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Pharmacology BAS208 > Cardiovascular drugs > Flashcards

Cardiovascular drugs Flashcards

1
Q

What is the action of Class I drugs?

A

Sodium Channel Blockade

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2
Q

Which Drugs are in class I?

A

IA- quinidine, procainamide
IB- lidogaine
1C- propafenone

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3
Q

What is the action of class II drugs?

A

Beta Blockade

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4
Q

Which drugs are Class II?

A

Beta Blockers
-olol

Esmolol
Propranolol
Atenolol
Metoprolol
Carvedilol
Nadolol
Sotalol
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5
Q

What is the action of Class III drugs?

A

Potassium Channel Blockers

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6
Q

Which drugs are in Class III?

A

Amiodarone

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7
Q

What is the action of Class IV drugs?

A

Calcium Channel blockade

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8
Q

Which drugs are class IV drugs?

A

CCB

verapamil, dilitiazem

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9
Q

Which drug classes treat Sinus tachycardia?

A

Class II, IV

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10
Q

Which classes treat atrial fibrillation?

A

Class IA, IC, II, III, IV, digitalis, adenosine

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11
Q

Which drugs treat paroxysmal supra ventricular tachycardia?

A

Class IA, IC, II, III, IV, adenosine

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12
Q

Which drug treat AV block?

A

atropine

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13
Q

Which drug classes treat ventricular tachycardia?

A

Class I, II, III

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14
Q

Which drug class treats premature ventricular complexes?

A

Class II, IV, Mg++ salts

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15
Q

Which drug classes treat digitalis toxicity?

A

Class IB, Mg++ salts, KCL

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16
Q

Propafenone MOA

A 
Class 1C sodium channel blocker
decrease slope of phase 0 and 4
stabilize myocardium
decrease height and rate of action potentials
slows conduction in parts of the heart
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17
Q

What is the MOA of Class I drugs?

A

reduce Na+ influx by moderate blockade of Na+ channel

  • decrease slope of phase 0 in contractile tissue
  • decrease slope of phase 4 depolarization in contractile tissue
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18
Q

Indications for Class I

A

Broad spectrum

- supraventricular and ventricular arrhythmias

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19
Q

What drug class is Amiodarone?

A

Class III: K+ Channel blocker

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20
Q

What are the indications for Amiodarone?

A

variety of arrhythmias
supra ventricular
ventricular arrhythmias

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21
Q

Amiodarone drug interactions

A

warfarin
digoxin
BB/CCB
other antiarrhythmics

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22
Q

Adverse drug reactions of Amiodarone

A 
pulmonary toxicity
t1/2= 50 hrs
hypotension, bradycardia
QT prolongation
GI upset, constipation
phlebitis (IV), photosensitivity, polyneuropathy, hepatic toxicity, thyroid dysfunction
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23
Q

What are the adverse reactions of anti arrhythmic drugs?

A 
light-headedness
weakness
hypotension
bradycardia
drowsiness
new arrhythmias or worsen
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24
Q

What are the actions of cardiotonic drugs?

A

Increase cardiac output

Depression of SA and AV nodes

25
Q

What is the most common cardiotonic drug?

A

Digoxin

26
Q

What are the only orally effective inotropic agent approved for use in NA?

A

Cardiac Glycosides

27
Q

What’s the MOA of Digoxin?

A

Slows AV conduction and increase refractoriness by direct action on nodal cells and by enhancing vagal activity
-PNS→ ↑Ach → ↓HR

28
Q

What effect does Digoxin have on Action Potential?

A

↑ refractoriness of AV node

29
Q

What are the indications for Digoxin?

A

Superventricular arrhythmias

  • A. fib/A. flutter
  • CHF
  • ischemic heart disease
  • abnormal systolic function
30
Q

Digoxin PK

A

Narrow therapeutic index
Variable absorption (45-85%)
excreted by KI

31
Q

Digoxin side effects

A

arrhythmias
AV node block
CI: anorexia, nausea, cramping, diarrhea
CNM: confusion, depression, vertigo

32
Q

What is the primary sign of Digoxin toxicity?

A

arrhythmias

33
Q

How do you treat digoxin toxicity?

A

1) IV K

2) Digoxin immune FAB

34
Q

Which are anti-platelet drugs?

A

Thienopyridines: Clopidogrel

Nonsteroidal anti-inflammatory drugs: aspirin

35
Q

What is the MOA for Clopidogrel

A

Anti-platelet

irreversibly blocks activation of platelet P2Y receptor by ADP

36
Q

What is the MOA for Aspirin?

A

Irreversible inhibition of COX pathway
prevents platelets from aggregating or sticking together
effect lasts 2 days

37
Q

What is the mainstay treatment for coronary artery disease?

A

clopidogrel

38
Q

what is the most common side effect of clopidogrel?

A

bleeding

39
Q

Clopidogrel indications

A

coronary artery disease
peripheral arterial occlusive disease
cerebrovascular disease

40
Q

Aspirin side effects

A

dose dependent GI upset
hypersensitivity
Reye’s syndrome in children

41
Q

What electrolyte is related to digoxin toxicity predisposition?

A

Potassium

42
Q

What is the impact of warfarin on clotting?

A

Interferes with manufacturing of vit. K dependent clotting factors in liver
depletes pro-thrombin

43
Q

How do anti-arthythmic drugs on conduction velocity?

A

Class I & IV decrease it

44
Q

How do anti-arrhythmic drugs impact refractory period?

A

Class III prolong it (Amiodarone)

45
Q

How do anti-arrhythmic drugs impact automacity?

A

decrease it

46
Q

how diff class I drugs affect action potential

A 
class IA: prolong AP
IB: shorten AP (lidocaine)
IC: don't change AP
47
Q

What Class is propafenone?

A

Class 1C

48
Q

Propafenone PK

A

Metabolized by Cyto P450 2D6

49
Q

Side effects of propafenone?

A

Cause new or worsen arrhythmias: caution with mechanical heart disease

50
Q

What are the indications for propafenone?

A

broad spectrum arrhythmias

supraventricular and ventricular

51
Q

Drug of choice for acute angina?

A

nitroglycerin

52
Q

Warfarin side effects

A

alopecia
cramps
bleeding

53
Q

Which anti-coagulant is administered subcutaneously?

A

Idraparinux

54
Q

Which anti-coagulants target factor Xa?

A

Rivaroxaban

Apixaban

55
Q

Which anti-coagulants are prodrugs?

A

Idraparinux

Dabigatran

56
Q

Which anti-coagulant drug has the longest half-life?

A

Idraparinux

57
Q

Which anti-coagulant is most bioavailable?

A

Idraparinux

58
Q

Which anti-arrhythmic drugs are used more due to decrease in mortality?

A

Class II and III

Pharmacology BAS208 (5 decks)

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