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PAS 531 > Cardio Pharm > Flashcards

Cardio Pharm Flashcards

1
Q

Difference in -dipine and non-dipine CCB

A

-dipines best for HTN (vasodilation in periphery)
Dilitazem and verapamil secrease heart conduction and contractility of SA and AV (best for CAD)

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2
Q

Hydralazine

A

Vasodilation to decrease BP
Decrease afterload for HF
NOT used in CAD

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3
Q

Minoxidil

A

Prodrug
Vasodilation decreasing BP

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4
Q

Sodium nitroprusside

A

Vasodilation via nitrous oxide
RAPIDLY decreases BP.
Need continuous BP monitoring

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5
Q

Fenoldopam

A

Vasodilation
D1 receptor agonist
Start low titrate slow
Don’t give if have gluacoma bc increases IOP

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6
Q

Vasodilators examples

A

CCB
Hydralazine
Minoxidil
Sodium nitroprusside
Fenoldopam

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7
Q

Thiazide diuretics

A

-ide
Chlorthalidone
Metolazone
Decreases DCT Na reabsorption
Can cause hypercalcemia
Used in HF
AVOID NSAIDs

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8
Q

Aldosterone receptor antagonist

A

-one
diuretic
Stop Na reabsorption.
Decreases K secretion
Spironolactone most potent and active on progesterone receptors.
Used in HF

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9
Q

Amiloride, Trimaterene

A

Epithelial sodium channel antagonists Stop Na reabsorption
Can cause hyperK and kidney stones.
amiloride not metabolized, trimaterene has short 1/2life
NOT good with NSAIDs

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10
Q

Beta blockers

A

-lol
Decrease HR and BP
CAD
HF med (BCM)
Class II antiarrhtyhmic

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11
Q

What beta blockers are specific to beta-1 receptors

A

MANBABE

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12
Q

What beta blockers have alpha-1 action

A

-lol (not -olol)

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13
Q

What beta blocker used for emergency HTN

A

Labetolol

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14
Q

Alpha-1 receptor agonists

A

-zosin
Vasodilation
Can cause sudden drop of BP

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15
Q

Alpha-2 receptor agonists

A

Methyldopa (good in preg)
Clonidine (rebound, goood for HTN in CKD)
Stop NE release to decrease BP

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16
Q

Aprocitentan

A

Dual endothelin receptor antagonist
TERATOGENIC
Inhibits vasoconstriction
Can cause fluid retension and hepatotoxicity

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17
Q

Statins

A

Inhibit HMG-CoA reductase
Avoid in liver failure
NOT for preg
Decrease LDL (increases receptors)
Increase HDL
Decrease TG
Take in evening

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18
Q

Ezetimibe

A

Cholesterol absorption inhibitor.
NOT for liver disease
Decreases LDL (increases receptors)
Decreases TG
Decreases VLDL
Take with statin

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19
Q

PCSK9 inhibitors

A

-ocumab
Human antibody
Inhibits breakdown of LDL receptors decreasing LDL
SQ injection every two weeks

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20
Q

Niacin

A

Increases HDL
Decreases TG synthesis
Can cause flush with warm pruritis

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21
Q

Bile acid sequestriants

A

Col- or Chol-
Bind bile acids in lumen stoping reabsorption.
NOT for diverticulitis
Increase bile acid secreation
Decrease LDL
Increase TG (not good)

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22
Q

Fibrates

A

-fibr-
Don’t use Gemfibrozil with statin.
Lowers TG
Increases HDL
Fenofibrate lowers LDL too

