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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
Severe hypertension with rapidly progressing end organ damage Disease?
Malignant hypertension
25
Target BP for Malignant HPN
Lower BP to 140-160/90-110 | Any BP lower than this may cause hypoperfusion of organs
26
Drugs for Malignant HPN
Vasodilators (Nitroprusside, Fenoldopam, or Diazoxide) Diuretics Beta blockers
27
Ultra short acting nitrate NO release, inc cGMP Drug for Cyanide poisoning SE: Methemoglobinemia
Amyl Nitrite
28
Cyanide affects which portion of ETC?
Complex IV: Cytochrome Oxidase
29
Antidote for Cyanide Poisoning
Inhaled Amyl Nitrite IV Sodium Nitrite IV Sodium Thiosulfate
30
Disease caused by occupational exposure to nitrates
Monday Disease
31
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
Nitroglycerin | Isosorbide dinitrate, Isosorbide mononitrate
31
Which does not bypass first pass effect? Nitroglycerin ISDN ISMN
ISMN
32
Pathophysiology of throbbing headaches in pxs taking nitroglycerin
Menigeal artery vasodilation
33
Drugs that cause gingival hyperplasia
Verapamil Cyclosporine (Calcineurin Inhibitor) Nifedipine Phenytoin Very Chaka NgiPin
34
Cardiovascular drug that causes this paradoxic effect: | reflex increase in HR and contractility
Nitrates alone
35
Cardiovascular drug that causes this paradoxic effect: | increase in End Diastolic Pressure and Increase in Ejection Time
Beta blocker or CCB Alone
36
Cardiovascular drugs that causes this paradoxic effect: | decreases HR, Arterial Pressure, End Diastolic Pressure
Nitrate + Beta blocker OR CCB
37
Decreases ventricular remodeling (cardioprotective) | First line drugs for chronic heart failure
ARBs | ACEI
38
Drugs that reduce progression of Chronic Heart Failure
Beta Blockers (Carvedilol, Labetalol, Metoprolol) Not of value in Acute heart failure
39
Drugs that inc cAMP, inc intracellular Ca2+, vasodilation | Not for use in chronic failure as they increase morbidity and mortality
``` Phosphodiesterase inhibitors (Inamrinone, Milrinone) ```
40
Drug with no value in CHF
CCB
41
Drugs that improve survival in heart failure
ABA! Buhay ka pa! ACE Inhibitors Beta blockers ARBs
42
Class_____ Antiarrhythmics: | Na channel blockers
1
43
Class_____ Antiarrhythmics: | Beta-adrenoreceptor blockers
2
44
Class_____ Antiarrhythmics: | K channel blockers
3
45
Class_____ Antiarrhythmics: | Ca channel blockers
4
46
Class I__ Antiarrhythmic: | Prolongs AP duration
A
47
Class I__ Antiarrhythmic: | Shortens AP duration
B
48
Class I__ Antiarrhythmic: | No effect on AP duration
C
49
Identify Class IA Antiarrhythmic drugs
QUIN PROtects DIS(o)PYRAMID Quinidine Procainamide Disopyramide
50
Class IA antiarrhythmic Drug for Atrial/ventricular arrhythmia esp post MI SE: lupus-like syndrome
Procainamide HIPP
51
Class IA Antiarrhythmic | SE: marked anti-muscarinic effects, heart failure
Disopyramide
52
Class IA Antiarrhythmic Drug for malaria SE: Torsades, Chinconism (headache, vertigo, tinnitus), Autoimmune rxns Reduces Digoxin clearance
Quinidine
53
``` Triad of: Headache Vertigo Tinnitus Seen in pxs taking Quinidine ```
Cinchonism
54
Tx for class IA antiarrhythmic induced arrhythmia
Sodium Lactate
55
``` Most selective of ischemic tissues among class I antiarrhythmics Little effect on normal cardiac cells, little effect on ECG ```
IB
56
Class IB Antiarrhythmics DOC for ventricular arrhythmia post MI and Digoxin induced arrhythmia SE: Seizures, Agranulocytosis (in Tocainide)
Lidocaine | Melexitine, Tocainide, Phenytoin
57
Drugs that cause agranulocytosis
``` COCO CAPIT Pa! Cotrimoxazole Colchicine Clozapine Aminopyrine PTU Indomethacin Tocainide Phenylbutazone ```
58
``` Depressant of Na current Can slow conduction velocity in atrium and ventricle Drug for refractory arrhythmia SE: increased arrhythmia Contraindicated for Post MI ```
