Cardio Drugs

Question 1

4 HTN Drugs for Pregnancy

Answer 1

Labetolol

Hydralazine

Methyldopa

Nifedipine

Question 2

5 Drugs for Hypertensive Emergency

Answer 2

Clevedipine

Fenoldopam (D1 agonist - coronary, peripheral, renal and splanchnic dilation)

Labetolol

Nicardipine

Nitroprusside (inc cGMP by direct NO release)

“if see inc LEVEL dont be a DOPE… LABEL it, be NICE and give nitroprusside”

Question 3

Ranolazine

Answer 3

MOA: inhibits late Na currents to dec intracellular Ca so less wall tension (less oxygen demand on heart)

Does NOT affect HR or contractility

Question 4

Statins

Answer 4

MOA: inhib HMG CoA reductase

dec LDL, inc HDL, dec TGs

LFTs and myopathy

Question 5

Bile Acid Resins

Answer 5

MOA: prevent reabsorption of bile acids so liver has to use cholesterol to make more

dec LDL but inc TGs

Question 6

Ezetimibe

Answer 6

MOA: prevents cholesterol absorption at SI brush border

dec LDL

Question 7

Fibrates

Answer 7

MOA: upregulate LPL so more TG clearance AND activate PPAR-alpha to induce HDL synthesis

dec LDL, inc HDL, HUGE dec TGs

Myopathy and stones

Inhibit cholesterol - alpha hydroxylase to dec bile salt formation so careful if hx gallstones

Question 8

Niacin

Answer 8

MOA: inhibit hormone sensitive lipase so less lipid breakdown AND reduces hepatic VLDL synthesis

dec LDL, inc HDL, dec TGs

Question 9

PCSK9 Inhibitors

Answer 9

Alirocumab, evolocumab

MOA: inactivate LDL receptor degradation so more LDL uptake into liver and out of blood

myalgia, delirium, dementia

Question 10

Class I Antiarrhythmics

Answer 10

Na block (work on muscle cells)

IA - inc AP duration, dec Na upstroke slop
IB - also dec slope of upstroke but dec AP duration (good for ischemic/ damaged heart - post MI)
IC - prolongs refractory period AV node and above (contraindicated in heart disease)

Question 11

Specific Drugs and Side Effects of Diff Class I Antiarrhythmics

Answer 11

IA - Quinidine (cinchoism - headache and tinnitus), procainamide (SLE-like), disopyramide (HF)

IB - lidocaine and Mexiletine (CNS)

IC - Flecainaide and Propafenone

Question 12

Class II Antiarrhythmics

Answer 12

Beta Blockers (work on pacemaker cels to dec cAMP and dec Ca++ to lower SA and AV bode activity)

DO NOT USE IF ASTHMA / COPD

Question 13

Class III Antiarrhythmics

Answer 13

K+ Channel Blockers (work on muscle cells - QT prolongation)

Amiodarone - also class I, II and IV effects (LIPOPHILIC)

Ibutilide, defotilide, sotalol

Check LFTs, PFTs (pulm) and Thyroid labs

Question 14

Class IV Antiarrhythmics

Answer 14

Ca++ channel blockers (work on pacemakers)

Verapamil, diltiazem