Cardiovascular I

Question 1

tx essential HTN

Answer 1

thiazide
ACE I
ARBs
DHP CCBs

Question 2

tx HTN with heart failure

Answer 2

diureti
ACE I 
ARBs
CCB
aldosterone antagonist
beta-agonist

Question 3

beta-blocker in heart failure

Answer 3

use with caution decompensated HF

CI in cardiogenic shock

Question 4

protective against diabetic nephropathy

Answer 4

ACE I

ARBs

Question 5

tx HTN in pregnancy

Answer 5

hydalazine
labetalol
methyldopa
nifedipine

Question 6

amlodipine

Answer 6

DHP Ca channel blocker

Question 7

clevidipine

Answer 7

DHP Ca channel blocker

Question 8

nicardipine

Answer 8

DHP Ca channel blocker

Question 9

nifedipine

Answer 9

DHP Ca channel blocker

Question 10

nimodipine

Answer 10

DHP Ca channel blocker

Question 11

diltiazem

Answer 11

nonDHP Ca channel blocker

Question 12

verapamil

Answer 12

nonDHP Ca channel blocker

Question 13

DHP vs. non-DHP

Answer 13

DHP - act on vasc smooth m

non-DHP - act on heart

Question 14

CCB mechanism

Answer 14

block voltage dependent L-type Ca channels cardiac and smooth muscle

decreased muscle contractility

heart - non-DHP
vasc smooth m - DHP

Question 15

tx subarachnoid bleed

Answer 15

nimodipine

prevent cerebral vasospasm

Question 16

tx atrial fib/flutter

Answer 16

non-DHP CCB

Question 17

adverse nonDHP CCB

Answer 17

AV block

Question 18

adverse CCB

Answer 18

cardiac depression
peripheral edema
flushing
dizzy
constipation
gingival hyperplasia

Question 19

hyperPRL

Answer 19

seen with verapamil - adverse effect

Question 20

hydralazine MOA

Answer 20

increase cGMP

• smooth m relaxation
• vasodilate arteriole > veins
• decrease afterload

Question 21

hydralazine adverse

Answer 21

compensatory tachy
fluid retention
HA
angina
lupus like syndrome

Question 22

nitroprusside MOA

Answer 22

short acting

incraese cGMP - via direct release NO

Question 23

adverse nitroprusside

Answer 23

CN toxicity

-releases cyanide

Question 24

fenoldopam MOA

Answer 24

dopamine D1 agonist

coronary, peripheral, renal, splanchnic vasodilation

decreased BP
increased natriureis

Question 25

tx HTN emergency

Answer 25

``` clevidipine fenoldopam labetalol nicardipine nitroprusside ```

Question 26

nitrates MOA

Answer 26

increased NO vasc smooth m increase cGMP smooth m relaxation dilate vein > arteries decreased preload

Question 27

nitroglycerin

Answer 27

nitrate

Question 28

isosorbide dinitrite

Answer 28

nitrate

Question 29

isosorbide mononitrite

Answer 29

nitrate

Question 30

adverse nitrates

Answer 30

reflex tachy (tx with beta-blockers) hypotension flushing HA

Question 31

monday disease

Answer 31

tolerance for vasodilator during week -loss of tolerance on weekend with nitrate use tachy, dizzy, HA upon reexposure

Question 32

determinants of myocardial O2 consumption

Answer 32

end-diastolic volume BP HR contractility target of antianginal therapy

Question 33

pindolol and acebutolol

Answer 33

CI in angina partial beta-agonists

Question 34

antiangina tx

Answer 34

nitrates beta blockers combo nitrates/beta blockers

Question 35

statin MOA

Answer 35

HMG CoA reductase inhibitors

Question 36

effect of statins

Answer 36

greatly decreased LDL** increased HDL and decreased TG

Question 37

adverse statins

Answer 37

hepatotoxic | myoapthy

Question 38

bile acid resin MOA

Answer 38

prevent intestinal reabsorption of bile acids liver must use cholesterol to make more

Question 39

adverse bile acid resins

Answer 39

GI upset decreased absorption other drugs decreased absorption fat soluble vits

Question 40

cholestyramine

Answer 40

bile acid resin

Question 41

colestipol

Answer 41

bile acid resin

Question 42

colesevelam

Answer 42

bile acid resin

Question 43

effect of bile acid resin

Answer 43

larger decrease LDL

Question 44

ezetimibe MOA

Answer 44

prevent cholesterol absorption small intestine brush border

Question 45

effect of ezetimibe

Answer 45

decreased LDL

Question 46

adverse ezetimibe

Answer 46

diarrhea | increased liver function tests

Question 47

gemfibrozil

Answer 47

fibrate

Question 48

colfibrate

Answer 48

fibrate

Question 49

bezafibrate

Answer 49

fibrate

Question 50

fenofibrate

Answer 50

fibrate

Question 51

fibrate MOA

Answer 51

upregulated LPL - increased TG clearance activate PPAR-a - induce HDL synthesis

Question 52

adverse fibrates

Answer 52

myopathy | cholesterol gallstones

Question 53

effects of fibrates

Answer 53

greatly decreased TGs

Question 54

niacin MOA

Answer 54

vit B3 inhibit lipolysis reduced hepatic VLDL synthesis

Question 55

adverse niacin

Answer 55

red, flushed face decreased by NSAIDs hyperglycemia hyperuricemia

Question 56

effects of niacin

Answer 56

increased HDL decreased LDL also slight decrease TG