Cardiopharmacology

Question 1

Methyldopa

Answer 1

MOA: alpha 2 agonist
Use: HTN in Pregnancy
AE: Direct Coombs+ hemolysis, SLE-like syndrome
DDI: TCA decreases effects (Direct Opposition)

Question 2

B-Blockers and MI?

Answer 2

Decreases Mortality

Question 3

B-Blockers in SVT?

Answer 3

Metoprolol and esmolol

Class II anti-arrhythmic

Question 4

Which B-Blockers are Beta 1 selective?

Answer 4

A-M

Question 5

Which B-Blockers are Non-selective?

Answer 5

N-Z

Question 6

Acebutalol and pindolol

Answer 6

MOA: partial B agonist
No change in Blood lipid
Can Bronchodilate

Question 7

Propanolol

Answer 7

Use: 1. CNS=>Sedation 2. inhibits deiodination

Question 8

B-Blockers AE?

Answer 8

Cardiovascular depression (Heart Block)
Increased LDL and TGs

Question 9

Propanolol Use?

Answer 9

Use: 1. CNS=>Sedation 2. inhibits deiodination

Question 10

With B-Blockers, watch out in people with what diseases?

Answer 10

Asthma, Vasospastic disorders, DM (masks hypoglycemia)

Question 11

Hydralazine MOA?

Answer 11

MOA: dilates arteries (cGMP smooth muscle relaxation via NO)

Question 12

Hydralazine AE?

Answer 12

AE: SLE-Like Syndrome (high protein binding)

Question 13

Are Hydralazine and methyl dopa safe to use in pregnancy? What else should be added to these drugs?

Answer 13

Yes; Diuretics (HCTZ)

Question 14

What is DOC IV of Hypertensive emergency?

Answer 14

Nitroprusside

Question 15

Nitroprusside AE? What is the problem with the AE? What can you give together to stop this problem?

Answer 15

CN toxicity=>binds to complex 4 of ETC
Nitrites=>methemoglobinemia Hb (Fe3+)=>binds to CN and releases O2
Thiosulfate=>binds to CN

Question 16

Verapamil/Diltiazem

Answer 16

MOA: non dihyropyridine CCB blockers in Heart (verampil=ventricles)
AE: Hyperprolactinemia (verapamil) and AV Block, Constipation (verapamil)

Question 17

Nifedipine and other “dipines” MOA? AE?

Answer 17

MOA: Blocks L-type Ca2+ channels in peripheral vascular smooth muscle=>vasodilate
AE: Gingival hyperplasia, Raynaud Phenomenon

Question 18

What drugs can be used in HTN of pregnancy?

Answer 18

Hydralazine, Labetalol, methyldopa, nifedipine

Question 19

HTN with DM and HF, DOC?

Answer 19

ACE inhibitors and ARBs

Question 20

HTN with Angina and Post MI? DOC?

Answer 20

B-Blockers

Question 21

HTN with BPH?

Answer 21

Alpha blockers

Question 22

What are the Class IA antiarrhythmics?

Answer 22

Quinidine, Procainamide, Disopyramide

Question 23

Quinidine MOA? AE?

Answer 23

MOA: Blocks Fast Na+Channels, Increases AP duration and ERP
AE: Cinchonism=Headache and tinnitus; Torsades de pointes

Question 24

Procainamide MOA? AE?

Answer 24

MOA: Blocks Fast Na+Channels, Increases AP duration and ERP
AE: Reversible-SLE like syndrome; Torsades de pointes

Question 25

Disopyramide MOA? AE?

Answer 25

MOA: Blocks Fast Na+Channels, Increases AP duration and ERP AE: Heart Failure; Torsades de pointes

Question 26

Class IA antiarrhythmics and digoxin?

Answer 26

Displaces digoxin

Question 27

Procainamide MOA? Use? Metabolism? AE?

Answer 27

MOA: Blocks Fast Na+Channels, Increases AP duration and ERP Use: WPW Metabolism: N-acetyltransferase AE: Reversible-SLE like syndrome; Torsades de pointes

Question 28

Class IA antiarrhythmics and digoxin?

Answer 28

Displaces digoxin

Question 29

What are the Class IA antiarrhythmics?

Answer 29

Quinidine, Procainamide, Disopyramide

Question 30

Quinidine MOA? AE?

Answer 30

MOA: Blocks Fast Na+Channels, Increases AP duration and ERP AE: *Cinchonism=Headache and tinnitus; Torsades de pointes

Question 31

Procainamide MOA? Use? Metabolism? AE?

Answer 31

MOA: Blocks Fast Na+Channels, Increases AP duration and ERP Use: WPW Metabolism: N-acetyltransferase AE: *Reversible-SLE like syndrome; Torsades de pointes

Question 32

Class IA antiarrhythmics and digoxin?

Answer 32

Displaces digoxin

Question 33

What are the Class IB antiarrhythmics?

Answer 33

Lidocaine, Mexiletine (Buy Liddy some Mexican Tacos)

Question 34

Lidocaine/Mexiletine MOA? AE?

Answer 34

MOA: Block inactivated Na+ channels in ischemic tissue=>prevents firing of new action potentials; Blocks Na+ slow window currents=>decreased action potential duration Use: Post MI and Digoxin Toxicity AE: Least Cardiotoxic Mexiletine=Oral

Question 35

Class IC drugs?

Answer 35

Flecainide and Propafernone

Question 36

Flecainide/Propafernone

Answer 36

MOA: Blocks all Na+ channels | Proarrhythmic (contraindicated in ischemic heart disease)