Cardiovascular

Question 0

Nitrate mechanism of action

Answer 0

Vasodilation systemic and coronary
Increase blood flow thu the coronary artery and cells and decrease workload.
Decrease preload and afterload

Question 1

Digoxin therapeutic range

Answer 1

0.5-2.0ng/dL

Question 2

3 types of Angina

Answer 2

1- Classic (stable): occur with stress or exertion
2- Unstable (preinfarction): occurs frequently with progressive severity, unrelated to activity level.
3- Variant (vasospatic): occur at rest.

Question 3

Antianginal agents

Answer 3

• Nitrates: nitroglycerine, and isosorbide dinitrate/mononitrate.
• Beta blockers: “lol”
• Calcium channel blockers
  Amlodipine (norvasc)
  Diltiazem (cardizem)
  Felodipine (plendil)
  Nifedipine (procardia, adalat)
  Verapamil (Calan)

Question 4

Antiarrhythmic agents

Answer 4

Sodium channel blockers
--> lidocaine
-->disopyramide (norpace)
Beta blockers
-->propranolol (inderal)
-->esmolol (breviblock)
-->acebutolol (spectral)
Potassium channel blockers
-->amiodarone (cordarone, pacerone)
Calcium channel blockers
-->diltiazem (cardizem)
-->verapamil (Calan, isoptin)

Question 5

What is the drug of choice for angina pectorals?

Answer 5

Selective beta blockers
Atenolol (tenormin) and metoprolol (lopressor)
Effective for stable angina

Question 6

Is unstable angina and emergency situation?

Answer 6

Yes.
It is a sign of impeding MI.
Stable Angina occurs frequently with progressive severity, unrelated to activity.

Question 7

What is the teaching for nitrates?

Answer 7

The most common side effect is headache, hypotension, and dizziness but they subside with usage.
Need a 8-12h interval of nitrate free to avoid tolerance.
Tapper down when dc.
Usage +Viagra= life threatening hypotensive effect
Airtight container
May decrease the effect of heparin.

Question 8

Contraindications for beta blocker

Answer 8

Non selective: asthma pts

Non selective and selective : DM

Question 9

How does a calcium channel blocker affect preload and after load?

Answer 9

It decrease both by vasodilation of peripheral and coronary vessels

Question 10

Which category of drug is effective in treating variant angina?

Answer 10

Calcium channel blockers

Question 11

Which calcium channel blocker are use as antianginal and antiarhytmics?

Answer 11

Diltiazem ( Cardizem)

Verapamil (Calan, Isoptin)

Question 12

Which antiarhytmics group is indicates for exercise related tachycardia and PSVT?

Answer 12

Calcium channel blockers

Diltiazem and verapamil

Question 13

Which Drugs are indicated for PVC?

Answer 13

Dysopyramide (norpace)–>sod CB

Acetabutolol (sectal)–> BB

Question 14

Which drugs is indicated for cardiac surgery, catherization, electrical cardio version and ventricular arrhythmias?

Answer 14

Lidocaine (sod CB)