Cardiovascular Drugs

Question 1

Formula for blood pressure

Answer 1

Cardiac Output X Systemic Vascular Resistance

Question 2

Expanded formula for blood pressure

Answer 2

(Heart rate X Stroke Volume) X Systemic Vascular Resistance

Question 3

First line drug for essential hypertension

Answer 3

Hydrochlorothiazide

Question 4

Used for hypertension with comorbid CHF/DM.

SE: Cough, angioedema

Contraindicated in bilateral RAS

Answer 4

Captopril

ACE inhibitors

Question 5

Used in ACE inhibitor intolerance, and for chronic HF

Answer 5

Losartan

ARBs

Question 6

Hypertension with comorbid BPH

Answer 6

Prazosin

Alpha-1 antagonist

Question 7

Pre-eclampsia (maintenance medication)

SE: hemolytic anemia (positive Coombs test)

Answer 7

Methyldopa

Question 8

Pre-eclampsia (acute BP lowering)

SE: Reflex tachycardia, drug-induced lupus

Answer 8

Hydralazine

Question 9

Hypertensive emergency

SE: Hypertrichosis

Answer 9

Minoxidil

Question 10

Hypertensive emergency

SE: Cyanide poisoning

Answer 10

Nitroprusside

Question 11

Portion of the electron transport chain affected by cyanide

Answer 11

Complex IV

Question 12

Antidote for cyanide poisoning

Answer 12

Inhaled amyl nitrate + IV sodium nitrite + IV sodium thiosulfate

Question 13

Relief of acute anginal attacks

SE: Headache

Answer 13

ISDN

NTG

Question 14

Angina maintenance
Vascular > cardiac effect

SE: Flushing, edema, gingival hyperplasia

Answer 14

Nifedipine

Question 15

Angina maintenance
Cardiac > vascular effect
Vasospastic angina
Reynaud's phenomenon
Does not cause gingival hyperplasia

Answer 15

Diltiazem

Question 16

Supraventricular tachycardia
Cardiac > vascular effect

SE: Gingival hyperplasia

Answer 16

Verapamil

Question 17

Why is calcium-dependent neurotransmission or hormone release not affected by CCB?

Answer 17

CCBs block L-type calcium channels. Other functions use N-, P-, and R-types

Question 18

Drugs which can cause gingival hyperplasia

Answer 18

Cyclosporine
Nifedipine
Phenytoin
Verapamil

Question 19

Positive inotrope for heart failure

SE: Arrhythmias (PVC, AVB), red-green color blindness, yellow visual halos

Answer 19

Digoxin (Na-K-ATPase pump)

Question 20

Treatment of pulmonary edema in CHF

Answer 20

Furosemide

Question 21

First line drug for chronic CHF
Cardio protective
Renoprotective

Answer 21

ACE-I, ARB

Question 22

Improves survival (decreases mortality) in CHF

Answer 22

ACE-I or ARBs
Beta-blockers
Spironolactone

Question 23

Decreases hospitalizations in CHF

Answer 23

Digoxin

Question 24

Improves survival in CHF patients of African-American descent

Answer 24

Hydralazine + ISDN

Question 25

Drugs shown to improve survival in cases of HF

Answer 25

ACE Inhibitors Beta blockers Aldosterone antagonists

Question 26

Treatment of all types of arrthymias WPW syndrome SE: Drug-induced lupus

Answer 26

Procainamide (Class IA)

Question 27

SE: Cinchonism (headache, tinnitus, vertigo)

Answer 27

Quinidine (Class IA)

Question 28

Post-MI arrhythmias Digitalis poisoning SE: Seizures

Answer 28

Lidocaine, Phenytoin, Mexiletine, Tocainide | Class IB

Question 29

Contraindicated post-MI | Refractory arrthymias

Answer 29

Flecainide, Propafenone, Encainide, Moricizine (Class IC)

Question 30

Perioperative and thyrotoxic arrhythmias | SVT

Answer 30

Esmolol (Class II)

Question 31

SE: Dose-dependent torsades de pointes

Answer 31

Sotalol (Class III)

Question 32

Most efficacious antiarrhythmic SE: Skin deposits, pulmonary fibrosis, hyper/hypothyroidism

Answer 32

Amiodarone

Question 33

Outpatient management of SVT SE: Gingival hyperplasia

Answer 33

Verapamil

Question 34

Effects of Class I antiarrhythmics on action potential

Answer 34

Class IA: Prolongs Class IB: Shortens Class IC: No effect

Question 35

Amiodarone toxicity

Answer 35

PCS PTT Paresthesia Corneal deposits Skin deposits Pulmonary fibrosis Tremors Thyroid dysfunction

Question 36

Why are dihydropyridine calcium channel blockers not useful as antiarrhythmics?

Answer 36

Vascular > cardiac effect Dihydropyridine CCBs evoke compensatory sympathetic discharge which facilitates arrhythmias rather than terminating them.

Question 37

Acts on PCT Treatment of glaucoma and mountain sickness SE: NAGMA, hepatic encephalopathy

Answer 37

Acetazolamide, Dorzolamide, Brinzolamide, Dichlorphenamide, Methazolamide (Carbonic anhydrase inhibitors)

Question 38

Acts on TAL Treatment of pulmonary edema Most efficacious diuretic SE: Ototoxicity, hypokalemia, hypocalcemia

Answer 38

Furosemide, Bumetanide, Tosemide, Ethacrynic Acid (Loop Diuretics)

Question 39

Acts on DCT SE: Hyperglycemia, hyperlipidemia, hypercalcemia

Answer 39

Hydrochlorothiazide, Chlorthalidone, Indapamide, Metolazone, Bendroflumethiazide, Hydroflumethiazide, Methylclothiazide, Polythiazide, Quinethazone, Trichlormethiazide (Thiazide Diuretics)

Question 40

Acts on CCD SE: Gynecomastia, hyperkalemia

Answer 40

Spironolactone, Eplerenone (Aldosterone Antagonists)

Question 41

Acts on PCT, DCT, and CCD Treatment of rhabdomyolysis and increased ICP Contraindicated in heart failure

Answer 41

Mannitol, Glycerin, Isosorbide, Urea (Osmotic Diuretics)

Question 42

Causes of HAGMA

Answer 42

"MUDPILES CAT" ``` Methanol Uremia Diabetic Ketoacidosis Paraldehyde, Phenformin Isoniazid, Iron, Inborn errors of metabolism Lactic Acid Ethanol, Ethylene Glycol Salicylate ``` Carbon monoxide, cyanide, congenital heart failure Aminoglycosides Toluene, Theophylline

Question 43

Causes of NAGMA

Answer 43

"HARDUP" ``` Hyperalimentation Acetazolamide Renal tubular acidosis Diarrhea Urethral diversion Pancreatic fistula ```

Question 44

Adverse effects associated with loop diuretics

Answer 44

" OH DANG" ``` Ototoxicity Hypokalemia Dehydration Allergy to sulfa Nephritis Gout ```

Question 45

Adverse effects of thiazides diuretics

Answer 45

"Hyper GLUC" Hyperglycemia Hyperlipidemia Hyperurecemia Hypercalcemia

Question 46

Drugs causing gynecomastia

Answer 46

"Some Drugs Create Awesome Knockers" ``` Spironolactone Digoxin Cimetidine Alcohol Ketoconazole ```