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Cardiovascular 1 Flashcards

1
Q

Drug class for Isosorbide dinitrate

A

vasodilator: nitrates

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2
Q

MoA for Isosorbide dinitrate

A

smooth muscle dilation of arteries & veins

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3
Q

Indications for Isosorbide dinitrate

A

frequent stable angina, CHF

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4
Q

SE/ADRs for Isosorbide dinitrate

A

HA, hypotension, tachycardia, rebound HTN

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5
Q

Contra-indications for Isosorbide dinitrate

A

hypersensitivity
head trauma
severe dehydration

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6
Q

Dx-Dx interactions for Isosorbide dinitrate

A

PDE-5 inhibitors

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7
Q

Monitoring for Isosorbide dinitrate

A

chest pain, BP

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8
Q

What is an off label use for Isosorbide denitrate?

A

esophageal spastic disorders

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9
Q

Drug class for Nitroglycerin

A

vasodilators: nitrates

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10
Q

MoA for Nitroglycerin

A

smooth muscle dilation of arteries & veins

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11
Q

Indications for Nitroglycerin

A

angina, CHF

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12
Q

SE/ADRs for Nitroglycerin

A

HA
hypotension
tachycardia

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13
Q

Contra-indications for Nitroglycerin

A

hypersensitivity
head trauma
severe dehydration

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14
Q

Dx-Dx interactions for Nitroglycerin

A

PDE-5 inhibitors

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15
Q

Monitoring for Nitroglycerin

A

chest pain

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16
Q

Drug class for Dihydropyridine: amlodipine

A

vasodilator: calcium channel blockers

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17
Q

MoA for Dihydropyridine: amlodipine

A

vasodilation due to blocking calcium channels in vascular smooth muscle & myocardium

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18
Q

Indications for Dihydropyridine: amlodipine

A

angina (chronic stable & vasospastic), HTN

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19
Q

SE/ADRs for Dihydropyridine: amlodipine

A

nausea, palpitations
peripheral edema
elderly-hypotension

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20
Q

Contra-indications for Dihydropyridine: amlodipine

A

hypersensitivity

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21
Q

Dx-Dx interaction for Dihydropyridine: amlodipine

A

grapefruit juice

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22
Q

Monitoring for Dihydropyridine: amlodipine

A

BP, chest pain

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23
Q

PG category for Dihydropyridine: amlodipine

A

PG C, but avoid

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24
Q

Drug class for Dihydropyridine: nifedipine

A

vasodilator: calcium channel blockers

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25
Q

MoA for Dihydropyridine: nifedipine

A

vasodilation due to blocking calcium channels in vascular smooth muscle & myocardium

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26
Q

Indications for Dihydropyridine: nifedipine

A

angina (chronic stable & vasospastic), HTN

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27
Q

SE/ADRs for Dihydropyridine: nifedipine

A

nausea, palpitations
peripheral edema
elderly-hypotension

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28
Q

Contra-indications for Dihydropyridine: nifedipine

A

hypersensitivity

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29
Q

Dx-Dx interactions for Dihydropyridine: nifedipine

A

grapefruit juice

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30
Q

Monitoring for Dihydropyridine: nifedipine

A

BP, chest pain

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31
Q

Drug class for Nondihydropuridine: diltiazem

A

vasodilator: calcium channel blockers

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32
Q

MoA for Nondihydropuridine: diltiazem

A

dilate coronary arteries & decrease myocardial oxygen demands

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33
Q

Indications for Nondihydropuridine: diltiazem

A

angina, HTN, A fib, A flutter, PSVT

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34
Q

SE/ADRs for Nondihydropuridine: diltiazem

A

edema, HA, dyspepsia

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35
Q

Contra-indications for Nondihydropuridine: diltiazem

A

bradycardia, SSS if no pacer

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36
Q

Dx-Dx interactions for Nondihydropuridine: diltiazem

A

grapefruit juice

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37
Q

Monitoring for Nondihydropuridine: diltiazem

A

BP, chest pain, LFTs

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38
Q

Drug class for Nondihydropuridine: verapamil

A

vasodilator: calcium channel blocker

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39
Q

MoA for Nondihydropuridine: verapamil

A

dilate coronary arteries & decrease myocardial oxygen demands

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40
Q

Indications for Nondihydropuridine: verapamil

A

angina, HTN, PSVT, A fib, A flutter

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41
Q

SE/ADRs for Nondihydropuridine: verapamil

A

HA, gingival hyperplasia, constipation, fatigue

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42
Q

Contra-indications for Nondihydropuridine: verapamil

A

bradycardia, SSS if not pacer

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43
Q

Dx-Dx interactions for Nondihydropuridine: verapamil

A

grapefruit juice

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44
Q

Monitoring for Nondihydropuridine: verapamil

A

chest pain, BP, LFTs

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45
Q

Drug class for Propranolol

A

beta blocks: nonselective (B1 & B2)

