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step 1 - pharm > cardio > Flashcards

cardio Flashcards

1
Q

tx of HTN in preggos?

A

hydral
labetalol
methyldopa
nifedipine

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2
Q

DHP CCBs?

A 
amlodipine
clevidipine
nicardipine
nifedipine
nimodipine

** act on vascular smooth mm

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3
Q

non-DHP CCBs?

A

dilt
verapamil

** act on heart

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4
Q

CCB MOA?

A

block L-type Ca channels –> decreased mm contractility

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5
Q

relative efficacy of CCBs on vascular mm?

A

amlodipine = nifedipine > dilt > verapamil

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6
Q

relative efficacy of CCBs on heart?

A

verapamil > dilt > amolidipine = nifedipine

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7
Q

nimodipine is used for?

A

SAH - prevention of vasospasm

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8
Q

clevidipine is used for?

A

HTN urgency/emergency

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9
Q

CCB toxicity?

A 
cardiac depression, AV block
peripheral edema
flushing
dizziness
constipation
gingival hyperplasia

** verapamil –> hyperprolactinemia

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10
Q

hydralazine MOA?

A

increases cGMP –> smooth mm relaxation (arterioles > veins)

AFTERLOAD reduction

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11
Q

hydralazine uses?

A 
severe HTN (esp acute)
HF (use with nitrate)
    • safe in preg
    • often with BB to prevent reflex tachy
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12
Q

hydralazine SEs?

A 
compensatory tachy
fluid retention
H/A
angina
drug-induced lupus
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13
Q

nitroprusside?

A

increases cGMP via direct NO release

** can cause cyanide toxicity - causes cyanide release

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14
Q

fenoldopam?

A

D1 receptor agonist –> coronary, peripheral, renal, splanchnic vasodilation
decreased BP, increased natriuresis

** used in HTN emergency

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15
Q

nitrates MOA?

A

increase NO –> increase cGMP –> vasodilation (veins&raquo_space; arterioles)
PRELOAD reduction

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16
Q

nitrates uses?

A

angina
ACS
pulm edema

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17
Q

nitrate toxicity?

A

reflex tachy
hypoT
flushing
H/A

** Monday dz: tolerance during work week from industrial exposure; tachy/dizziness/HA upon reexposure on Monday

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18
Q

what are pindolol and acebutolol?

A

partial beta agonists

CONTRAINDICATED in angina

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19
Q

statins?

A

cause large LDL decrease, some TG decrease, some HDL increase
inhib HMG-CoA reductase

SEs: hepatotoxicity, myopathy

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20
Q

bile acid resins?

A

moderate LDL decrease, slight increase in HDL and TGs
prevent intestinal bile acid reabsorption

SEs: GI upset, decreased drug/fat soluble vitamin absorption

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21
Q

ezetimibe?

A

moderate LDL decrease
prevents cholesterol absorption at SI brush border

SEs: rare increase in LFTS, diarrhea

22
Q

fibrates?

A

large decrease in TGs, small decrease in LDL, small increase in HDL
upreg of LDL –> increased TG clearance
activatio of PPAR-a –> increased HDL synth

SEs: myopathy, cholesterol stones

23
Q

niacin as lipid tx?

A

moderate LDL decrease, moderate HDL increase, slight TG decrease
inhibits HSL in adipose, inhibits hepatic VLDL synthesis

SEs: red flushed face (NSAIDs or long term use decrease), hyperglycemia, hyperuricemia

24
Q

dig MOA?

A

direct inhib of Na/K ATPase –> indirect inhib of Na/Ca exchg
increased Ca –> positive inotropy

** also stimulates vagus –> decreased HR

25
Q

dig uses?

A

HF

Afib (SA depression, decreased AV conduction)

26
Q

dig toxicity?

A

cholinergic - N/V/D, yellow blurry vision, arrhythmias, AV block
hyperkalemia

** predisposing factors: renal failure, hypoK, verapamil, amiodarone, quinidine

27
Q

how does quinidine predispose to dig toxicity?

A

displaces dig from tissue binding sites

decreases dig clearance

28
Q

class I antiarrhythmics?

A

Na channel blockers

decrease phase 0 slope
slow or block conduction

** state dependent

29
Q

class Ia?

A

quinidine, procainamide, disopyramide
increase AP length, ERP, QT
used in atrial and vent arrhythmias - esp SVT and VT

30
Q

class Ia toxicity?

A

TCP

torsades

31
Q

quinidine toxicity?

A

cinchonism

32
Q

procainamide toxicity?

A

drug-induced lupus

33
Q

disopyramide toxicity?

A

HF

34
Q

class Ib?

A

lidocaine, mexilitine
decrease AP duration in ischemic Purkinje and ventricular tissue
used in acute ventricular arrhythmias, dig-induced arrhythmias, post-MI

35
Q

Ib toxicity?

A

CNS stimulation/depression

cardiovascular depression

36
Q

class Ic?

A

flecainide, propafenone
significant increase in ERP in AV and bypass tracts
used in SVTs, including Afib

37
Q

class Ic toxicity?

A

proarrhythmic, especially post MI (CONTRAINDICATED)

38
Q

class II antiarrhythmics?

A

BBs
decrease cAMP, Ca –> decrease SA and AV nodes, decrease phase 4 slope
used in SVT, Afib/flutter rate control

39
Q

BB toxicity?

A

impotence
COPD/asthma exacerbation
may mask hypoglycemia signs?

40
Q

metoprolol toxicity?

A

dyslipidemia

41
Q

propranolol toxicity?

A

can exacerbate Prinzmetal angina spasm

42
Q

tx of BB overdose?

A

saline
atropine
glucagon

43
Q

class III antiarrhythmics?

A

K blockers - amiodarone, ibutilide, dofetilide, sotalol
increase AP duration, ERP, QT
used in Afib, Aflutter, VT

44
Q

sotalol toxicity?

A

torsades

excessive beta blockade

45
Q

ibutilide toxicity?

A

torsades

46
Q

amio toxicity?

A 
pulmonary fibrosis
hepatotoxicity
hypo or hyperthyroidism
corneal deposits
blue/gray skin deposits, photodermatitis
neurologic
constipation
47
Q

class IV antiarrhythmics?

A

CCBs - verapamil, dilt
decrease conduction velocity, increase ERP, PR interval
used in preventing SVT, Afib rate control

48
Q

class IV toxicity?

A

constipation
flushing
edema

49
Q

adenosine MOA?

A

increases K efflux –> hyperpolarization - decreases Ca conductance

50
Q

adenosine use?

A

dx and abolish SVT
very short acting

** blunted by theophylline and caffeine

51
Q

adenosine toxicity?

A 
flushing
hypoT
chest pain
sense of impending doom
bronchospasm
52
Q

Mg2+ uses?

A

torsades

dig toxicity

step 1 - pharm (13 decks)

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