Cardiopharmacology

Question 1

Methyldopa

Answer 1

MOA: alpha 2 agonistUse: HTN in PregnancyAE: Direct Coombs+ hemolysis, SLE-like syndromeDDI: 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 esmololClass 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 agonistNo change in Blood lipidCan 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

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

Answer 9

Asthma, Vasospastic disorders, DM (masks hypoglycemia)

Question 10

Hydralazine MOA?

Answer 10

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

Question 11

Hydralazine AE?

Answer 11

AE: SLE-Like Syndrome (high protein binding)

Question 12

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

Answer 12

Yes; Diuretics (HCTZ)

Question 13

What is DOC IV of Hypertensive emergency?

Answer 13

Nitroprusside

Question 14

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

Answer 14

CN toxicity=>binds to complex 4 of ETCNitrites=>methemoglobinemia Hb (Fe3+)=>binds to CN and releases O2Thiosulfate=>binds to CN

Question 15

Verapamil/Diltiazem

Answer 15

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

Question 16

Nifedipine and other “dipines” MOA? AE?

Answer 16

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

Question 17

What drugs can be used in HTN of pregnancy?

Answer 17

Hydralazine, Labetalol, methyldopa, nifedipine

Question 18

HTN with DM and HF, DOC?

Answer 18

ACE inhibitors and ARBs

Question 19

HTN with Angina and Post MI? DOC?

Answer 19

B-Blockers

Question 20

HTN with BPH?

Answer 20

Alpha blockers

Question 21

What are the Class IA antiarrhythmics?

Answer 21

Quinidine, Procainamide, Disopyramide

Question 22

Quinidine MOA? AE?

Answer 22

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

Question 23

Procainamide MOA? AE?

Answer 23

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

Question 24

Disopyramide MOA? AE?

Answer 24

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

Question 25

Class IA antiarrhythmics and digoxin?

Answer 25

Displaces digoxin

Question 26

Procainamide MOA? Use? Metabolism? AE?

Answer 26

MOA: Blocks Fast Na+Channels, Increases AP duration and ERPUse: WPWMetabolism: N-acetyltransferaseAE: Reversible-SLE like syndrome; Torsades de pointes

Question 27

What are the Class IA antiarrhythmics?

Answer 27

Quinidine, Procainamide, Disopyramide

Question 28

Quinidine MOA? AE?

Answer 28

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

Question 29

Procainamide MOA? Use? Metabolism? AE?

Answer 29

MOA: Blocks Fast Na+Channels, Increases AP duration and ERPUse: WPWMetabolism: N-acetyltransferaseAE: *Reversible-SLE like syndrome; Torsades de pointes

Question 30

Class IA antiarrhythmics and digoxin?

Answer 30

Displaces digoxin

Question 31

What are the Class IB antiarrhythmics?

Answer 31

Lidocaine, Mexiletine (Buy Liddy some Mexican Tacos)

Question 32

Lidocaine/Mexiletine MOA? AE?

Answer 32

MOA: Block inactivated Na+ channels in ischemic tissue=>prevents firing of new action potentials; Blocks Na+ slow window currents=>decreased action potential durationUse: Post MI and Digoxin ToxicityAE: Least CardiotoxicMexiletine=Oral

Question 33

Class IC drugs?

Answer 33

Flecainide and Propafernone

Question 34

Flecainide/Propafernone

Answer 34

MOA: Blocks all Na+ channelsProarrhythmic (contraindicated in ischemic heart disease)

Question 35

B-Blockers MOA?

Answer 35

Decrease SA and AV nodal activity by?cAMP,?Ca2+ currents=>decreases slope 4

Question 36

Class 3 antiarrhythmics?

Answer 36

``` AIDS Amiodarone Ibutilide Dofetilide Sotalol ```

Question 37

Class 3 MOA?

Answer 37

Prolongs repolarization

Question 38

Amiodarone AE?

Answer 38

Pulmonary Fibrosis Blue Skin Blue corneal deposits Blue=>iodine=>hyperthyroidism

Question 39

Sotalol, Ibutilide AE?

Answer 39

Torsades De Pointes

Question 40

Verapamil, Diltiazem MOA?

Answer 40

Decreases conduction velocity