CARDIO - drugs

Question 1

Primary HTN rx

Answer 1

ACEI, ARB, Thiazide, CCB

Question 2

HTN with HF rx

Answer 2

ACEI, ARB, Diuretics, aldosterone antagonists, b-blockers

Question 3

HTN with DM

Answer 3

ACEI, ARB, Thiazide, CCB, b-blocker

Question 4

HTN in pregnancy

Answer 4

Hydralazine, methyldopa, labetalol, nifedipine

Question 5

methyldopa AE

Answer 5

HTN pregnancy
a2 agonist
SLE-like
Coombs +

Question 6

hydralazine AE

Answer 6

SLE-like

Question 7

CCB’s block:

Answer 7

L-type VG Ca channels of cardiac and smooth muscle

Question 8

general CCB dihydropyridine use

Answer 8

HTN, angina (including prizmetal), raynaud

Question 9

CCB for SAH

Answer 9

Nimodipine (cerebral selectivity)

Question 10

CCB for hypertensive urgency/emergency

Answer 10

Clevidipine and nicardipine

Question 11

General non-dihydropyridine CCB use

Answer 11

HTN, angina, atrial fib/flutter

Question 12

Verapamil AE

Answer 12

hyperprolactinemia

Question 13

General CCB AE

Answer 13

constipation, gingival hyperplasia

Question 14

hydralazine MOA

Answer 14

increases cGMP causing vasodilation of arteries > veins. Can cause reflex tachycardia so can give with b-blocker, also avoid in angina/CAD

Question 15

Hydralazine use

Answer 15

acute/severe HTN, HTN pregnancy, HTN HF

Question 16

HTN emergencies

Answer 16

Clevidipine, nicardipine, labetalol, fenoldopam, nitroprusside

Question 17

CCB for pregnancy

Answer 17

Nifedipine

Question 18

Nitroprusside MOA and AE

Answer 18

MOA = release of NO causing increased cGMP.

AE = cyanide poisoning

Question 19

Fenoldopam

Answer 19

D1 agonist - vasodilation of coronaries, renal, peripheral, splanchnic - keep up naturesis

Question 20

nitrates MOA

Answer 20

Release NO causing cGMP, veins > arteries, decreases preload

Question 21

nitrates AE

Answer 21

Hypotension, reflex tachycardia, headache, flushing

Question 22

Digoxin MOA (2)

Answer 22

Direct block Na//K; indirect block Na//Ca; so increased contractility.

Stimulates vagus to decrease HR.

Question 23

Digoxin use

Answer 23

HF for contractility

A fib for slowed AV and depressed SA

Question 24

Digoxin toxicity

Answer 24

Cholinergic: blurry yellow vision, arrhythmia, AV block.

Hyperkalemia.

Question 25

Increase digoxin toxicity via:

Answer 25

Hypokalemia, renal failure, verapamil, amiodarone, quinidine (decrease clearance + displaces from tissue)

Question 26

Digoxin antedote

Answer 26

fix K+, Mg, anti-digoxin Fab, pacer

Question 27

Class I AA MOA

Answer 27

block Na+ channels slowing conduction, especially in depolarized muscle cells

Question 28

Class IA names

Answer 28

Disopyramide, Quinidine, Procainamine

Question 29

Class 1B names

Answer 29

Lidocaine, Tocainide, Mexiletine

Question 30

Class 1C names

Answer 30

Flecainide, Propafenone, Moricizine

Question 31

Class 1A AE

Answer 31

Cinchonism (quinidine - HA, tinnitus), SLE-like (procainamide), heart failure (disopyramide), thrombocytopenia, torsades

Question 32

Post MI acute ventricular arrhythmia rx (class)

Answer 32

Class 1B

Question 33

Class 1C AE

Answer 33

pro-arrythmic (especially post-MI)

Question 34

Class 1 affinities for phase 0 inhibition

Answer 34

A = intermediate, B = weak, C = strongest

Question 35

Class 1 alterations in QT (AP duration)

Answer 35

A = increase, B = decrease, C = N/A

Question 36

Class II: group and specific AEs

Answer 36

beta blockers. Metoprolol = dyslipidemia. Propanolol = prizmetal exacerbation

Question 37

Phase of AP altered by Class II

Answer 37

Phase 4 (Ca channels of nodal tissue)

Question 38

Class III: names and function

Answer 38

K+ blockers, increasing AP, ERP, QT. | Amiodarone, Ibutilide, Dofetilide, Sotalol.

Question 39

Sotalol AE

Answer 39

Torsades, excessive beta blockade (K+ and Na+ blocker)

Question 40

Ibutilide AE

Answer 40

Torsades

Question 41

Amiodarone AE

Answer 41

*NO torsades! PULMONARY FIBROSIS, hepatotoxicity, hypo/hyper-thyroidism and blue-grey skin in sun (via iodine content), neurological, constipation. Check LFTs, TFTs, PFTs

Question 42

Class IV names

Answer 42

CCBs verapamil and diltiazem

Question 43

Class IV mechanism

Answer 43

Decrease conduction velocity. Increase ERP and PR

Question 44

Class IV

Answer 44

constipation (verapamil), flushing, edema

Question 45

Adenosine use in cardio

Answer 45

Diagnosing/abolishing SVTs (including paroxysmal SVTs)

Question 46

Blunting adenosine via:

Answer 46

theophylline and caffeine

Question 47

Adenosine AE

Answer 47

Flushing, hypotension, sense of impending doom, bronchospasm, chest pain

Question 48

Mg++ in cardio treats

Answer 48

Torsades, digoxin toxicity (because it antagonizes Ca)

Question 49

drugs causing kyperkalemia:

Answer 49

ACE-I. ARB. K+ sparing diuretics. Digoxin. Non-selective beta antag (b2 causes intracellular uptake). NSAIDs (block PG, decrease renin + aldost.)