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Pharmacology > Cardiovascular Drugs > Flashcards

Cardiovascular Drugs Flashcards

0
Q

Inhibits Na/Cl transporter in DCT, increasing reabsorption
Drug for HPN, can decrease BP by 10-15 mmHg
SE: sulfa allergy

A

Hydrochlorothiazide

Chlorthalidone, Indapamide, Metolazone

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1
Q

Target BP in hypertensives with no comorbidities?
With DM?
With CKD?

A

No comorbidities: <125/75

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2
Q

Toxicities of HCTZ

A 
Hyper GLUC
HyperGLYCEMIA
HyperLIPIDEMIA
HyperURICEMIA
HyperCALCEMIA
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3
Q

Identify Sulfa drugs:

Allergies to these drugs can cause fever, UTI, SJS, hemolytic anemia, thrombocytopenia, agranulocytosis, urticaria

Popular FACTSSS

A 
Probenecid
Furosemide
Acetazolamide
Celecoxib
Thiazides
Sulfonamide
Sulfasalazine
Sulfonylureas
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4
Q

Inhibits Na/K/2Cl transporter in TAL of Loop of henle
Causes powerful diuresis and increase Ca excretion
Drug for HPN, Pulmonary edema, Hypercalcemia, ARF
SE: Ototoxicity, Dehydration, Sulfa allergy

A

Furosemide

Bumetanide, Torsemide, Ethacrynic Acid

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5
Q

Ganglion blocker (nonselective)
Drug previously used for HPN (obsolete)
SE: postural hypotension

A

Hexamethonium

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6
Q

Nerve terminal blocker (NE, Dopa, Serotonin)
Drug previously used for HPN (obsolete)
Irreversible Vesicular Monoamine Transporter (VMAT) blocker
SE: rebound suicide

A

Reserpine

Guanethidine

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7
Q

Drugs for BP control in Pheochromocytoma

A

Phenoxybenzamine
Phentolamine
Labetalol
Carvedilol

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8
Q

Oral Vasodilator
Alters Ca2+ metabolism
Relaxes ARTERIOLAR smooth muscle, decreases Afterload
Drug for HPN, Pre-eclampsia
SE: reflex tachycardia, Drug induced Lupus

A

Hydralazine

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9
Q

Drugs that can cause lupus

A

Hydralazine
Isoniazid
Procainamide
Penicillamine

HIPP to have Lupus
Test with Anti-histone

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10
Q

Vasodilator
Opens K channels in Vascular smooth muscle, causing hyperpolarization, muscle relaxation and vasodilation (decreased afterload)
Drug for HPN and ALOPECIA
SE: Reflex tachycardia, Hypertrichosis

A

Minoxidil

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11
Q

Non-dihydropyridine CCB
blocks voltage gated L-type calcium channels (cardiac>vascular)
Drugs for SVT (in OPD), Arrhythmia
SE: GINGIVAL HYPERPLASIA, heart failure, AV Block, Sinus node depression

A

Verapamil

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12
Q

Non-dihydropyridine CCB
blocks voltage gated L-type calcium channels (cardiac>vascular)
Drugs for SVT (in OPD), Arrhythmia
SE: REYNAUD’S PHENOMENON, heart failure, AV Block, Sinus node depression

A

Diltiazem

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13
Q

Dihydropyridine CCB
blocks voltage gated L-type calcium channels (vascular>cardiac)
No cardiodepressant effects
Drugs for HPN, angina
SE: pre-tibial edema, flushing, gingival hyperplasia

A

Nifedipine

Amlodipine, Felodipine, Nicardipine, Nisoldipine, Israpidine

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14
Q

Vasodilator
Activates guanylyl cyclase, inc cGMP, NO release
Decreases both preload and afterload
Drug for Hypertensive emergency
SE: Cyanide toxicity (to Thiocyanate via Rhodanase)

A

Nitroprusside

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15
Q

Dopamine 1 agonist
Increases renal blood flow, by ARTERIOLAR vasodilation of afferent and efferent arterioles
Drug for hypertensive emergency
SE: Hypokalemia

