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HD 1 > Cardio/Resp. Pharmacology > Flashcards

Cardio/Resp. Pharmacology Flashcards

0
Q

Atorvastatin (lipitor)

A

oral antihyperlipidemic, statin;
= HMG CoA reductase inhibitor (blocks cholesterol synth, etc)
Lowers LDL and triglycerides, for CAD patients.

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1
Q

plant sterol (benechol)

A

oral antihyperlipidemic,
reduces cholesterol absorption
(lipid-lowering)

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2
Q

Colesevelam (welchol)

A

oral antihyperlipidemic, bile acid resin;

  • new, lipid lowering –> bind LDL to liver.
  • low toxicity, non-systemic effects.
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3
Q

gemfibrozil (lopid)

A

oral antihyperlipidemic, fibrate; = PPAR-a agonist.
lipid lowering - lower LDL, increase HDL;
for hyperglyceridemia.

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4
Q

Fenofibrate (tricor)

A

oral antihyperlipidemic, fibrate; = PPAR-a agonist.
lipid lowering - lower LDL and increase HDL;
for hyperglyceridemia

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5
Q

Niacin

A

oral antihyperlipidemic,
“vitamin mega-dose”
lipid lowering –> increases HDL;
** contraindication: Diabetes

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6
Q

Ezetimibe (Zeita)

A

oral antihyperlipidemic,
blocks cholesterol transporter
(lipid lowering)

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7
Q

Ezetimbe/simvastatin (vytorin)

A

oral antihyperlipidemic, statin AND intestinal cholesterol transporter blocker;
lipid lowering – decrease plasma LDL;
* often used in combo w/ statins (if statins alone don’t work)

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8
Q

fluvastatin (Lescol)

A

oral antihyperlipidemic, statin;
HMG CoA reductase inhibitor (block cholesterol synth)
lipid lowering -> lowers LDL and triglycerides

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9
Q

Lovastatin (mevacor)

A

oral antihyperlipidemic, statin;
HMG CoA reductase inhibitor (blocks cholesterol synth, etc.)
Lowers LDL and triglycerides, for CAD patients.
*Pro-drug! <– liver metabolism

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10
Q

pravastatin (Prevachol)

A

oral antihyperlipidemic, statin;
HMG CoA reductase inhibitor (blocks cholesterol synth, etc.)
lipid lowering - lowers LDL and triglycerides, for CAD patients.

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11
Q

Rosuvastatin (crestor)

A

Oral antihyperlipidemic, statin;
HMG CoA Reductase Inhibitor (blocks cholesterol synth, etc)
lipid lowering –> lowers LDL and triglycerides, for CAD patients.

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12
Q

Simvastatin (Zocor)

A

oral antihyperlipidemic, statin;
HMG CoA Reductase Inhibitor (blocks cholesterol synth, etc)
lipid lowering –> esp. LDL and triglycerides, for CAD patients.
* Pro-drug! <– liver metabolism

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13
Q

Propanolol (inderal)

A

oral Sympatholytic, II antiarrhytmic,
NS beta-agonist
* Anti-anginal

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14
Q

Atenolol (tenorim)

A

oral sympatholytic, II anti-arrhythmic
b2-antagonist
*anti-anginal

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15
Q

Metroprolol (Lopressor)

A

oral Sympatholytic, II Anti-arrhythmic,
b1-antagonist
*anti-anginal

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16
Q

glyceryl nitrate (nitrolingual)

A

sublingual/oral vasodilator, organic nitrate;
*fast-acting Anti-anginal,
for acute episode of stable angina, NOT MI!

