Cardiology Clues Pharm Flashcards

1
Q

What are theh Renin-angio system effectors?

A

ACE inhibitors and ARBs

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2
Q

What are the ACE inhibitors?

A

Captopril, Enalapril, Fosinopril, Lisinopril

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3
Q

What is the MOA of ACE inhibitors?

A

Inhibits conversion of Ang I to Ang II, decreases Ang II

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4
Q

What are the Indications for ACE inhibitors?

A

HTN, CHF, post MI and vasodilation

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5
Q

What are the adverse effects of ACE inhibitors?

A

Hyperkalemia, cough, angioedema contraindicated in pregnancy (fetal renal malformations)

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6
Q

What is the MOA of ARBS?

A

Ang II blockers:

prevents alpha 1 vasoconstriction from Ang II

prevents aldosterone secretion stimulated by Ang II

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7
Q

What are the indications for Losartan?

A

HTN

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8
Q

What are the adverse effects of Losartan?

A

Fetal renal toxicity Hyperkalemia

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9
Q

What are the sympathoplegics?

A

Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine

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10
Q

What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?

A

Selective B1-Blockers

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11
Q

What is the MOA of Propranolol, Timolol?

A

B1 and B2 Blockers

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12
Q

What is the MOA of Carvedilol?

A

Alpha and B-Blocker

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13
Q

What are the indications for B-blockers

A

HTN, Angina, MI, Antiarrhythmic

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14
Q

What are the adverse effects of B-blockers?

A

Impotence, asthma, bradycardia, AV block, heart failure, sedation, sleep alterations

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15
Q

What is the MOA of Prazosin?

A

Alpha 1-Blocker, vasodilation, decreases TPR

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16
Q

What are the indications for Prazosin?

A

Pheochromocytoma, HTN

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17
Q

What are the adverse effects of Prazosin?

A

Orthostatic Hypotension

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18
Q

What is the MOA of Clonidine?

A

Alpha 2 agonist = decreases peripheral resistance

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19
Q

What are the indications for Clonidine?

A

HTN Smoking Cocaine Heroin withdraw

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20
Q

What are the adverse effects of Clonidine?

A

Drowsiness, dry mouth, and rebound HTN after abrupt withdraw

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21
Q

What is the MOA of Methyldopa?

A

Alpha 2 agonist = decreases peripheral resistance

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22
Q

What are the indications for Methyldopa?

A

HTN

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23
Q

What are the adverse of Methyldopa?

A

Sedation and Hemolytic Anemia (+) Coombs test

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24
Q

What is the MOA of Hexamethonium?

A

Nicotinic Ganglionic blocker

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25
Q

What are the adverse effects of Hexamethonium?

A

Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction

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26
Q

What is the MOA of Reserpine?

A

Prevents the storage of monoamines in synaptic vesicle

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27
Q

What are the indications for Reserpine?

A

HTN

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28
Q

What are the adverse effects of Reserpine?

A

Mental depression

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29
Q

What is the MOA of Guanethidine?

A

Interferes with norepinephrine release

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30
Q

Whata re the indications for Guanethidine?

A

Severe HTN

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31
Q

What are the adverse effects of Guanethidine?

A

Contraindicated in patients taking TCA’s

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32
Q

What are the Vasodilators?

A

Hydralazine, Minoxidil, Nifedipine, Verapamil, Nitroprusside, Diazoxide

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33
Q

What is the MOA of Hydralazine?

A

increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction

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34
Q

What are the indications for Hydralazine?

A

Severe HTN, 1st line treatment for HTN in pregnancy

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35
Q

What are the adverse effects of Hydralazine?

A

Compensatory tachycardia, fluid retention, Lupus like syndrome, contraindicated in Angina/CAD because of compensatory tachy

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36
Q

What is the MOA of Minoxidil?

A

K+ channel opener, hyperpolarizes and relaxes smooth muscle

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37
Q

What are the adverse effects of Minoxidil?

A

Hypertrichosis and Pericardial Effusion

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38
Q

What is the MOA of Nifedipine and verapamil?

A

Ca+ channel antagonists

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39
Q

What are the indications for Nifedipine and verapamil?

A

HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud’s

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40
Q

What is the MOA of Nitroprusside?

A

Direct release of NO, increases cGMP, vasodilator

41
Q

What are the indications for Nitroprusside?

A

Hypertensive emergency, CHF, Angina

42
Q

What are the adverse effects of Nitroprusside?

A

Cyanide Toxicity, hypotension, short acting

43
Q

What is the MOA of Diazoxide?

A

K+ channel opener, hyperpolarizes and relaxes smooth muscle

44
Q

What are the indications for Diazoxide?

A

HTN

45
Q

What are the adverse effects of Diazoxide?

A

Hypoglycemia (reduces insulin release) and hypotension

46
Q

What are the HMG-CoA reductase inhibitors?

A

Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin

47
Q

What are the indications for HMG-CoA reductase inhibitors?

A

Strong decrease LDL Decrease Triglycerides Increase HDL

48
Q

What are the adverse effects of HMG-CoA reductase inhibitors?

A

Hepatotoxicity (increase LFT’s) Rhabdo

49
Q

What is the MOA of Niacin?

A

Inhibits lipolysis in adipose tissue reduces hepatic VLDL secretion into circulation

50
Q

What are the indications for Niacin?

A

Decrease LDL and Triglycerides Strong increase HDL

51
Q

What are the adverse effects of Niacin?

A

Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia

52
Q

What are the Bile acid resins?

