receptor inhibitors = Abciximab, Eptifibatide, Tirofiban

Blocks late Na+ and KIR currents = Ranolazine

28
Q

All of the following are ADP receptor inhibitors EXCEPT:

A. Clopidogrel

B. Prasugrel

C. Ranolazine

D. All of the above are ADP receptor inhibitors

A

C. Ranolazine

ADP receptor inhibitors = Clopidogrel and Prasugrel

Glycoprotein receptor inhibitors = Abciximab, Eptifibatide, Tirofiban

Blocks late Na+ and KIR currents = Ranolazine

29
Q

All of the following are true regarding Ranolazine EXCEPT:

A. prolongs ventricular AP

B. improves contractile dysfunction

C. blocks late Na+ KIR currents

D. All of the above are true

A

D. All of the above are true

30
Q

Which of the following are used to treat high LDL levels?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. None of the above

A

A. Statins

Statins = high LDL

Fibrates = high VLDL

31
Q

Which of the following are used to treat high VLDL levels?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. None of the above

A

B. Fibrates

Statins = high LDL

Fibrates = high VLDL

32
Q

Which of the following is used to treat a patient with high LDL and VLDL levels?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. None of the above

A

C. Statins and Fibrates

Statins = high LDL

Fibrates = high VLDL

33
Q

Which of the following types of dyslipidemia have elevated LDL only?

A. Type I dyslipidemia

B. Type IIa dyslipidemia

C. Type IIb dyslipidemia

D. Type III dyslipidemia

E. Type IV dyslipidemia

A

B. Type IIa dyslipidemia

Type IIa = LDL

Type IIb = LDL and VDL

Type III = VLDL

Type IV = VLDL

34
Q

Which of the following types of dyslipidemia have elevated LDL and VLDL?

A. Type I dyslipidemia

B. Type IIa dyslipidemia

C. Type IIb dyslipidemia

D. Type III dyslipidemia

E. Type IV dyslipidemia

A

C. Type IIb dyslipidemia

Type IIa = LDL

Type IIb = LDL and VDL

Type III = VLDL

Type IV = VLDL

35
Q

Which of the following types of dyslipidemia have elevated VLDL only?

A. Type I dyslipidemia

B. Type IIa dyslipidemia

C. Type IIb dyslipidemia

D. Type III dyslipidemia

E. Type IV dyslipidemia

A

D. Type III dyslipidemia

Type IIa = LDL

Type IIb = LDL and VDL

Type III = VLDL

Type IV = VLDL

36
Q

Which of the following drugs is used to treat Type IIa dyslipidemia?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. none of the above

A

A. Statins

Statins = Type IIa

Statin and Fibrates = Type IIb

Fibrates = Type III, IV and V

37
Q

Which of the following drugs is used to treat Type IIb dyslipidemia?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. none of the above

A

C. Statins and Fibrates

Statins = Type IIa

Statin and Fibrates = Type IIb

Fibrates = Type III, IV and V

38
Q

Which of the following drugs is used to treat Type III dyslipidemia?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. none of the above

A

B. Fibrates

Statins = Type IIa

Statin and Fibrates = Type IIb

Fibrates = Type III, IV and V

39
Q

Which of the following drugs is used to treat Type IV dyslipidemia?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. none of the above

A

B. Fibrates

Statins = Type IIa

Statin and Fibrates = Type IIb

Fibrates = Type III, IV and V

40
Q

Which of the following drugs is used to treat Type V dyslipidemia?

A. Statins

B. Fibrates

C. Statins and Fibrates

D. none of the above

A

B. Fibrates

Statins = Type IIa

Statin and Fibrates = Type IIb

Fibrates = Type III, IV and V

41
Q

Which of the following is an HMG-CoA reductase inhibitors?

A. Statins

B. Fibrates

C. Ezetimibe

D. Cholestyramine

A

A. Statins

Statins = HMG-CoA reductase inhibitors

Fibrates = Clofibrate, Fenofibrate, Gemfibrozil

Ezetimibe = cholesterol absorption inhibitor

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

42
Q

Which of the following activate PPAR nuclear receptor?

A. Statins

B. Fibrates

C. Ezetimibe

D. Cholestyramine

A

B. Fibrates

Statins = HMG-CoA reductase inhibitors

Fibrates = Clofibrate, Fenofibrate, Gemfibrozil

Ezetimibe = cholesterol absorption inhibitor

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

43
Q

Which of the following inhibits cholesterol absorption and is usually used as an adjunct with other drugs?