Flecainide (Propafenone, Encainide, Moricizine) C: PROject & FLECs (Flex), Every Morning
59
Which Class I antiarrhythmic? All types of arrhythmia Arrhythmia in acute MI Procainamide and Amiodarone for WPW
Class IA
60
Which Class I antiarrhythmic? Acute Ventricular arrhythmia, esp post MI Digitalis-induced arrhythmia
Class IB
61
Which Class I antiarrhythmic? | Refractory Arrhythmia
Class IC
62
``` Identify which class of antiarrhythmic drugs: Prolonged PR interval Acts on Phase 4 Cardiac beta blockade Reduction in cAMp ```
Class II
63
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
Propranolol | Metoprolol, Timolol
64
Class II antiarrhythmic Selective beta 1 blocker Drug for acute perioperative and thyrotoxic arrhythmia, SVT SE: bronchospasm
Esmolol
65
Identify the Beta Blocker: | Nonselective
Propranolol | Timolol
66
Identify the Beta Blocker: | Beta1 selective
``` Acebutolol Betaxolol Esmolol Atenolol Metoprolol ``` A BEAM
67
Identify the Beta Blocker: | Partial agonist
Pindolol | Acebutolol
68
Identify the Beta Blocker: | Lacking local anesthetic effect
Timolol | Betaxolol
69
Identify the Beta Blocker: | Low lipid solubility
Atenolol
70
Identify the Beta Blocker: | Shortest acting
Esmolol
71
Identify the Beta Blocker: | Longest acting
Nadolol
72
Identify the Beta Blocker: | Combined alpha and beta blockade
Carvedilol | Labetalol
73
``` Identify which class of antiarrhythmic drugs: Acts on Phase 3 Increase Effective Refractory Period Increased QT interval Most TOXIC & EFFECTIVE ```
Class III
74
Identify Class III antiarrhythmic drugs
``` (D)AIDS Dronedarone Amiodarone Ibutilide Dofetilide Sotalol ```
75
Sx of Amiodarone Toxicity
``` PUtek PAre Tinik Talaga Sa Chicks Pulmonary fibrosis Paresthesia Thyroid dysfunction Tremors Skin deposits Corneal deposits ```
76
``` 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 ```
Class IV
77
Why are dihydropiridine CCBs ineffective for arrhythmia?
They evoke compensatory sympathetic discharge which facilitates arrhythmia rather than terminate them
78
Identify antiarrhythmic drug and class: | Prolongs PR interval
Propranolol, Class II | Verapamil, Class IV
79
Identify antiarrhythmic drug and class: | Prolongs QT interval
Dofetilide, Class III
80
Identify antiarrhythmic drug and class: | Prolongs QRS duration
Flecainide, Class IC
81
Miscellaneous antiarrhythmic drug Causes marked hyperpolarization and conduction block Drug for AV nodal arrhythmia, DOC for Paroxysmal SVT SE: flushing
Adenosine
82
____________ Ion: depresses ectopic pacemakers Decrease can cause increased incidence of arrhythmia Increase can depress conduction and cause reentry arrhythmia
Potassium
83
____________ 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
Magnesium
84
Cardiac glycoside Inhibits Na/K ATPase, inc intracellular Ca, inc contractility Drug for heart failure and arrhythmia SE: Narrow therapeutic window, Arrhythmia, visual changes
Digoxin
84
Reduced clearance with quinidine | Arrhythmogenesis increased by HypoK, HypoMg, HyperCal
Digoxin
85
Drugs with Narrow Therapeutic Index
``` WALA Cyang PaPa, Very Tragic Day Warfarin Aminoglycosides Lithium Amphotericin B Carbamazepine Phenytoin Phenobarbital Vancomycin Theophylline Digoxin ```
85
Drug of choice for arrythmia secondary to Digoxin
Lidocaine
85
First line therapy for chronic heart failure
Loop diuretics Spironolactone Spironolactone + Eplerenone can reduce mortality in HF
86
First line drug for ACUTE heart failure
Furosemide
87
First line drugs for CHRONIC heart failure
ACEi | ARB
88
Drugs that improve survival in CHF
ACEi/ARB Beta blocker Spironolactone
89
Decreases hospitalizations in CHF
Digoxin
90
Improves survival in pxs of African-American descent
Hydralazine + ISDN

Pharmacology (31 decks)

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