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46
Q

MoA for Propranolol

A

adrenergic B1 & B2 receptor inhibitor; reduction in myocardial oxygen demand

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47
Q

Indications for Propranolol

A

angina, HTN, tachy arrhythmias, essential tremor, migraine PX, anxiety

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48
Q

SE/ADRs for Propranolol

A

fatigue, sleep, disturbance, depression

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49
Q

Contra-indications for Propranolol

A

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression, bronchospasm

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50
Q

Dx-Dx interactions for Propranolol

A

ethanol (may increase or decrease concentration)

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51
Q

Monitoring for Propranolol

A

BP, chest pain, HR, LFTs

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52
Q

Drug class for Metoprolol

A

beta blockers: selective (B1)

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53
Q

MoA for Metoprolol

A

selective B1 adrenergic receptor inhibitor

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54
Q

Indications for Metoprolol

A

angina, HTN, hemodynamically stable MI

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55
Q

SE/ADRs for Metoprolol

A

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

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56
Q

Contra-indications for Metoprolol

A

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression

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57
Q

Dx-Dx interactions for Metoprolol

A

multiple

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58
Q

Monitoring for Metoprolol

A

BP, HR, LFTs

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59
Q

Drug class for Atenolol

A

beta blockers: selective (B1)

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60
Q

MoA for Atenolol

A

selective B1 adrenergic receptor inhibitor

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61
Q

Indications for Atenolol

A

angina, HTN, hemodynamically stable post MI

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62
Q

SE/ADRs for Atenolol

A

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN

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63
Q

Contra-indications for Atenolol

A

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression

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64
Q

Dx-Dx interactions for Atenolol

A

multiple

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65
Q

Monitoring for Atenolol

A

BP, HR, eGFR

66
Q

Drug class for Carvedilol

A

beta blockers: nonselective (B1, B2, & Alpha 1)

67
Q

MoA for Carvedilol

A

mixed alpha, beta receptor inhibition

68
Q

Indications for Carvedilol

A

angina (off label), HTN, stable HF, stable post-MI

69
Q

SE/ADRs for Carvedilol

A

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

70
Q

Contra-indications for Carvedilol

A

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression, bronchospasm, severe liver failure

71
Q

Dx-Dx interactions for Carvedilol

72
Q

Monitoring for Carvedilol

A

BP, HR, eGFR, LFTs

73
Q

Drug class for Ranolazine

A

anti-anginal: miscellaneous

74
Q

MoA for Ranolazine

A

inhibits inward Na channel in ischemic cardiac myocytes during depolarization thereby reducing Na/Ca exchange which relaxes cardiac muscle & reduces myocyte oxygen consumption

75
Q

Indications for Ranolazine

A

chronic angina

76
Q

SE/ADRs for Ranolazine

A

constipation, HA, hyperhidrosis, bradycarida, hypotensions, QT prolongation

77
Q

Contra-indications for Ranolazine

A
  • any degree of hepatic cirrhosis
  • concurrent strong CYP3A4 inhibitors/inducers
  • not for acute angina
78
Q

Dx-Dx interactions for Ranolazine

A
  • CYP3A4 inhibitors (diltiazem, erythromycin, verpamil)
  • P-glycoprotein inhibitors (cyclosporin)
  • w/ Simvastatin max dose is 20mg/day
  • grapefruit juice & St John’s wort
79
Q

Monitoring for Ranolazine

A

BP, HR, eGFR, LFTs

80
Q

PG category for Ranolazine

81
Q

Drug class for Aspirin

A

anti-platelet drug: COX-1 inhibitor

82
Q

MoA for Aspirin

A

irreversible inactivation (via acetylation) of COX-1- inhibits synthesis of thromboxane A2, prevents platelet aggregation & vasoconstriction by thromboxane A2

83
Q

Indications for Aspirin

A

secondary prophylaxis for MI, CVA

84
Q

SE/ADRs for Aspirin

A

30% gastritis, dyspepsia, bleeding, tinnitus (high dose)