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17
Q

isosorbide dinitrate (dilatrate)

A

sublingual vasodilator, organic nitrate

  • anti-anginal, not for MI!
  • slow acting can be used prophylactically (somewhat)
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18
Q

Isosorbide mononitrate

A

oral/topical vasodilator, organic nitrate

  • anti-anginal
  • slow acting can be prophylactic, but quick tolerance dvpt
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19
Q

diltiazem (dilacor)

A

oral calcium channel blocker
(cardiac blocker and vascular effects –> decrease BP)
* anti-anginal

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20
Q

Amlodipine (norvasc)

A

oral dihydropyridine calcium channel blocker
(vascular effects only)
* anti-anginal

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21
Q

nifedipine (procardia)

A

oral dihydropuridine calcium channel blocker,
mostly sm muscle/vascular effects;
* anti-anginal

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22
Q

Ranolazine (Ranexa)

A

oral anti-anginal, metabolized by liver;
inhibitor of late Na+ current I(Na-L) => reduce Ca2+ overload after ischemia.
–> lower angina frequency, for pts on 2+ other angina meds.
SE: prolonged QT interval, nausea, dizziness, constipation

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23
Q

Ivabradine

A

oral anti-anginal,
inhibitor of cardiac current (f) => decrease HR, increase BF to heart;
for chronic angina pts w/ Sxs despite other meds, OR CHF

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24
Q

lisinopril (prinivil)

A

oral ACE inhibitor,
anti-anginal AND for LV failure patients
–> to prevent MI

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25
Q

albuterol (proventil)

A

inhaled bronchodilator,
short-acting beta-2 agonist (SABA)
for asthma or COPD
SE: tremor, hypOkalemia, maybe tachycardia (B1)

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26
Q

terbutaline (brethaire)

A

inhaled bronchodilator,
Short-acting beta-2 agonist (SABA)
for asthma/COPD
SE: tremor, hypOkalemia, maybe tachycardia (B1)

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27
Q

salmeterol (serevent)

A

inhaled bronchodilator,
LONG-acting beta-2 agonist (LABA)
for asthma/COPD
*should NOT be used by itself!

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28
Q

fluticasone (flonase)

A

inhaled anti-inflammatory steroid
* high potency ICS –> for episodic relief
#1 for asthma/COPD

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29
Q

theophylline

A

oral or IV bronchodilator *same as salmeterol
(IV = aminophylline)
for asthma/COPD

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30
Q

budesonide (pulmicort)

A

inhaled anti-inflammatory steroid,
* high potency ICS
for asthma/COPD (episodic relief)

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31
Q

Flunisolide

A

inhaled anti-inflammatory steroid
* low potency ICS
for asthma/COPD

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32
Q

prednisone

A

oral anti-inflammatory steroid,
for asthma/COPD
* systemic so avoid using for very long!

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33
Q

beclomethasone (beclovent)

A

inhaled anti-inflammatory steriod
* low potency ICS
for asthma/COPD

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34
Q

cromolyn

A
  • type of prednisone
    inhaled anti-inflammatory
    for asthma prophylaxis (NOT episodic relief)
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35
Q

ipratropium bromide (atrovent)

A

inhaled bronchodilator,
short-acting muscarinic antagonist (SAMA)
for asthma/COPD

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36
Q

tiotropium bromide (spiriva)

A

inhaled bronchodilator,
LONG-acting muscarinic antagonist (LAMA)
for asthma/COPD
*NOT safe for use alone

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37
Q

montelukast (singulair)

A

oral bronchodilator and anti-inflammatory,
CysLTR1 antagonist, blocks sm. muscle R binding;
for asthma/COPD

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38
Q

zafirlukast

A

oral bronchodilator and anti-inflammatory,
CysLTR1 antagonist, blocks sm. muscle R binding;
for asthma/COPD

39
Q

zilueton

A

oral bronchodilator and anti-inflammatory,
5-lipoxygenase inhibitor, blocks synthesis of spasmogens;
for asthma/COPD

40
Q

omalizumab (xolair)

A

IV anti-inflammatory,
IgE antibody,
* for allergic asthma

41
Q

roflumilast

A

oral anti-inflammatory (reduces chronic inflamm.)
PDE-IV inhibitor
for COPD (won’t reverse lung damage)
SE: nausea, diarrhea, headache

42
Q

captopril

A

oral ACE inhibitor and vasodilator,
–> block renin/ang/aldosterone system =>
for CHF

43
Q

enalapril

A

oral ACE inhibitor and vasodilator,

for CHF

44
Q

Lisinopril

A

oral ACE inhibitor and vasodilator,

for CHF

45
Q

Losartan

A

oral Angiotensin receptor antagonist and vasodilator,
“ARB” - use if intolerance to ACE Inhibitors;
for CHF.

