Cardio Drugs - CLASSES/MECHANISMS

Question 1

Hydralazine

Answer 1

Increases cGMP → smooth muscle relaxation

(arterioles > veins)

Question 2

Nitroprusside

Answer 2

Short acting

Increases cGMP via direct release of NO

Question 3

Fenoldopam

Answer 3

D1 receptor agonist → coronary, peripheral, renal, and splanchnic vasodilation

Decreases BP

Increases natriuresis

Question 4

Ranolazine

Answer 4

Inhibits the late phase of sodium current → reducing diastolic wall tension and oxygen consumption

Does NOT affect HR or contractility

Question 5

Milrinone

Answer 5

Selective PDE-3 inhibitor

Cardiomyocytes: Increases cAMP → Inccreases calcium influx → increases inotropy/chronotropy

Vascular smooth muscle: Increases cAMP → inhibition of MLCK → general vasodilation

Question 6

Cholestyramine

Answer 6

• *Bile acid resin:** Prevent intestinal reabsorption of
• *bile acids** → liver must use CH to make more

Question 7

Colestipol

Answer 7

• *Bile acid resin:** Prevent intestinal reabsorption of
• *bile acids** → liver must use CH to make more

Question 8

Colesevelam

Answer 8

• *Bile acid resin:** Prevent intestinal reabsorption of
• *bile acids** → liver must use CH to make more

Question 9

Ezetimibe

Answer 9

Prevent cholesterol absorption at
small intestine brush border

Question 10

Gemfibrozil

Answer 10

Upregulate LPL → increases TG clearance

Activates PPAR-alpha → HDL synthesis

Question 11

Bezafibrate

Answer 11

Upregulate LPL → increases TG clearance

Activates PPAR-alpha → HDL synthesis

Question 12

Fenofibrate

Answer 12

Upregulate LPL → increases TG clearance

Activates PPAR-alpha → HDL synthesis

Question 13

Niacin

Answer 13

Inhibits lipolysis (hormone sensitive lipase) in adipose tissue → reduces hepatic VLDL synthesis

Question 14

Alirocumab

Answer 14

Inactivation of LDL-receptor degradation → increases amount of LDL removed from bloodstream

Question 15

Evolocumab

Answer 15

Inactivation of LDL-receptor degradation → increases amount of LDL removed from bloodstream

Question 16

Quinidine

Answer 16

Class IA antiarrhythmic

Increase AP duration

Increase ERP

Increase QT interval

Some K+ channel blocking effects

Question 17

Procainamide

Answer 17

Class IA antiarrhythmic

Increase AP duration

Increase ERP

Increase QT interval

Some K+ channel blocking effects

Question 18

Disopyramide

Answer 18

Class IA antiarrhythmic

Increase AP duration

Increase ERP

Increase QT interval

Some K+ channel blocking effects

Question 19

Lidocaine

Answer 19

Class IB antiarrhythmic

Decrease AP duration

Preferentially affect ischemic or depolarized
Purkinje and ventricular tissue

Question 20

Mexiletine

Answer 20

Class IB antiarrhythmic

Decrease AP duration

Preferentially affect ischemic or depolarized
Purkinje and ventricular tissue

Question 21

(Phenytoin)

Answer 21

Class IB antiarrhythmic

Decrease AP duration

Preferentially affect ischemic or depolarized
Purkinje and ventricular tissue

Question 22

Flecainide

Answer 22

Class IC antiarrhythmic

Significantly prolongs ERP in AV node
and accessory bypass tracts

No effect on ERP in Purkinje and ventricular tissue

Question 23

Propafenone

Answer 23

Class IC antiarrhythmic

Significantly prolongs ERP in AV node
and accessory bypass tracts

No effect on ERP in Purkinje and ventricular tissue

Question 24

Beta-blockers

Answer 24

Class II antiarrhythmic

Decrease SA and AV nodal activity by
decreasing cAMP and calcium currents

Suppress abnormal pacemakers by
decreasing slope of phase 4

AV node particularly sensitive → increases PR interval

Question 25

Amiodarone

Answer 25

**Class III antiarrhythmic: K+ channel blocker** Increase AP duration Increase ERP Increase QT interval

Question 26

Ibutilide

Answer 26

**Class III antiarrhythmic: K+ channel blocker** Increase AP duration Increase ERP Increase QT interval

Question 27

Dofetilide

Answer 27

**Class III antiarrhythmic: K+ channel blocker** Increase AP duration Increase ERP Increase QT interval

Question 28

Sotalol

Answer 28

**Class III antiarrhythmic: K+ channel blocker** Increase AP duration Increase ERP Increase QT interval (also a beta-blocker)

Question 29

Verapamil, Diltiazem

Answer 29

**Class IV antiarrhythmics: CCBs** Decrease conduction velocity Increase ERP Increase PR interval

Question 30

Adenosine

Answer 30

Increase K+ efflux from cells → hyperpolarizing cell and decrease calcium influx (inhibits L-type calcium channels) → decreasing AV node conduction

Question 31

Mg²⁺

Answer 31

Effective in torsades and digoxin toxicity

Question 32

Ivabradine

Answer 32

Selective inhibition of funny sodium channels → prolonging slow depolarization phase (phase 4) Decreases SA node firing **Negative chronotropic** effect **without inotropy** Reduces cardiac O2 requirement