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Step Nuggets > Cardio Drugs > Flashcards

Cardio Drugs Flashcards

1
Q

Hydralazine

A

Increases cGMP (makes cGMP Hya!!). Used in severe hypertension and prego hypertension with methyldopa. Can lead to lupus like syndrome (SHIPPE) Sulfa, hydralazine, isoniazid, procainamide, phenytoin, etanercept

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2
Q

Nitroprusside

A

Short acting increase in cGMP via NO. Can cause cyanide tox (for which we give nitrite and thiosulfate)

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3
Q

Fenoldopam

A

D1 receptor agonist. fenolDopam. Coronary peripheral renal and splanchnic vasodilation. DECREASED BP AND NATRIURESIS.

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4
Q

Nitroglycerin, Isosorbide Dinitrate

A

NO –> cGMP. Dilates veins&raquo_space; arteries leading to decrease in preload. Used for angina, coronary syndrome, pulm edema. MONDAY DISEASE- industrial exposure, body gets used to vasodilation through week and then loss of tolerance over weekend leads to tachycardia, dizzy, headache upon reexposure.

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5
Q

Goal of anti-anginal therapy

A

Reduce MVO2 by decreasing EDV, BP, HR, Contractility

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6
Q

Statins

A

Inhibit HMG-COA Reductase (RLS of cholesterol synthesis, HMG-COA –> mevalonate). Large decrease in LDL, minor increase in HDL and decrease in TGs. ADR: Hepatotox and rhabdo (worse with fibrates and niacin)

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7
Q

Niacin

A

Inhibit lipolysis in adipose. Reduce hepatic VLDL synth. Leads to decrease in LDL, Increase HDL, small decrease in TGs. ADR: Flushing, hyperglycemia, hyperuricemia

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8
Q

Bile Acid Resins (Cholestyramine, colestipol, colesevelam)

A

Decrease reabsorption of bile acids. Decreases LDL. ADR: GI discomfort, decrease in fat soluble vitamins, CHOLESTEROL GALLSTONES

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9
Q

Cholesterol Absorption Blockers (ezetimibe)

A

Prevent abs in brush border. Decreases LDL. Rare increase in LFTs and diarrhea.

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10
Q

Fibrates (gemfibrozil, -fibrate)

A

Upregulate LPL (which is on vascular endothelium and breaks down TGs on VLDL and Chylos). Also activates PPAR-a leading to HDL synth. Slight decrease in LDL and increase in HDL, good decrease in TGs. ADRS: Myositis, Hepatotox, Gallstones

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11
Q

Cardiac Glycosides (Digoxin)

A

Block Na/K ATPase. Increase intracell. Na leads to decrease in Ca/Na transport and increase in intracell Ca to increase contractility. Used in CHF and Afib.
ADR: Cholinergic- NVD, YELLOW VISION. Can lead to hyperkalemia. Factors predisposing to tox= renal failure, hypokalemia, verapamil, amiodarone, quinidine. Tx overdose with anti-dig Fab fragments.

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12
Q

Class I antiarrhythmics

A

Sodium channel blockers. Decrease slope of phase 0 in myocytes and increase threshold in pacemaker cells. State dependent. HYPERKALEMIA causes increased tox of all class I drugs.

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13
Q

Quinidine, Procainamide, Disopyramide

A

Class IA- Increase AP duration and effective refractory period. PROLONG QT INTERVAL. Used for many arrhythmias but especially for re-entrant and ectopic SVT/VT. ADR: Cinchonism (HA, tinnitus with quinidine), SLE like syndrome (SHIPPE), CHF, thrombocytopenia, torsades.

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14
Q

Lidocaine, Mexiletine, (Phenytoin)

A

Class IB- Decrease AP duration. Preferentially in ischemic or depol purkinje/vent tissue. Used in ventricular arrhythmias post MI and Dig induced arrythmias (IB Is Best post-MI). ADR: CNS Stim/Depression, Cardio depression

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15
Q

Flecainide, Propafenone

A

Class IC- Prolongs refractory in AV node. Used in SVTs and A fib. ADR: Proarrhythmic, ESPECIALLY POST-MI (contra). IC-Contraindicated in isChemic heart disease.

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16
Q

Class II anti-arrhythmics

A

B-Blockers -lol. Decrease cAMP and Ca2+ currents leading to decreased SA/AV node activity. Decrease slope of phase 4 in pacemakers. Increased PR interval.
Used in SVT (Afib and Aflutter)
ADR: Impotence, asthma = bad, MASKS HYPOGLYCEMIA. Treat overdose with glucagon. CI in cocaine use.

17
Q

Class III anti-arrhythmics

A

K+ Channel blockers. AIDS- Amiodarone, Ibutilide, Dofetilide, Sotalol. Increase AP duration. Used when others fail, PROLONG QT. Prolong ERP. Used in Afib, Aflutter, Vtach.
ADR: Sotalol- torsades
Ibutilide- torsades
Amiodarone- pulm fibrosis, hepatotox, hypo/hyperthyroid (amiodarone is 40% iodine). Corneal/skin deposits (blue) –> photodermatitis. Neuro, constipation, CV effects. Check PFTS, LFTS, and TFTS.

18
Q

Class IV antiarrhythmics

A

Ca2+ channel blockers (verapamil and diltiazem)
Decrease conduction velocity, PRolong ERP, Increase PR. Used to prevent nodal arrhythmias and RATE CONTROL in Afib.
ADR: Flushing, edema, constipation, CV effects

19
Q

Adenosine

A

Increases K+ efflux –> hyperpolarization. Dx and abolish SVT. Short acting. Blocked by theophylline and caffeine (PDE inhibitors). Can cause flushing, hypotension, chest pain.

20
Q

Mg2+

A

Used in torsades and dig tox

21
Q

Cholestyramine

A

Bile acid resin

22
Q

Colestipol

A

Bile acid resin

23
Q

colesevelam

A

Bile acid resin

24
Q

Ezetimibe

A

Cholesterol absorption blocker

25
Q

Gemfibrozil

A

Fibrate

26
Q

Quinidine

A

Class IA anti-arrhythmic (Na channel blocker)

27
Q

Procainamide

A

Class IA anti-arrhythmic (Na channel blocker)

28
Q

Disopyramide

A

Class IA anti-arrhythmic (Na channel blocker)

29
Q

Lidocaine

A

Class IB anti-arrhythmic (Na channel blocker)

30
Q

Mexiletine

A

Class IB anti-arrhythmic (Na channel blocker)

31
Q

Flecainide

A

Class IC anti-arrhythmic (Na channel blocker)

32
Q

Propafenone

A

Class IC anti-arrhythmic (Na channel blocker)

33
Q

Amiodarone

A

Class III anti-arrhythmic (K+ channel blocker)

34
Q

Ibutilide

A

Class III anti-arrhythmic (K+ channel blocker)

35
Q

Dofetilide

A

Class III anti-arrhythmic (K+ channel blocker)

36
Q

Sotalol

A

Class III anti-arrhythmic (K+ channel blocker)

37
Q

Verapamil

A

Class IV anti-arrhythmic (Ca2+ channel blocker)

38
Q

Diltiazem

A

Class IV anti-arrhythmic (Ca2+ channel blocker)

Step Nuggets (23 decks)

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