46
Q

Hydralazine

A

oral vasodilator –> reflex increase HR,
preserves NO (reduces NADPH oxidase activity);
for CHF (decrease tolerance to nitrates)
*always used in combo with isosorbide dinitrate!
SE: arthralgias (esp. in women/slow acetylators)

47
Q

Sildenafil (Viagra)

A

oral vasodilator and PDE-5 inhibitor,
–> decrease preload, afterload, & hypertrophy/remodeling;
CHF: good for, but not approved yet.
SE: headache, flushing, nosebleed, changes in color vision,
* careful of cardiac collapse if use w/ nitrates or ARBs!

48
Q

hydrochlorothiazide

A

oral diuretic
(thiazide)
for CHF

49
Q

Nesiritide

A

pseudoBNP, IV diuretic and vasodilator;
decreases aldosterone influence (natriuresis).
For acute CHF decompensation (dyspnea @ rest)
*do NOT use if hypOtensive!

50
Q

Furosemide (Lasix)

A

oral OR IV diuretic,

for CHF

51
Q

Eplerenone

A 
oral diuretic and aldosterone antagonist,
--> Blocks aldosterone (mineralocorticoid R blocker); 
for CHF (decrease edema & risk of arrhythmias)
52
Q

Spironolactone

A 
oral diuretic and aldosterone antagonist, 
- specifically blocks aldosterone (mineralocorticoid R blocker);
for CHF (decrease edema & risk of arrhythmias). 
SE: gynecomastia
53
Q

Tolvaptan

A

orally active diuretic, = vasopressin V2 antagonist;
–> increase H2O diuresis,
for CHF w/ hyponatremia

54
Q

Bisoprolol

A

oral sympatholytic, beta R antagonist,

for CHF

55
Q

Carvedilol

A

oral sympatholytic, combined alpha & beta antagonist,
*acts on Ryanodine R;
- reduce heart damage (remodeling & apoptosis) and prevent complications (arrhythmias, HTN, etc), antioxidant
For all CHF pts!

56
Q

Nebivolol

A

oral sympatholytic, beta antagonist, & eNOS stimulator,
- reduce heart damage (remodeling & apoptosis) and prevent complications (arrhythmias, HTN, etc), antioxidant
For ALL CHF pts!

57
Q

Ivabradine

A

orally active anti-anginal, specific bradycardic agent;
inhibits Na+ & K+ current I(f) in pacemaker circuit
–> decrease HR.
for CHF
*hepatic clearance – do NOT use w/ CYP3A4 inhibiting drugs

58
Q

Digoxin

A

oral OR IV inotrope, antiarrhythmic agent
= AV block, increase vagal tone/decrease SNS, increase CO,
Also: increase renal f(x) and decrease Renin/angII activity.
narrow Therapeutic range, so start very low dose
–> MANY side effects! (toxicity!)
For end-stage CHF, or A-fib w/ rapid ventricular response.
*renally-cleared –> check amylase!

59
Q

Dobutamine

A

IV sympathomimetic

for CHF

60
Q

Dopamine

A

IV sympathomimetic

for CHF

61
Q

Inamrinone

A

IV phsophodiesterase inhibitor,

for CHF

62
Q

side effects of ACE Inhibitors

A 
"CAPTOPRIL"
Cough (common!), 
Angioedema (rare), 
Proteinuria (rare),  
Taste changes, 
hypOtension (!!!), 
Pregnancy, 
Rash, 
Increased renin, 
Low AngII (hyperkalemia if use drug combo)
63
Q

ACE Inhibitor and ARB contraindications

A
  1. renal stenosis (loss of efferent art. constriction -> low filtration)
  2. renal insufficiency (P too low)
  3. hyperkalemia
  4. pregnancy
  5. arterial hypotension
    * general intolerance
64
Q

side effects/contraindications of statins

A
  1. pregnancy (= teratogenic!)
  2. liver disease – transient ALT, AST elevation; dose-related.
    *test after start or change dose
  3. Myopathy/rhabdomyolysis – dose-dep.; check serum CK regularly! (creatinine kinase)
    Also: memory loss & hyperglucemia (DM II)
65
Q

secondary effects of statins

A

(1. block cholesterol synth)
2. decrease maladaptive compensation processes:
- - decrease: vascular inflammation, cell migration, coagulation
- - increase: fibrinolysis, vascularization, endothelial function