A

Cholestyramine Colestipol Colesevelam

53
Q

What is the MOA of Bile Acid resins?

A

Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more

54
Q

What are the indications for Bile Acid Resins?

A

Slightly increase HDL and triglycerides Decrease LDL

55
Q

What are the adverse effects of Acid Resins?

A

Tastes bad and causes GI discomfort bile decreases absorption of fat soluble vitamins cholesterol gallstones

56
Q

What are the cholesterol Absorption blockers?

A

Ezetimibe

57
Q

What is the MOA of Ezetimibe?

A

Prevents cholesterol reabsorption at small intestine brush border

58
Q

What are the indications for Ezetimibe?

A

Decrease LDL

59
Q

What are the adverse effects of Ezetimibe?

A

Rare increase LFT’s

60
Q

What are the Fibrates?

A

Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate

61
Q

What is the MOA of FIbrates?

A

Upregulate LPL, increase triglyceride clearance

62
Q

What are the indications for fibrates?

A

Strong decrease of triglycerides slight decrease of LDL slight increase in HDL

63
Q

What are the adverse effects of fibrates?

A

Myositis, hepatotoxicity (increase LFT’s) cholesterol gallstones

64
Q

What is the MOA of Digoxin?

A

Direct inhibition of Na+/K= ATPase leads to indirect inhibition of Na+/Ca2+ exchanger, positive inotrope, stimulates vagus nerve

65
Q

What are the indications for digoxin?

A

CHF (increase contractility) A fib (decrease conduction at the AV node) depression of the SA node

66
Q

What are the adverse effects of Digoxin?

A

Cholinergic, ECG: icnrease PR, decrease QT worsened by renal failure Quinidine displaces Digoxin from tissue binding sites

67
Q

What is the MOA of Nesiritide?

A

Recombinant BNP, increase in cGMP and vasodilation

68
Q

What are the indications for Nesiritide?

A

Acute decompensated heart failure

69
Q

What are the adverse effects of Nesiritide?

A

Hypotension

70
Q

What are the Class IA antiarrhythmic?

A

Quinidine, Procainamide, Disopyramide

71
Q

What is the MOA of Class IA antiarrhythmic?

A

Na+ channel blocker

72
Q

What are the indications for the Class IA antiarrhythmic?

A

Increase AP duration, icnrease effective refractory period (ERP) QT interval, affect reentrant and ectopic SVT and ventricular tachy

73
Q

What are the adverse effects of the Class IA antiarrhythmic?

A

Quinidine: Cinchonism Procainamide: Torsades de Pointes

74
Q

What are the Class IB antiarrhythmic?

A

Lidocaine, Mexiletine, Tocainide

75
Q

What is the MOA of Class IB antiarrhythmic?

A

Na+ channel blocker

76
Q

What are the indications for the Class IB antiarrhythmic?

A

Decrease AP duration, acute ventricular Arrhythmias, local anesthesia

77
Q

What are the adverse effects of the Class IB antiarrhythmic?

A

CNS stimulation and depression Cardiovascular depression Hyperkalemia increases toxicity

78
Q

What are the Class IC antiarrhythmic?

A

Flecainide, Encainide, Propafenone

79
Q

What is the MOA of Class IC antiarrhythmic?

A

Na+ channel blocker

80
Q

What are the indications for Class IC antiarrhythmic?

A

Ventricular tachy progressing to V. fib, last resort

81
Q

What are the adverse effects of Class IC antiarrhythmic?

A

Prolongs refractory period in AV node Hyperkalelmia increases toxicity

82
Q

What are the K+ channel blockers?

A

Sotalol, Ibutilide, Bretylium, Amiodarone

83
Q

What is the MOA of the K+ channel blockers?

A

Increase AP duration, increase effective refractory period (ERP), increase QT interval

84
Q

What are the adverse effects of the K+ channel blockers?

A

WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism

85
Q

What are the Ca2+ channel blockers?

A

Verapamil, Diltiazem

86
Q

What is the MOA of the Ca2+ blockers?

A

Decreases conduction velocity of the AV node, increases ERP and PR interval

87
Q

What are the indications for the Ca2+ channel blockers?

A

SVT/ prevent nodal arrhythmias

88
Q

What are the adverse effects of the Ca2+ channel blockers?

A

Flushing, edema, constipation, CHF, AV block

89
Q

What is the MOA of adenosine?

A

Increase K+ efflux, hyperpolarizes the cell

90
Q

What are the indications for adenosine?

A

Dx. and tx. of AV nodal arrhythmias

91
Q

What are the adverse effects of adenosine?

A

flushing, hypotension, and chest pain very short acting

92
Q

What is the MOA of Potassium on the heart?

A

Depresses ectopic pacemaker in hypokalemia

93
Q

What are the indications for administering Potassium?

A

Digoxin toxicity, activated charcoal: binds digoxin in the intestine Digibind: binds to digoxin in the bloodstream

94
Q

What are the indications from Magnesium?

A

Effective in Torsades and Dig toxicity

95
Q

What are the indications of the K+ channel blockers?

A

a fib, a flutter, Vtach (ami and soto esp)

96
Q

What are the indications for the Dihydropyridines?

A

(amlodipine, clevidipine, nicardipine, nifedipine, nimodipine) all of those except nimodipine are for HTN, angina (including prinzmetal angina), and reynauds

97
Q

What are the indications for the non-dihydropyridines?

A

verapamil, diltiazem- HTN, angina, a fib/a flutter

98
Q

Neprilysin

A

prevents degredations of ANP/BNP