Cardio Pharm High Yield

Question 1

4 types of drugs used to HTN in heart failure?

Answer 1

Diuretics

ACEi/ ARB

Beta bloclers

Aldosterone antagonisits

Question 2

4 drugs to be used in HTN with diabetes mellitus?

Answer 2

ACEi/ ARB

Ca channel blocker

Thiazide diurects

Beta blocers

Question 3

4 Drugs to be used in HTN of pregnancy?

Answer 3

Hydralazine

Labetalol

Methyldopa

Nifedipine

Question 4

Name the major dihydropyridine Calcium channel blocker?

Answer 4

Amlodipine, nifedipine

Question 5

Name the 2 non-dihydropyridine CCBs?

Answer 5

Diltiazem and verapamil

Question 6

Mechanism of CCBs?

Answer 6

decreased contractility of the heart

Question 7

Treatment for subarachnoid hemorrhage?

Answer 7

nimodipine (CCB)

Question 8

3 main uses of dihydropyridine CCBs?

Answer 8

HTN, angina, Raynaud

Question 9

3 Major uses of nondihydropridine CCBs?

Answer 9

HTN, angina, A. fib/ flutter

Question 10

AE of amlodipine?

Answer 10

gingival hyperplasia

Question 11

AE of nondihydropiridine CCBs?

Answer 11

Constipation, AV block, cardiac depression

Question 12

Mechanism of Hydralazine?

Answer 12

increased cGMP to vasodilate (arterioles> veins) leading to afterload reduction

Question 13

AE of hydralazine?

Answer 13

SLE like syndrome, fluid retention, compensatory tachycardia

Question 14

Mechanism of nitroprusside?

Answer 14

increased cGMP to vasodilate (arterioles + veins) leading to afterload reduction

Question 15

Main AE of nitroprusside treatment?

Answer 15

cyanide toxicity

Question 16

2 drugs used in hypertensive emergencies?

Answer 16

Nitroprusside and fenoldapam

Question 17

How do nitrates work?

Answer 17

vasodilation by increased NO–> increase in cGMP and smooth muscle relaxation

dilates veins&raquo_space;> arteries (decreased preload)

Question 18

“monday disease”

Answer 18

development of tolerance to NO during the workweek due to industrial exposure and then loss of tolerance over the weekend

Tachycardia, dizziness, headache upon reesposure

Question 19

Name 3 endogenous substances that increase release of NO?

Answer 19

ACh, bradykinin, 5HT

Question 20

Name 3 endogenous substances that increase release of NO?

Answer 20

ACh, bradykinin, 5HT

Question 21

Mechanism of cholestrymine?

Answer 21

Bile acid resins:

prevent intestinal reabsorption of bile acids (so liver must make more cholesterol)

Question 22

What is the mechanism of ezetimibe?

Answer 22

prevent cholesterol absorption at small intestine brush border

Question 23

AE of ezetimibe?

Answer 23

increased LFTs and diarrhea

Question 24

what does ezetimibe decrease?

Answer 24

LDL

Question 25

What do fibrates decrease?

Answer 25

TG!!

Question 26

Mechanism of fibrates?

Answer 26

Activates PPAR to induce HDL synthesis upregulates LPL

Question 27

AE of fibrantes?

Answer 27

myopathy and cholesterol gallstones

Question 28

Mechanism of niacin?

Answer 28

inhibits lipolysis in adipose tissue and reduces hepatic VLDL synthesis

Question 29

What are the main AE of digoxin *cardiac glycosides)?

Answer 29

Cholinergic (N/V/D, blurry yellow vision), arrhythmias, AV block Hyperkalemia

Question 30

What can predispose to digoxin toxicity?

Answer 30

renal failure, hypokalemia, verapamil, amiodarone, quinidine

Question 31

Why is hypokalemia a risk factor for digoxin toxicitity?

Answer 31

Because K+ and digoxin both bind the same spot...so when there is low K+ digoxin can bind more

Question 32

What is the treatment for digoxin toxicity?

Answer 32

Slowly normalize K+, cardiac pacer, antidigoxin Fab fragments, Mg2+

Question 33

Name 2 class IIa antiarrhythmics?

Answer 33

quinidine and procainamide

Question 34

What are 3 major AEs of quinidine and procainamide?

Answer 34

1- SLE like (P) 2- cinchonism (Q) 3- TdP (increased QT interval)

Question 35

What is quinidine and procainamide used for?

Answer 35

Atrial and ventricular arrhythmias (SVT and VT)

Question 36

Name 2 class IIb antiarrhythmics?

Answer 36

Lidocaine and mexiletine Phenytoin

Question 37

Use of lidocaine and mexiletine?

Answer 37

acyte ventricular arrhythmias, digitalis induced arrhythmias POST MI!!

Question 38

What type of tissue does lidocaine and mexiletine preferrentially affect?

Answer 38

preferentially affects ischemic or depolarizated purkinje and ventricular tissue

Question 39

Name 2 class Ic antiarrhythmics?

Answer 39

Flecainde and propafenone

Question 40

AE of flecainide and propafenone?

Answer 40

Arrhythmia!

Question 41

Mechanism by which class II antiarrhymics work?

Answer 41

Beta blockers--> decreased SA and AV node activity by decreasee cAMP and decrease Ca currents

Question 42

Name the class III antiarrhythmics (K channel blockers)?

Answer 42

Amiodarone, Sotalol

Question 43

Use of amiodarone and sotalol?

Answer 43

Atrial fibrillation and atrial flutter Ventricular tachycardia

Question 44

AE of sotalol?

Answer 44

TdP, excessive beta blockade

Question 45

AE of amiodarone?

Answer 45

Pulmonary fibrosis Hepatotoxicity Hypothyroidism/ hyperthyroidism Corenal deposits Blue/ gray skin

Question 46

Problem with amiodarone?

Answer 46

Extensive tissue binding....LONG half life

Question 47

Name the class IV antiarrhythmics?

Answer 47

Verapamil and diltiazem

Question 48

Use of verapamil and diltiazem?

Answer 48

prevention of nodal arrhythmias, and rate control in a fib

Question 49

DOC for diagnosing and abolishing SVT?

Answer 49

adenosine

Question 50

Use of Mg2+?

Answer 50

Effective in TdP and Digoxin toxicity