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Pharm II > cardio big picture and DOC > Flashcards

cardio big picture and DOC Flashcards

1
Q

What drugs do you use for Cardiac Arrhythmias

A

Class I: sodium channel blockers

  • IA: quinidine, procainamide (bind activated)
  • IB: lidocaine (bind inactivated)
  • IC:flecainide (bind all)

Class II: BB
*olol

Class III: K channel blocker (prolong repol)
*Amiodarone, Sotalol

Class IV: CCB
*verapamil, diltiazem

Misc: adenosine, Mg, digoxin, K

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2
Q

Diuretics

A 
CA inhibitors
LOOPS
thiazide and thiazide like
K sparing (aldosterone antagonist and K channel blocker)
Osmotic Diuretics
ADH agonists and antagonists
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3
Q

Drugs used in CHF

A

Inotropic agents

  • Digitalis: digoxin
  • PDE inhibitors (bipiridines): imamrinone, milrinone
  • sympathomimetics: Dobutamine, Dopamine

Drugs w/o inotropic effect

  • Diuretics: loopd, aldo antag, K sparing, thiazide
  • ACEI: pril
  • BB: carvedilol, metropolol
  • ARB: artan
  • vasodilators: sodium nitroprusside, hydralazine, isosorbide dinitrate
  • digitalis antibody: fab (digibind)
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4
Q

anti HTN drugs

A
  • Diuretics
  • SNS altering: central a2 agonist, a1 blocker (zosin), BB
  • Vasodilators: NO, minoxidil, CCB, D1 agonist
  • RAS inhibitors: ACEI, RB
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5
Q

vasodilators/ tx angina

A 
nitrates/nitrites
CCB
BB
PDE5
others: ranolazine
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6
Q

Heparin use

A

IV anticoag,

post op DVT, PE prophylaxis

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7
Q

Enoxaprin/Fondaparinux use

A

DVT/PE prophylax

  • replace warfarin in preg
  • less incidence HIT
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8
Q

Warfarin use

A 
prevent embolism (not effective on already formed thrombi)
chronic DVT/PE prophylaxis
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9
Q

Clopidogrel use

A

DOX platelet inhibition/prevent thrombosis in stent replacement
*used if ASA allergy to decrease risk thrombosis post MI/stroke

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10
Q

ASA use

A

primary prevention MI

prophylaxis for pt at risk for embolism

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11
Q

Abciximab/eptifibatide/tirofiban use

A

combine with heparin for PCI

used in pt undergoing angioplasty, atherectomy, stent

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12
Q

aminocaproic acid use

A

reverse tPA aka alteplase (anti fibrinolytic)

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13
Q

Alteplase/ tenectaplase/ use

A

activates plasminogen to lyse clots and re establish tissue perfusion post MI

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14
Q

Bile acid binding resins

A

high LDL/chol

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15
Q

Niacin

A

decrease VLDL and LDL
**increase HDL
effective in heterozygous familial hyperchol

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16
Q

statin

A

decrease LDL, TAG and increase HDL
decrease CRP, lipoprotein ox, platelet aggregation
increase NO production and plaque stability

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17
Q

fibrates

A

decrease TAG

*inhibit statin metab

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18
Q

Zetia

A

dec LDL (blocks intestinal abs)

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19
Q

Quinidine use

A

acute and chronic SV and V arrhythmia

*procainamide is same by increased SLE risk

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20
Q

Lidocaine use

A

Ventricular arrhythmia DOC (IV) - acute?

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21
Q

Flecainide use

A

SV and lifethreatening V arrhthmia *LAST RESORT

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22
Q

BB use

A

early stage CHF: dec HR, contractility, renin, BP, post MI mortality, classic angina

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23
Q

amiodarone use

A

SV and V arrhythmia (w/o torsade)

DOC for chronic V arrhythmia (ACLS) instead of lidocaine

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24
Q

Sotalol use

A

SV and V arrrhythmia

25
Q

Verapamil use

A

Reentrant SV tachy

A fib/flutter

26
Q

Diltiazem use

A

dec HR, PSVT, control ventricular rate in a fib and a flutter

27
Q

adenosine use

A

ODC PSVT, WPW

*depends on reentry

28
Q

Mg use

A

DOC for torsade
digitalis induced arrhythmia
mgmt seizures, HTN ,ecclampsia

29
Q

K use

A

DOC digoxin toxicity

30
Q

Acetazolamide use

A

alkalinization of urine

*metabolic/respiratory mountain sickness

31
Q

Dorzolamide/brinzolamide use

A

DOC closed angle glaucoma

32
Q

Furosemide use

A

most effective diuretic: large fluid mvmt CHF, pulm edema, hyperCa, pulm congestion (increase venous capacitance)

33
Q

Ethacrynic acid use

A

sulfa allergy and need loop

34
Q

Thiazide use

A

DOC HTN, CHF,

vasodilation (PG synthesis dep), nephrogenic DI, nephrolithiasis

35
Q

Metolazone use

A

thiazide for GFR <20 pt

36
Q

Indapamide use

A

thiazide that doesn’t increase plasma lipid, biliary excretion so good if renal problems, and causes pronounced vasodilation

37
Q

Spironolactone use

A

hyperaldosteronism
K sparing but watch out for androgen
*for CHF pt, increases lifespan bc inhibits aldo receptor

38
Q

amiloride use

A

DOC Li induced DI

main use in combo with K losing diuretic

39
Q

Osmotic diuretics use

A

diuresis in acute kidney disease, decrease ICP, decrease IOP before eye surgery, protect kidney from nephrotoxic substances

40
Q

desmopressin use

A

DOC central DI

41
Q

Digoxin use

A

decrease normal tone via Na/K ATPase inhibition

decrease HR: increase contractility causes decrease SNS in failing heart = more vasodilation, increase CO?

42
Q

Dopamine use

A

+inotropic for end stage CHF (b1 specific)

only use in refractory CHF

43
Q

ACEI, ARB use

A

DOC HTN and CHF (decrease cardiac workload by decreasing preload and afterload and remodeling)
increase diuretic effectiveness

44
Q

Inamrinone and milrinone (bipyridine use)

A

increase CO in acute HF

45
Q

BB use

A

early stage CHF: decrease mortality, decrease HR and renin, decrease remodeling

preferred HTN drug for pt post MI, angina, migraine

46
Q

Esmolol use

A

short acting 2nd line PSVT

47
Q

Clonidine

A

decrease SNS outflow, decrease renin in HTN

48
Q

Methyldopa

A

DOC HTN in preg

49
Q

alpha 1 blockers

A

HTN: dilate aa and vv without effecting lipids

BPH

50
Q

Labetolol

A

Preferred HTN emergency in preg w/o reflex tachy

51
Q

Carvedilol

A

HTN and CHF esp after MI
lipid neutral
no tachy

52
Q

Minoxidil

A

chronic HTN, can cause hair growth

53
Q

Fenoldopam

A

HTN emergencies specific D1 agonist

54
Q

Nifedipine

A

CCB with vasodilatory effect (thus reflex tachy)

55
Q

Diltiazem

A

dec HR, PSVT, control ventricular rate in a fib and a flutter

56
Q

Verapamil use

A

Reentrant SV tachy
A fib/flutter
angina

57
Q

nitrates use

A

DOC acute angina

58
Q

nitrates + CCB

A

DOC prinzmetals angina

Pharm II (12 decks)

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