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Pharm > cardio 2 > Flashcards

cardio 2 Flashcards

1
Q

Drug Tx for angina?

A

to restore balance b/w myocardial O2 supply/demand

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2
Q

MOA of nitrates?

available as

A

dilate vascular smooth muscle
decrease cardiac pre/afterload.

paste/sublingual/transderma/oral/spray

no more than 3 sprays in 15 mins. call ambulance after first 5 mins

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3
Q

ADR of nitrates?

A 
reflex tachycardia from drop in BP
dizzy
orthostatic hypotension
headache**
burn under tongue
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4
Q

What are the platelet aggregator inhibitors?

A

aspirin
clopidogrel (plavix)
Reopro

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5
Q

MOA of aspirin?

A

block thromboxane A2 synthesis from AA in platelet.

single dose followed by daily of 81 mg

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6
Q

MOA of clopidogrel (plavix)?

side effect is

A

inhibit ADP induced platelet aggregation. comparable to medium dose aspirin.

bleeding

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7
Q

MOA of anticoagulants?

heparin

A

incativate factors involved in normal coagulation

preventing conversion of prothrombin to thrombin. which induces fibrin

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8
Q

MOA of lmw heparin?

A

decrease affinity to bind plasma proteins.

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9
Q

indication for anti-coagulants.

A

DVT/PE/MI/after surgery

every 12 hours

bleeding.

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10
Q

MOA of warfarin?

A

interfere with liver synthesis of vitamin K dependent clotting factors.

watch for INR

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11
Q

use of warfarin?

A 
prophylaxis
DVT/PE
prevent stroke in fib
acute MI
mechanical heart valved.
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12
Q

Tx for warfarin skin necrosis?

A 
drug withdrawal
vit K
heparin
fresh frozen plasma
protein C
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13
Q

lots of drugs make unstable plaque stable … whats one?

A

Lipitor

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14
Q

shelflife for nitrate?

A

6 mo closed

3 open. away from sunlight

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15
Q

MOA of Reopro?

A

inhibit binding of fibrin and vWF to glycoprotein 2b/3a

prevents restenosis after angioplasty

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16
Q

long standing HTN?

A

rough lining of artery, causing it to get sticky and possible clottingg factor.

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17
Q

explain formation of thrombus?

A

prothrombin turns to thrombin which cause platelets to firm by attracting fibrin (think of a scar)

anticoagulants block thrombin/production of clotting factors by liver to prevent this.

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18
Q

wafarin has a lot of interactions with

A

drugs and food (broccoli)

19
Q

MOA for Pradaxa?

antidote for it?

A

Clot buster

Thrombin inhibitor through competitive inhibition. for stroke in a fib and DVT.

no antidote. ppl can bleed to death. especially with fall.

20
Q

Dosing of Pradaxa?

what to note

A

32-38 days for THR. 10-14 for TKA. within 12-24 hr window.

pt can bleed. no interaction with vitamin K foods.

21
Q

MOA for thrombolytics?

clot buster.

A

convert plasminogen to plasma to break down fibrin clots.

after CVA.. unless it happened overnight.

22
Q

Dosing for Thrombolytics

A

3-4.5 hrs after stroke,

wishing 12 hours of MI

23
Q

Contraindications of thrombolytics?

A

head trauma, ulcer, bleeding issue, uncontrolled HTN

preggo, Glucose <50/

24
Q

MOA of statins?

A

competitive inhibitor of HMG CoA reductase. synthesizes cholesterol reduced LDL.
liver is target organ

lowers cholesterol

25
Q

ADR of statins?

A

gas/cramps/headache/nausea
new onset diabetes
peripheral neuropathy
tendon rupture

26
Q

what cant you have with statins?

A

grapefruit juice

27
Q

what are other effects of statins?

A 
protect brain from stroke
increase NO
inhibit action of cytokine
prevent thrombus
increase bone formation (ww)
28
Q

Muscle pain due to statins treated with

A

Vitamin D

29
Q

Muscle ache or weakness w/o elevated Creatine Kinase?

A

Myalgia very common with statins

30
Q

Muscle symptoms with elevated CK?

A

myositis

31
Q

muscle symptoms with CK elevation greater than 10x upper limit. brown urine

A

Rhabdomyolysis.

rare

32
Q

Risk factor for muscle pain with statin?

A 
large dose
taken with med that inhibit statin metabolism
>70 y./o
female
impaired liver/renal
skinny
alcohol
untreated hypothyroid.
33
Q

Prevent muscle injury with statin

A 
low dose
monitor CK level
switch statin
withdraw.
measure grip strength
34
Q

Zetia MOA?

A

reduce cholesterol absorption through small intestine.

combine with simvastatin= Vytorin. more beneficial.

35
Q

Goals for pharmacotherapy in CHF?

A 
remove salt+water (loop diuretic)
improve contractility (+inotropic)
decrease pre/afterload (vasodilator)
dec after load and retain salt/water (ACE 1 ARB)
antagonize aldosterone.
36
Q

MOA of Digoxin?

A

Block Na/K pump. enhancing Na/Ca2+ pump increasing force of contraction w/o decreasing BP or HR.

helps L ventricle pump more effectively (CHF)

parasympathetic action at SA node.

also for arrhythmia

37
Q

ADR of Digoxin?

A

arrhythmia
CNS effects
nausea/vomit/diarrhea
digitalis toxicity* result in bradycardia, halo vision.

38
Q

What are some agents for CHF?

A 
Diuretics-increase excretion
Betablockers-dec contractility
ACE 1 + ARB-v renin release
Vasodilators
Spironolactone-bind to aldosterone
Beta activation-vasodilation relieve edema.
39
Q

What cant happen during ERP? when does it? what doe anti-arrhythmias do?

A

AP
can during relative refractory .

increase duration of effective refractory period. (widen AP)

40
Q

What are dysarrhythmic drugs?

A

class 1: Sodium blockers

2: beta blockers
3: true anti arrhythmia prolong repo.
4: calcium channel blockers
5: digoxin

41
Q

Therapeutic concerns with anti-arrhythmics?

A

widely used but don’t work very well.

42
Q

Exercise and anti-arrhythmia:

A

meds not effective with exercise.

some negative inotropic effects (performance or BP_

don’t stop exercise abruptly.

43
Q

Alpha blockers do what?

A

dilate arteries and reduces BP

Pharm (14 decks)

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