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STEP 1 > cardio pharm. > Flashcards

cardio pharm. Flashcards

1
Q

hypertension drugs that can be used in pregnancy

A

hypertensive moms love nifedipine

hydralazine
methyldopa
labetalol
nifedipine

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2
Q

hypertension drugs that cannot be used in pregnancy

A

ace inhibitor

arbs

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3
Q

what drugs must be used cautiously in decompensated HF

A

beta blockers

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4
Q

what drugs are contraindicated in cardiogenic shock

A

beta blockers

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5
Q

hypertension with heart failure

A

diuretics/ace inhibitors/arbs

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6
Q

minidoxil MOA

A

opens K+ channels, hyperpolarizing smooth muscle causing relaxation of vascular smooth muscle

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7
Q

hypertrichosis, hypotension, reflex tachycardia, fluid retention/edema

A

minidoxil side effects

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8
Q

orthostatic hypotension with first few doses

A

alpha 1 blockers (-zosin)

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9
Q

drug-induced lupus (Anti-histone ab)

A

hydralazine

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10
Q

minoxidil compensatory responses

A

marked salt/water retention and marked tachycardia (all others have less compensation)

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11
Q

sudden discontinuation of what drug can cause severe rebound hypertension?

A

clonidine

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12
Q

pt with second degree AV block + constipation

A

non-dihydropyridine toxicity (verapamil)

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13
Q

what calcium channel blocker is used in patients with subarachnoid hemorrhage and why

A

nimodipine to prevent cerebral vasospasm (rmr Nemo)

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14
Q

hyperprolactinemia

A

verapamil toxicity

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15
Q

gingival hyperplasia

A

calcium channel blocker toxicity

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16
Q

hydralazine MOA

A

increases cGMP –> smooth muscle relaxation

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17
Q

does hydralazine affect arterioles or veins

A

arterioles > veins thus causes decreased afterload

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18
Q

why is hydralazine administered with a beta blocker

A

to prevent reflex tachycardia

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19
Q

what is contraindicated in CAD and why

A

hydralazine because it causes compensatory tachycardia which would increased O2 stress on myocardium

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20
Q

what calcium channel blocker can be used in hypertensive emergency

A

clevidipine

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21
Q

nitroprusside moa

A

increases cGMP via direct release of NO

venodilator ~ arterioles ( decreases preload and afterloda)

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22
Q

what toxicity can nitroprusside cause

A

cyanide

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23
Q

fenoldopam MOA

A

dopamine D1 receptor agonist

coronary peripheral renal splanchnic vasodilation (good for renal failure)

24
Q

does fendoldopam work on arterioles or veins

A

arterioles

25
Q

common side effect of nitrates

A

headache (vc it vasodilates veins in meninges)

26
Q

MOA nitrates

A

increases NO in smooth muscle, increases cGMP and smooth muscle relaxation
venodilator, so decreases preload and thus decreases cardiac work

27
Q

how do you treat reflex tachycardia

A

propranolol - beta blockers

28
Q

explain nitrate tolerance

A

patients on nitrates need to have a nitrate free period every day to avoid tolerance - usually done at night when patient is sleeping and cardiac work is the least

29
Q

how do verapamil and diltiazem affect HR?

A

decrease (inhibit SA and AV nodes)

30
Q

does minoxidil cause reflex tach?

A

yes so much so that it must be controlled with beta blockers

dose-dependent rise in HR

31
Q

hypertension + diabetes drugs

A

ACE inhibitors or ARBs because they not only lower BP but also slow diabetic nephropathy

32
Q

statins decrease what the most

A

LDL

33
Q

statins upregulate what

A

LDL receptor

34
Q

bile acid resins decerease what (cholestyramine)

A

LDL

35
Q

what lipid lowering agent has a gritty unpleasant taste

A

bile acid resins / cholestyramine

36
Q

what LLA causes decreased absorption of vitamins or other drugs from intestinal tract

A

bile acid resins/ cholestyramine

37
Q

hepatotoxicity, rhabdomyolysis/myopathy

A

side effect of statins

38
Q

bile acid resins MOA

A

prevent intestinal reabsorption of bile acids (decreased reabsorption of cholesterol)

39
Q

statins MOA

A

competitively inhibit hmg coa reductase (rate limiting enzyme in cholesterol synth) - reduces hmg-coa converstion to malevonate

40
Q

how do statins affect HDL

A

increase

41
Q

how do bile acid resins affect HDL

A

slightly increase

42
Q

how do bile acid resins affect triglycerides

A

slightly increase

43
Q

how to statins affect triglycerides

A

decrease

44
Q

what does ezetimbe reduce

A

LDL

45
Q

how does ezetemibe affect HDL/Triglyerides?

A

no affect

46
Q

if ezetimibe and statins are given together, what side effect risk is increased

A

hepatotoxicity

47
Q

ezetimibe moa

A

prevent cholesterol reabsorption at small intestine brush border

48
Q

cutaneous flushing is a common adverse affect of what lipid lowering agent

A

niacin

49
Q

what drug do you give if someone has low HDL

A

niacin

50
Q

how can you reduce cutaneous flushing due to niacin

A

pretreatment with aspirin/nsaid

51
Q

if someone is on niacin, how do you need to adjust the rest of their drugs?

A

niacin causes hyperglycemia - increase diabetes drugs

niacin potentiates hypertension drugs so decrease dose

52
Q

fibrates MOA

A

increases synthesis of lipoprotein lipase by adipocytes via interaction with ppar-alpha protein - increases triglyceride clearance

53
Q

fibrates decrease what the most

A

triglycerides

54
Q

fibrates increase the risk of developing what

A

choelsterol gallstones

55
Q

what two lipid lowering agents shouldnt be used together because they both increase risk of choelsterol gallstones and increased risk for mypoathy

A

statins and fibrates

56
Q

what lipid lowering agent will exacerbate gouty arthritis

A

niacin

57
Q

what lipid lowering agents are teratogenic?

A

statins (hmg coa reductase inhibitors)

STEP 1 (26 decks)

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