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23
Q

Omega fatty acids

A

Fish oils
Omega-3 acid ethyl esters
Icosapent ethyl
Lower TG

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24
Q

Lomitapide

A

Lowers LDL
Low fat diet necessary

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25
Bempedoic acid
Lowers LDL Stops cholesterol synthesis causing increased LDL receptors
26
Inclisiran
Lowers LDL Prevents PCSK9 production preventing LDL receptor breakdown
27
Evencumab
Decreases TG Decreases LDL Decreases VLDL Increases lupoprotein lipase by inhibiting ANGLPTL3
28
Beta blockers in CAD
Decrease effect of norepi reducing myocardial O2 demand AVOID in cocaine MI
29
What to avoid with nitrates
PDE5 Inhibitors
30
Isosorbide
Nitrate Need regular nitrate free intervals
31
How many nitros can you give someone with angina before 911
3
32
Ranolazine
Na channel blocker CAD Reserved for pts with failed other treatment Decreases O2 demand increasing diastolic function
33
Fibrinolytics
-plase and streptokinase (not in US) Binds to fibrin clot and catalyzes breakdown.
34
CAD treatment options
BB CCB Nitrates Na channel blocker Fibrinolytics Antiplatelets Anticoagulants
35
Antiplatelet example
Cox inhibitors (ASA) ADP2Y12 receptor antagonists (-grel(or)) PAR-1 antagonist (Vorapaxar) Glycoprotein IIb/IIIa (Eptifibatide/tirofiban PDE inhibitors (Cilostazol and dypyridamole)
36
Aspirin
COX inhibitor antiplatelet AVOID in younger than 19 bc Reye's syndrome.
37
ADP2Y12 receptor antagonist
-grel or -grelor antiplatelet AVOID aspirin>100mg with ticagrelor
38
Vorapaxar
PAR-1 (thrombin receptor) antagonist antiplatelet
39
Eptifibatide Tirofiban
Glycoprotein IIb/IIIa inhibitors Antiplatelet Used with other antiplatelets/anticoagulants in PCI (cath)
40
Dipyridamole (not for unstable angina) Cilostazol (not for HF)
PDE inhibitors Antiplatelet
41
Anticoagulants
Indirect Thrombin inhibitors Low molecular weight heparin Fondaparinux Warfarin Direct thrombin inhibitors Direct oral anticoagulants (DOAC)
42
Unfractioned heparin
Anticoagulant Indirect thrombin inhibitor. Prevents clot from growing while body breaks it down. Binds to antithrombin blocking Factor Xa DVT PE
43
Low molecular weight heparin
-parin Binds to antithrombin blocking factor Xa. Good for DVT in preg
44
Fondaparinux
Factor Xa inhibitor Binds to antithrombin DVT, PE, VTE prophylaxis after ortho and abd surgery
45
Warfarin
Vitamin K antagonist TERATOGENIC affects factors II, VII, IX, X Narrow range between efficacy and toxicity AVOID cranberry and vitamin K. Vitamin K is antidote
46
Direct thrombin inhibitors
Argatroban used for prophylaxis or treatment of VTE in pts with thrombocytopenia Bivaliruden blocks catalytic site of thrombin
47
Direct oral angicoagulants (DOAC)
-xaban directly inhibit factor Xa so less production of thrombin an dprothrombin Dabigatran is prodrug to treat DVT/PE
48
HF meds
SGLT2 BB ARNI ACEi/ARB MRA Loop diuretics Thiazide diuretics Vasodilators Ivabradine Nesiritide DIgoxin Dobutamine Dopamine Phosphodiasterase-3 inhibitor
49
SGLT2i
-flozin Stops glucose reabsorption in PCT AVOID in T1D, DKA, and preg Used in HF
50
Beta blockers used in HF
Bisoprolol Carvedilol Metoprolol
51
ARNI
Sacubitril/valsartan Neprilysin inhibitor and ARB Increased Na and water excretion and vasodilation Used in HF
52
Loop diuretcs
-semide Stop reabsorption of K in ascending loop Used in HF AVOID NSAIDs
53
Vaso and venodilators in HF
Hydralazine decreases peripheral resistance decreasing afterload Isosorbide dinatrate venodilator causing decreased preload and arteriolar dilator causing decreases afterload
54
Ivabradine
Blocks HCN Na channel of SA node slowing HR. Used in HF
55
Nesiritide
Activates natriuretic peptide causing reduced peload and afterload in acute decompensated HF
56
Digoxin
Increases contractility in HF Helps in Afib
57
Beta-adrenergic agonists
Dobutamine an dopamine Increase contraction in HF
58
Phosphodiesterase-3 inhibitor
Increases contraction in HF
59
DIsopyramide Quinidine Procainamide
Calss 1A antiarrhythmics Blocks FAST Na channels decreasing slope of phase 0 and K channels prolonging repolarization causing QT elongation
60
Lidocaine MExiletine
Class 1B antiarrhythmics Blocks SLOW Na channels in phase 2 Also decreases slope of phase 0 AVOID in 2º and 3º heart block
61
Flecainide Propafenone
Class 1C antiarryhthmics Block FAST Na channels decreasing slope of phase 0. AVOID in ischemic (post-MI)
62
Class 2 antiarrthmics
Beta blockers -lol Decrease Ca influx at Sa and AV node prolonging phase 4 RATE CONTROL
63
Amiodarone Ibutilide Dronedarone Dofetilide
Class 3 antiarrhthmics Block K channels proonging refactory period (phase 3) RHYTHM CONTROL
64
Class 4 antiarrhthmics
non-DHP CCB (Verapamil, Dilitiazem) Blocks Ca channels of SA and AV node in phase 0 and on contractile cells in phase 2] RATE CONTROL
65
Adenosine
Slows SA and AV node. Useful in SVT
66
Magnesium sulfate
Ca channel blocking slows SA node impluse. Used in torsades de pointes and digoxin induced arrhthmias

PAS 531 (15 decks)

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