85
Q

Contra-indications for Aspirin

A

hypersensitivity, nasal polyposis + bronchospasm

86
Q

Dx-Dx interactions for Aspirin

A

other anticoagulants, NSAIDs

87
Q

Monitoring for Aspirin

A

H&H, melana

88
Q

Drug class for Clopidogrel

A

platelet ADP inhibitor

89
Q

MoA for Clopidogrel

A

irreversibly blocks ADP receptor on platelets preventing platelet/fibrinogen binding & platelet aggregation

90
Q

Indications for Clopidogrel

A

secondary prevention AMI, CVA, PAD

91
Q

SE/ADRs for Clopidogrel

A

27% gastritis, abd pain, dyspepsia; thrombocytopenia, leukopenia (rare)

92
Q

Contra-indications for Clopidogrel

A

active bleeding, hypersensitivity

93
Q

Dx-Dx interactions for Clopidogrel

A
  • other anti platelet or anticoags (increase)
  • atorvastatin (decrease)
  • macrolide abx (decrease)
  • ginko biloba (increase)
94
Q

Monitoring for Clopidogrel

95
Q

PG category for Clopidogrel

A

no impact on PG metabolism

96
Q

Drug class for Furosemide

A

diuretics: loop diuretics

97
Q

MoA for Furosemide

A

inhibits Na/K/2Cl symporter in TAL of loop & distal tubule

98
Q

Indications for Furosemide

A

edema secondary to CHF, renal failure, liver failure

99
Q

SE/ADRs for Furosemide

A

hypotension, dehydration, hyperglycemia, incr then dec serum uric acid, electrolyte abnormalities, cholestatic jaundice

100
Q

Contra-indications for Furosemide

A

hypersensitivity to sulfa

101
Q

Dx-Dx interactions for Furosemide

A

increase impact of anti-HTN, lithium

corticosteroids increase Furosemide impact

102
Q

Monitoring for Furosemide

A

serum electrolytes, BUN, CrCl

103
Q

Drug class for Torsemide

A

diuretics: loop diuretics

104
Q

MoA for Torsemide

A

inhibits Na/K/2Cl symporter in TAL of loop & distal tubule

105
Q

Indications for Torsemide

A

edema of cardiac, renal, hepatic failure

HTN

106
Q

SE/ADRs for Torsemide

A

constipation, diarrhea

107
Q

Contra-indiciations for Torsemide

A

anuria, sulfa sensitivity

108
Q

Dx-Dx interactions for Torsemide

A

other K+ wasting drugs

109
Q

Monitoring for Torsemide

A

serum K, BP, daily wt, eGFR

110
Q

PG Category for Torsemide

111
Q

Drug class for Ethacrynic acid

A

diuretics: loop diuretics

112
Q

MoA for Ethacrynic acid

A

inhibits Na/K/2Cl symporter in TAL of loop & distal tubule

113
Q

Indications for Ethacrynic acid

A

edema secondary to CHF, renal failure, liver failure

114
Q

SE/ADRs for Ethacrynic acid

A

hypotension, dehydration, hyperglycemia, incr then dec serum uric acid, electrolyte abnormalities, jaundice

115
Q

Contra-indications for Ethacrynic acid

A

hypersensitivity, hx of severe water diarrhea w/ ethacrynic acid

116
Q

Dx-Dx interactions for Ethacrynic acid

A

increase impact of anti-HTN, lithium

corticosteroids increase Furosemide impact

117
Q

Monitoring to Ethacrynic acid

A

serum electrolytes, BUN, CrCl, BP

118
Q

PG Category for Ethacrynic acid

119
Q

Drug class for Spironolactone

A

diuretics: aldosterone antagonists

120
Q

MoA for Spironolactone

A

aldosterone receptor antagonist in distal rental tubule & blood vessels

121
Q

Indications for Spironolactone

A

excessive aldosterone excretion or heart failure, HTN, hyokalemia, liver cirrhosis w/ edema or ascites, nephrotic syndrome

122
Q

SE/ADRs for Spironolactone

A

ataxia, SJS, gynecomastia, amenorrhea, agranulocytosis, hepatotoxicity

123
Q

Contra-indications for Spironolactone

A

anuria, acute renal insufficiency, hyperkalemia, Addison’s disease

124
Q

Dx-Dx interactions for Spironolactone

125
Q

Monitoring for Spironolactone

A

serum K, eGFR, BP, daily wt, gynecomastia

126
Q

PG Category for Spironolactone

127
Q

Drug class for Eplerenone

A

diuretic: aldosterone antagonist

128
Q

MoA for Eplerenone

A

more specific aldosterone receptor antagonist is kidney, heart, blood vessels, brain; reduces vascular & cardiac fibrosis