66
Q

Contraindications and side effects for fibrates

A

contraindications:
1) hepatic/renal dysfunction; 2) gall bladder disease

Side Effects: upset GI, nausea, skin rashes

67
Q

drugs that are “nitrovasodilators”

A
  1. glyceryl trinitrate
  2. isosorbide dinitrate
  3. isosorbide mononitrate
68
Q

Disopyramide

A 
oral anti-arrhythmic, class 1a;
Na+ channel blocker, prolongs AP duration. 
Use: V-fib, sustained ventricular tachycardia
SE: dry mouth, blurred vision, urinary retention (anti-cholinergic effects), long-term pro-arrhythmic
69
Q

Procainamide

A 
IV/oral anti-arrhythmic, class 1a; 
Na+ channel blocker, prolongs AP duration. 
Use: V-fib, sustained ventricular tachycardia
SE: *lupus-like sundrome*, hypotension, long-term pro-arrhytmic
70
Q

Quinidine

A 
oral anti-arrhythmic, class 1a; 
Na+ channel blocker, prolongs AP. 
Use: V-fib, sustained ventricular tachycardia
SE: *risk of digitalis toxicity!*, GI effects, long term pro-arrhythmic
71
Q

Lidocaine

A

IV anti-arrhythmic, class 1b;
Na+ channel blocker, shortens AP duration.
Use: acute Tx for V-fib or ventricular tachycardia, * in emergency*
SE: CNS depression/stimulation

72
Q

Flecainide

A

oral anti-arrhythmic, class 1c;
Na+ channel blocker, no change to AP.
Use: A-fib. rhythm management
SE: CNS - dizzy, blurry vision, headaches

73
Q

Propafenome

A

oral anti-arrhythmic, class 1c;
Na+ channel blocker, no effect on AP.
Use: A-fib. rhythm management
SE: CNS - dizzy, blurry vision, headaches

74
Q

Amiodarone

A

oral/IV anti-arrhythmic, class III;
K+ channel blocker, prolongs repolarization.
Use: AF rhythm management (also V-fib & v-tachycardia)
SE: pulmonary toxicity & fibrosis, CNS effects, increase Warfarin & digoxin effects…

75
Q

Dronedarone

A

oral anti-arrhythmic, multi-class/class III;
K+ channel blocker, prolongs repolarization.
Use: AF rhythm management
* synthetic, not as effective as amiodarone*
SE: fewer than amiodarone

76
Q

Sotalol

A 
oral anti-arrhythmic, class III & beta blocker; 
K+ channel blocker, prolongs repolarization. 
Use: A-fib/flutter rhythm control
SE: risk QT prolongation if renal insufficiency, few other SEs
77
Q

Bretylium

A

IV anti-arrhythmic, class III;
K+ channel blocker, prolongs repolarization.
Use: recurrent V-fib or ventricular tachycardia IF other Txs fail.
SE: hypotension (bc also blocks Na+ release)

78
Q

Verapamil

A 
oral anti-anginal & class IV anti-arrhythmic; 
blocks volt-dep. Ca2+ channels, esp. in cardiac m. 
--> decrease pacemaker rate (delay depol.)
--> prolong AV node repolarization
Use: Supraventricular tachycardia, AV nodal reentry, A-fib rhythm control. 
SE: AV block, negative inotropic action, CNS effects
79
Q

Adenosine

A

IV anti-arrhythmic;
Inhibits parasympathetic signaling to SA node –> decrease HR
(decrease SA & AV depolarization)
Use: Dx supraventricular tachycardia
* rapid clearance, minimal effects on contractility
(not bad for CHF or hypotensive pts)