A

Fenoldopam

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16
Q

ACE inhibitor
Inhibits ACE and formation of Angiotensin II
Decreases Aldosterone secretion
Drug for HPN, Heart failure, Post-MI, DM Nephropathy
SE: COUGH, Hyperkalemia, angioedema
Contraindicated in bilateral Renal Artery Stenosis

A

Captopril

Enalapril, Benazepril, Fosinopril, Lisinopril, Quinapril, Ramipril, Trandolapril

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17
Q

Slows ventricular remodeling and increases survival in heart failure
Delays progression of DM nephropathy (micro to macroalbuminuria)
RENOPROTECTIVE

A

ACE Inhibitors

ARBs

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18
Q

Drug class that is essential for Heart Failure

A

Diuretics

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19
Q

Drug class that is essential for MI

A

Beta blocker

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20
Q

Drug class that is essential for Diabetes

A

ACE Inhibitor

Or ARB?

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21
Q

Blocks Angiotensin I receptors in vascular smooth muscle and adrenal cortex, dec Aldosterone secretion
Drug for HPN, Heart failure, DM Nephropathy
SE: Teratogen, Hyperkalemia
Given in pxs with ACEi intolerance

A

Losartan

Candesartan, Valsartan, Irbesartan, Eprosartan, Telmisartan

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22
Q

Pathophysiology of hyperkalemia in ACE I and ARBs

A

Aldosterone inc K secretion, its inhibition leads to hyperkalemia

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23
Q

Renin antagonist
Prevents conversion of Angiotensinogen to Angiotensin I
Drug for HPN

A

Aliskiren

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24
Q

Severe hypertension with rapidly progressing end organ damage

Disease?

A

Malignant hypertension

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25
Q

Target BP for Malignant HPN

A

Lower BP to 140-160/90-110

Any BP lower than this may cause hypoperfusion of organs

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26
Q

Drugs for Malignant HPN

A

Vasodilators (Nitroprusside, Fenoldopam, or Diazoxide)
Diuretics
Beta blockers

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27
Q

Ultra short acting nitrate
NO release, inc cGMP
Drug for Cyanide poisoning
SE: Methemoglobinemia

A

Amyl Nitrite

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28
Q

Cyanide affects which portion of ETC?

A

Complex IV: Cytochrome Oxidase

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29
Q

Antidote for Cyanide Poisoning

A

Inhaled Amyl Nitrite
IV Sodium Nitrite
IV Sodium Thiosulfate

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30
Q

Disease caused by occupational exposure to nitrates

A

Monday Disease

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31
Q

Short acting nitrate with shortest onset of action
NO release, inc cGMP, relaxes smooth muscle (esp. Veins)
Drug for Angina, ACS
SE: Headache, Tolerance, reflex tachycardia, orthostatic hypotension

A

Nitroglycerin

Isosorbide dinitrate, Isosorbide mononitrate

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31
Q

Which does not bypass first pass effect?
Nitroglycerin
ISDN
ISMN

A

ISMN

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32
Q

Pathophysiology of throbbing headaches in pxs taking nitroglycerin

A

Menigeal artery vasodilation

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33
Q

Drugs that cause gingival hyperplasia

A

Verapamil
Cyclosporine (Calcineurin Inhibitor)
Nifedipine
Phenytoin

Very Chaka NgiPin

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34
Q

Cardiovascular drug that causes this paradoxic effect:

reflex increase in HR and contractility

A

Nitrates alone

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35
Q

Cardiovascular drug that causes this paradoxic effect:

increase in End Diastolic Pressure and Increase in Ejection Time

A

Beta blocker or CCB Alone

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36
Q

Cardiovascular drugs that causes this paradoxic effect:

decreases HR, Arterial Pressure, End Diastolic Pressure

A

Nitrate + Beta blocker OR CCB

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37
Q

Decreases ventricular remodeling (cardioprotective)

First line drugs for chronic heart failure

A

ARBs

ACEI

38
Q

Drugs that reduce progression of Chronic Heart Failure

A

Beta Blockers
(Carvedilol, Labetalol, Metoprolol)