A. Statins

B. Fibrates

C. Ezetimibe

D. Cholestyramine

A

C. Ezetimibe

Statins = HMG-CoA reductase inhibitors

Fibrates = Clofibrate, Fenofibrate, Gemfibrozil

Ezetimibe = cholesterol absorption inhibitor

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

44
Q

All of the following are Fibrates EXCEPT:

A. Clofibrate

B. Fenofibrate

C. Gemfibrozil

D. Cholestyramine

A

D. Cholestyramine

Statins = HMG-CoA reductase inhibitors

Fibrates = Clofibrate, Fenofibrate, Gemfibrozil

Ezetimibe = cholesterol absorption inhibitor

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

45
Q

Which of the following are Bile Acid Sequestrants?

A. Clofibrate

B. Simvistatin

C. Gemfibrozil

D. Cholestyramine

A

D. Cholestyramine

Statins = HMG-CoA reductase inhibitors

Fibrates = Clofibrate, Fenofibrate, Gemfibrozil

Ezetimibe = cholesterol absorption inhibitor

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

46
Q

All of the following are Bile Acid Sequestrants EXCEPT:

A. Cholestyramine

B. Colesevelam

C. Colestipol

D. Gemfibrozil

E. All of the above are Bile Acid Sequestrants

A

D. Gemfibrozil

Statins = HMG-CoA reductase inhibitors

Fibrates = Clofibrate, Fenofibrate, Gemfibrozil

Ezetimibe = cholesterol absorption inhibitor

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

47
Q

All of the following are HMG-CoA reductase inhibitors EXCEPT:

A. Simvastatin

B. Lovastatin

C. Atorvastatin

D. Ezetimibe

E. All of the following are HMG-CoA reductase inhibitors

A

D. Ezetimibe

Statins = HMG-CoA reductase inhibitors

Fibrates = Clofibrate, Fenofibrate, Gemfibrozil

Ezetimibe = cholesterol absorption inhibitor

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

48
Q

Which of the following has bulky resins that are unpalatable and often cause diarrhea?

A. Statins

B. Fibrates

C. Bile Acid Sequestrants

D. Cholesterol absorption inhibitors

A

C. Bile Acid Sequestrants

Bile Acid Sequestrants = Cholestyramine, Colesevelam, Colestipol

49
Q

All of the following are true recarding Nicotinic Acid (Niacin) EXCEPT:

A. inhibits VLDL secretion

B. increases HDL

C. decreases LDL

D. decreases HDL

E. All of the above are true

A

D. decreases HDL

note: Nicotinic Acid (Niacin) is used as an adjunct when a statin is contraindicated (liver disease)

50
Q

What do PCSK9 inhibitors do?

A

Inhibition of PCSK9 leadss to recycling of liver LDL receptors and removal of more cholesterol

51
Q

(T/F)

Alirocuman and Evolocumab are newly approved drugs that are less safe to use than statins in patients with liver disease.

A

False

Correct statement: They are safer to use than statins on pts w/ liver disease.

note: Alirocumab and Evolocumab are monoclonal antibodies that are really expesive

52
Q

Prophylactic antiobiotics are indicated in which of the following?

A. Previous myocardial infarction (heart attack)

B. Pts with cardiac pacemakers

C. History of endocarditis

D. Mitral valve prolapse

E. Previous coronary artery bypass surgery

A

C. History of endocarditis

Prophylactic antibiotics are contraindicated in:

  • Previous myocardial infarction (heart attack)
  • Pts with cardiac pacemakers
  • Mitral valve prolapse
  • Previous coronary artery bypass surgery
  • innocent heart murmurs
53
Q

What heart conditions are contraindications for use of prophylactic antibiotics? (pre-medicated before dental tx)

A

Premedication is contraindicated in:

  • previous MI (heart attack)
  • cardiac pacemakers
  • mitral valve prolapse
  • previous coronary artery bypass surgery
  • innocent heart murmur
54
Q

Discuss each of the following regarding prophylactic prevention of bacterial endocarditis:

  • Standard regimen
  • Penicillin allergy
  • IV or IM medications for pts who can’t take medication orally
  • What antibiotic has a 10% risk of cross-allergy with penicillin?
A

Prophylaxis

Standard regimen: amoxicillin

Penicillin allergy: Clindamycin, cephalexin and azithromycin

IM or IV medications: Cefazolin, Ceftriaxone or Ampicillin

  • Cephalasporins have a 10% risk of cross-allergy with penicillin
55
Q

What are the indications for Prophylaxis before a dental appt?

A

Indications for Prophylaxis:

  • heart valve surgery
  • hx of endocarditis
  • heart transplant
  • cyanotic congenital heart disease
56
Q

What are the two medications that are PCSK9 inhibitors?

A

Alicrocumab, Evolocumab