80
Q

Digoxin

A

Cardiac glycoside –> inotropic & bradycardic (decreease AV node conduction)
Mech: blocks Na/K pump, w/o Na+ gradient, can’t pump out Ca2+ –> increase intracellular Ca2+ = depolarize myocyte
Route: oral, rapid activation, bind to plasma proteins, excreted by urine. * antacids decrease absorption
Use: CHF, rate control for A-fib
SE: pro-arrhythmic if long term, narrow therapeutic index (toxicity!)
- w/ diuretics: hypOkalemia; w/ heparin: hypERkalemia

81
Q

Acetylsalicylic acid (aspirin)

A

Oral anti-platelet agent,
= Irreversible COX inhibitor, minimal effect on endothelium.
Use: anti-coagulant esp. for arterial disease (CAD, PCI)
SE: GI toxicity

82
Q

Clopidogrel (plavix)

A

oral anti-platelet agent (APD R blocker), pro-drug;
=> P2Y12 irreversible antagonist (once metabolized), blocks platelet binding.
Use: anti-coagulant (additive effect w/ aspirin)
SE: neutropenia & thrombocytopenic purpura (rare), attenuated platelet inhibition (“resistance”)

83
Q

Ticagrelor

A

oral anti-platelet agent (rapid-acting ADP R blocker),
= P2Y12 reversible antagonist
use: anti-coagulant (additive effect w/ aspirin)
more protective than clopidogrel
SE: bleeding

84
Q

Abciximab

A

IV anti-platelet agent,
= GPIIb/IIIa R antagonist (blocks final/common pathway –> VERY effective)
Use: in-hospital anti-coagulant & for PCI

85
Q

Epoprostenol

A

IV anti-platelet agent,
= synthetic prostaglandin –> inhibits PGI2 (platelet aggregation)
Use: anti-coagulant in PCI & hemodialysis

86
Q

Cilostazal

A

oral anti-platelet agent,
PDE III inhibitor –> increase cAMP;
Use: Anti-coagulant for claudication/peripheral arterial disease (makes walking less painful!)

87
Q

tranexamic acid

A

oral/IV hemostatic agent, anti-fibrinolytic;

blocks plasminogen activation.

88
Q

Protamine sulfate

A

IV hemostatic agent, heparin antidote

antagonizes heparin effect

89
Q

Heparin (aka UFH)

A

IV/SC anti-coagulant, rapid;
hard to dose/unpredictable
binds antithrombin III –> INcrease proteolytic effect (inactivate factors IIa and Xa, also IX, XI, XII, XIII)
Use: IN-hospital anti-coagulant; esp. for VTE, A-fib, and DVTs
SE: hep-induced thrombocytopenia (HIT), osteoporosis

90
Q

Enoxaprin

A

IV/SC anti-coagulant,
= low molec. weight heparin –> easier dosing (but still unpredictable)
Binds antithrombin III, but mostly inactivates Xa (not II)
Use: IN-hospital anti-coagulant, esp. for VTE, A-fib, and DVTs
SE: fewer than heparin

91
Q

Fondaparinux

A

IV/SC anti-coagulant, dosing difficult.
= Factor Xa inhibitor by binding antithrombin III;
Use: IN-hospital anti-coagulant, esp. for VTE, A-fib, and DVTs

92
Q

Warfarin (coumadin)

A

ORAL anti-coagulant, slow pharmacokinetics,
inhibits vit. K reductase (in liver) –> blocks factor II, VII, IX, X activation.
Use: long term anti-coagulation
SE: many! (drug-drug, variations w/ metabolism, narrow therapeutic window), NOT if pregnant (teratogen!)
* early hypercoagulability state - must bridge w/ heparin!

93
Q

Dabigatran

A

Oral anti-coagulant,
= direct thrombin inhibitor; pro-drug, renal excretion;
Use: anti-coagulant for A-fib (prevent stroke)
Reduce intracranial bleeding by 50%!

94
Q

Rivaroxaban

A

oral anti-coagulant,
= direct Xa inhibitor;
Use: anti-coagulant for A-fib (prevent stroke)
Reduce intracranial bleeding by 50%!

95
Q

Alteplase (TPA)

A

IV thrombolytic,
= recombinant tPA;
Use: thrombolysis in acute PE, MI, thrombosis, ischemic stroke
SE: GI/CNS hemorrhage

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