Not of value in Acute heart failure

39
Q

Drugs that inc cAMP, inc intracellular Ca2+, vasodilation

Not for use in chronic failure as they increase morbidity and mortality

A 
Phosphodiesterase inhibitors
(Inamrinone, Milrinone)
40
Q

Drug with no value in CHF

A

CCB

41
Q

Drugs that improve survival in heart failure

A

ABA! Buhay ka pa!
ACE Inhibitors
Beta blockers
ARBs

42
Q

Class_____ Antiarrhythmics:

Na channel blockers

A

1

43
Q

Class_____ Antiarrhythmics:

Beta-adrenoreceptor blockers

A

2

44
Q

Class_____ Antiarrhythmics:

K channel blockers

A

3

45
Q

Class_____ Antiarrhythmics:

Ca channel blockers

A

4

46
Q

Class I__ Antiarrhythmic:

Prolongs AP duration

A

A

47
Q

Class I__ Antiarrhythmic:

Shortens AP duration

A

B

48
Q

Class I__ Antiarrhythmic:

No effect on AP duration

A

C

49
Q

Identify Class IA Antiarrhythmic drugs

A

QUIN PROtects DIS(o)PYRAMID
Quinidine
Procainamide
Disopyramide

50
Q

Class IA antiarrhythmic
Drug for Atrial/ventricular arrhythmia esp post MI
SE: lupus-like syndrome

A

Procainamide

HIPP

51
Q

Class IA Antiarrhythmic

SE: marked anti-muscarinic effects, heart failure

A

Disopyramide

52
Q

Class IA Antiarrhythmic
Drug for malaria
SE: Torsades, Chinconism (headache, vertigo, tinnitus), Autoimmune rxns
Reduces Digoxin clearance

A

Quinidine

53
Q 
Triad of:
Headache
Vertigo
Tinnitus
Seen in pxs taking Quinidine
A

Cinchonism

54
Q

Tx for class IA antiarrhythmic induced arrhythmia

A

Sodium Lactate

55
Q 
Most selective of ischemic tissues among class I antiarrhythmics
Little effect on normal cardiac cells, little effect on ECG
A

IB

56
Q

Class IB Antiarrhythmics
DOC for ventricular arrhythmia post MI and Digoxin induced arrhythmia
SE: Seizures, Agranulocytosis (in Tocainide)

A

Lidocaine

Melexitine, Tocainide, Phenytoin

57
Q

Drugs that cause agranulocytosis

A 
COCO CAPIT Pa!
Cotrimoxazole
Colchicine
Clozapine
Aminopyrine
PTU
Indomethacin
Tocainide
Phenylbutazone
58
Q 
Depressant of Na current
Can slow conduction velocity in atrium and ventricle
Drug for refractory arrhythmia
SE: increased arrhythmia
Contraindicated for Post MI
A

Flecainide
(Propafenone, Encainide, Moricizine)

C: PROject & FLECs (Flex), Every Morning

59
Q

Which Class I antiarrhythmic?
All types of arrhythmia
Arrhythmia in acute MI
Procainamide and Amiodarone for WPW

A

Class IA

60
Q

Which Class I antiarrhythmic?
Acute Ventricular arrhythmia, esp post MI
Digitalis-induced arrhythmia

A

Class IB

61
Q

Which Class I antiarrhythmic?

Refractory Arrhythmia

A

Class IC

62
Q 
Identify which class of antiarrhythmic drugs:
Prolonged PR interval
Acts on Phase 4
Cardiac beta blockade
Reduction in cAMp
A

Class II

63
Q

Class II antiarrhythmic drug
Drug for post MI prophylaxis vs sudden death, thyrotoxicosis
SE: bronchospasm, AV block, Hypotension
Reduces progression of CHF and decrease incidence of potentially fatal arrhythmia

A

Propranolol

Metoprolol, Timolol

64
Q

Class II antiarrhythmic
Selective beta 1 blocker
Drug for acute perioperative and thyrotoxic arrhythmia, SVT
SE: bronchospasm

A

Esmolol

65
Q

Identify the Beta Blocker:

Nonselective

A

Propranolol

Timolol

66
Q

Identify the Beta Blocker:

Beta1 selective

A 
Acebutolol
Betaxolol
Esmolol
Atenolol
Metoprolol

A BEAM

67
Q

Identify the Beta Blocker:

Partial agonist

A

Pindolol

Acebutolol

68
Q

Identify the Beta Blocker:

Lacking local anesthetic effect

A

Timolol

Betaxolol

69
Q

Identify the Beta Blocker:

Low lipid solubility

A

Atenolol

70
Q

Identify the Beta Blocker:

Shortest acting

A

Esmolol

71
Q

Identify the Beta Blocker:

Longest acting

A

Nadolol

72
Q

Identify the Beta Blocker:

Combined alpha and beta blockade

A

Carvedilol

Labetalol

73
Q 
Identify which class of antiarrhythmic drugs:
Acts on Phase 3
Increase Effective Refractory Period
Increased QT interval
Most TOXIC & EFFECTIVE
A

Class III

74
Q

Identify Class III antiarrhythmic drugs

A 
(D)AIDS
Dronedarone
Amiodarone
Ibutilide
Dofetilide
Sotalol
75
Q

Sx of Amiodarone Toxicity

A 
PUtek PAre Tinik Talaga Sa Chicks
Pulmonary fibrosis
Paresthesia
Thyroid dysfunction
Tremors
Skin deposits
Corneal deposits
76
Q 
Identify which class of antiarrhythmic drugs:
PR interval is consistently increased
AV conduction velocity is decreased and effective refractory period increased
Causes a state- and use-dependent selective depression of Calcium currents
A

Class IV

77
Q

Why are dihydropiridine CCBs ineffective for arrhythmia?

A

They evoke compensatory sympathetic discharge which facilitates arrhythmia rather than terminate them

78
Q

Identify antiarrhythmic drug and class:

Prolongs PR interval

A

Propranolol, Class II

Verapamil, Class IV

79
Q

Identify antiarrhythmic drug and class:

Prolongs QT interval

A

Dofetilide, Class III

80
Q

Identify antiarrhythmic drug and class:

Prolongs QRS duration

A

Flecainide, Class IC

81
Q

Miscellaneous antiarrhythmic drug
Causes marked hyperpolarization and conduction block
Drug for AV nodal arrhythmia, DOC for Paroxysmal SVT
SE: flushing

A

Adenosine

82
Q

____________ Ion: depresses ectopic pacemakers
Decrease can cause increased incidence of arrhythmia
Increase can depress conduction and cause reentry arrhythmia

A

Potassium

83
Q

____________ Ion: possible MOA is increase in Na/K/ATPase activity
Effective in some cases of Torsades
Similar depressant effects as K on Digitalis-induced arrhythmia

A

Magnesium

84
Q

Cardiac glycoside
Inhibits Na/K ATPase, inc intracellular Ca, inc contractility
Drug for heart failure and arrhythmia
SE: Narrow therapeutic window, Arrhythmia, visual changes

A

Digoxin

84
Q

Reduced clearance with quinidine

Arrhythmogenesis increased by HypoK, HypoMg, HyperCal

A

Digoxin

85
Q

Drugs with Narrow Therapeutic Index

A 
WALA Cyang PaPa, Very Tragic Day
Warfarin
Aminoglycosides
Lithium
Amphotericin B
Carbamazepine
Phenytoin
Phenobarbital
Vancomycin
Theophylline
Digoxin
85
Q

Drug of choice for arrythmia secondary to Digoxin

A

Lidocaine

85
Q

First line therapy for chronic heart failure

A

Loop diuretics
Spironolactone

Spironolactone + Eplerenone can reduce mortality in HF

86
Q

First line drug for ACUTE heart failure

A

Furosemide

87
Q

First line drugs for CHRONIC heart failure

A

ACEi

ARB

88
Q

Drugs that improve survival in CHF

A

ACEi/ARB
Beta blocker
Spironolactone

89
Q

Decreases hospitalizations in CHF

A

Digoxin

90
Q

Improves survival in pxs of African-American descent

A

Hydralazine + ISDN

Pharmacology (31 decks)

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