129
Q

Indications for Eplerenone

A

excessive aldosterone excretion or heart failure, HTN, hypokalemia, liver cirrhosis w/ edema or ascites, nephrotic syndrome

130
Q

Drug class for Captopril

A

vasodilators: ACE inhibitor

131
Q

MoA for Captopril

A

competitive inhibitor of ACE prevention conversion of AT1 to AT2 decreasing vasoconstriction by A2 & decreases aldosterone secretion

132
Q

Indications for Captopril

A

HTN, heart failure, left ventricular dysfunction after MI, diabetic neuropathy

133
Q

Drug class for Lisinopril

A

vasodilators: ACE inhibitor

134
Q

MoA for Lisinopril

A

competitive inhibitor of ACE prevention conversion of AT1 to AT2 decreasing vasoconstriction by A2 & decreases aldosterone secretion

135
Q

Indications for Lisinopril

A

heart failure, left ventricular dysfunction

136
Q

Drug class for Fosinopril

A

vasodilator: ACE inhibitor

137
Q

MoA for Fosinopril

A

competitive inhibitor of ACE prevention conversion of AT1 to AT2 decreasing vasoconstriction by A2 & decreases aldosterone secretion

138
Q

Indications for Fosinopril

A

heart failure, left ventricular dysfunction

139
Q

Drug class for Losartan

A

vasodilators: angiotensin II receptor blockers (ARBs)

140
Q

MoA for Losartan

A

selectively & competitively blocks AT1 & AT2 receptors

141
Q

Indications for Losartan

A

HTN, diabetic neuropathy in T2DM, stroke risk reduction in HTN, LVH

142
Q

Drug class for Hydralazine & Isosorbide dinitrate

A

direct-acting vasodilator

143
Q

MoA for Hydralazine & Isosorbide dinitrate

A

direct acting ateriolar vasodilator

144
Q

Indications for Hydralazine & Isosorbide dinitrate

A

adjunctive tx in HF, esp in Afro-Americans

145
Q

Drug class for Digoxin

A

positive inotropic agents: cardiac glycosides

146
Q

MoA for Digoxin

A

inhibits Na/K ATPase pump in myocardial cells promoting influx Ca leading to increased contractility; also direct suppressor of AV node decreasing ventricular rate

147
Q

Indications for Digoxin

A

mild to moderate HF; A fib rate control

148
Q

Drug class for Dobutamine

A

positive inotropic agents: B-agonists

149
Q

MoA for Dobutamine

A

stimulates B1 adrenergic receptors increasing cardiac contractility & HR; little impact on B2 or alpha receptors

150
Q

Indications for Dobutamine

A

short-term management of cardiac decompensation

151
Q

Drug class for Milrinone

A

positive inotropic agents: PDE inhibitors

152
Q

MoA for Milrinone

A

selective PDE inhibitor in cardiac & vascular tissue producing vasodilation & inotropic effects w/ little chronotropic activity

153
Q

Indications for Milrinone

A

short-term IV therapy of acutely decompensated HF

154
Q

Drug class for Nesiritide

A

miscellaneous: recombinant BNP

155
Q

MoA for Nesiritide

A

increases intracellular GMP in vascular smooth muscle cells & endothelium resulting in smooth muscle relaxation reducing pulmonary capillary wedge pressure & systemic arterial pressure

156
Q

Indications for Nesiritide

A

acutely decompensated HF w/ dyspnea at rest or w/ minimal activity

157
Q

Drug class for Aliskiren

A

miscellaneous: direct renin inhibitor

158
Q

MoA for Aliskiren

A

direct renin inhibitor prevention conversion of angiotensinogen to AT1 which reduces conversion to A2 producing arteriolar vasodilation

159
Q

Indications for Aliskiren

160
Q

Drug class for Ivabradine

A

miscellaneous: SA node If channel inhibitor

161
Q

MoA for Ivabradine

A

selective & specific inhibition of If within SA node & prolonging diastolic depolarization & reducing HR

162
Q

Indications for Ivabradine

A

-stable HR w/ EF less than 35%, in sinus rhythm w/ HR greater than 70, & are max tolerated doses on B-blocker or unable to take B-blocker

Pharmacology (16 decks)

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