Cardio Pharm Flashcards

1
Q

How do B Blockers work?

A

By decreasing the oxygen demand and the incidence of ventricular arrhythmia. They allow increased perfustion to cardiac tissue.

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2
Q

What is the relationship between ACEI and MI

A

Have a greater effect on a post MI pt with a decreased Ejection Fraction less than 40%

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3
Q

When is digoxin contraindicated and why?

A

Contraindicated post MI because increased ionotrope would mean more oxygen demand and we don’t want that with a patient who is having or is post MI.

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4
Q

Spironalactone has been shown to increase mortality in which patients?

A

Patients with Systolic heart failure (low ejection fraction)

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5
Q

who are beta blockers best for?

A

Post MI and patients with acute coronary syndrome. they decrease HR and BP which decrease strain on the heart and increases perfusion.

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6
Q

Drug of choice for hypertrophic obstructive cardiomyopathy aka idiopathic hypertrophic subaortic stenosis. And why is this drug beneficial

A

beta blocker. It slows ventricular rate and allows an increase in ventricular filing time.

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7
Q

What is Ebtifibatide?

A

The drug is the third inhibitor of GPIIb/IIIa that has found broad acceptance after the specific antibody abciximab and the non-peptide tirofiban entered the global market.

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8
Q

Who should use Diltiazem?

A

Pts who have high BP and require rate control but cannot have b blocker (asthmatics, COPD). It is a CCB.

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9
Q

ACEI are good for those patients who have 1)?, 2), and 3)?

A

Diabetic nephropathy and CHF, post MI pts with left ventricular damage.

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10
Q

Why do ACEI improve survival in those with CHF

A

because they are an afterload reducer.

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11
Q

How does Nifedipine work?

A

peripheral vasodilator and decrease blood pressure

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12
Q

biggest side effect of nifedipine

A

reflex tacchycardia

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13
Q

side effects of diuretics

A

hypokalemia, hyperglycemia, hyperlipidemia, hyperuricemia, azotemia

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14
Q

side effect of b block?ers

A

bronchospasm, bradycardia, CHF exaserbation, impotence, fatigue, depression

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15
Q

ACEI side effect

A

cough, rash, leukopenia, angioedema, hyperkalemia

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16
Q

What are the two categories of CCBs?

What are the side effects of each category.

A

dihydropyradines: headache, flushing, peripheral edema

non DHPs: decreased contractility

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17
Q

Name 2 Vasodilators and their side effects.

A

Hydralazine: Headache, Lupus like syndrome
Minoxidil: Orthostasis, Hirtsuism

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18
Q

a1adrenergic blocker side deffects

A

orthostatic hypotension

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19
Q

centrally acting adrenergic agonist side effects

methyldopa, clonodine

A

somnolence, orthostatic hypotension, impotence, rebound hypertenstion

20
Q

electrical alternans is diagnostic of ?

A

pericardial effusion/cardiac tamponade

21
Q

MOA of diuretics

A

decrease extracellular fluid volume and thereby decrease vascular resistance

22
Q

How do b blockers work?

A

They decrease cardiac contractility and renin release

23
Q

MOA of ACEI and ARBs

A

block aldosterone formation, reduce peripheral resistance, and salt/water retention

24
Q

MOA of CCBs

A

decrease smooth muscle tone and cause vasodilation; may also decrease cardiac output

25
Q

How do vasodilators work?

A

They decrease peripheral resistance by dilating arteries/arterioles

26
Q

MOA of a1adrenergic blockers

A

cause vasodilation by blocking actions of norepi on vascular smooth muscle

27
Q

procainimide is used for…?

A

use for WPW (short PR with wide QRS and slurred upstroke).

28
Q

if procainamide doesnt work for WPW, then use

A

adenosine

29
Q

adenosine

A

1st line for pts with stable narrow complex tach and second line for WPW

30
Q

Besides copd and asthma, who should beta blockers be avoided in?

A

pts with WPW because it blocs AV conduction, causing increased conductin in abberant pathway that can lead to SVT and VT.

31
Q

when is synchronized cardioversion indicated?

A

when a pt is unstable (hypotension, tachycardia)

32
Q

A patient has green/yellow visual disturbance, or blurry vision. what might this be from?

A

digitoxin toxicity

33
Q

besides visual disturbance, what might be another clue of dig toxicity?

A

renal failure

34
Q

side effects of Lisinopril

A

hypotension, cough, acute renal failure, hyperkalemia

35
Q

side effects of propranolol

A

asthma exaserbation, vasospasm, impotence, altered metabolism

36
Q

drugs of choice for supraventricular tacchycardia

A

adenosine and verapamil (but not until AFTER vagal manuvers of carotid massage and valsalva).

37
Q

Moa of verapamil

A

L type voltage dependent calcium channel blocker.

Since calcium channels are especially concentrated in the sinoatrial and atrio-ventricular nodes, these agents can be used to decrease impulse conduction through the AV node, thus protecting the ventricles from atrial tachyarrhythmias.

38
Q

Adverse effects of ccb’s

A

Edema
Constipation
Heart block

39
Q

Adverse effects of statins

A

Elevation of transaminases, myositis

40
Q

adverse effects of niacin

A

elevation and glucose and uric acid level, pruritis

41
Q

adverse effects of fibric acid derivatives

A

increased risk of myositis when combined with statins

42
Q

Adverse effects of Cholestyramine

A

Flatus and abdominal cramping

43
Q

When should you use calcium channel blockers in a pt with CAD?

A

Severe asthma
Prinzmetal angina
Cocaine induced chest pain

44
Q

What treatment is contraindicated in cocained induced chest pain?

A

Beta blockers

45
Q

Best initial treatment for bradycardia

A

Atropine –>pacemaker if atropine doesn’t help.