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Pharmacology > Cardiovascular Pharm > Flashcards

Cardiovascular Pharm Flashcards

1
Q

Digoxin

A

inhibit Na/K ATPase
increasing Na/Ca
increasing contractility

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2
Q

ACE inhibitor

A

“pril”
prevent conversion of Ag I to Ag II
increase bradykinin

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3
Q

Angiotensin II antagonist

A

“sartan”
block angiotensin II
do not cause cough

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4
Q

What are the side effects of ACE inhibitors and ARBs

A

changes in renal function
contraindicated in pregnancy
contraindicated in bilateral renal artery stenosis

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5
Q

Aliskiren

A

inhibits renin–> blocks angiotensinogen to Ag I

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6
Q

What are the side effects of aliskerin

A

hyperkelemia
angioedema
contraindicated in pregnancy

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7
Q

Acetozolamide

A

decrease Na/H antiport
increases water loss
tx: increase CSF, acute mountain sickness, decrease aqueous humour

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8
Q

Mannitol

A

Increase permeability of PCT

tx: glaucoma

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9
Q

What are the side effects of mannitol?

A

increase Heart failure

pulmonary edema

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10
Q

What are the side effects of acetozolamide ?

A

renal tubule acidosis type 2
hypokalemia
sulfa allergy

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11
Q

Hypothermia

A

slow shallow breathing

hypoventilation–> increased CO2

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12
Q

Hyperthermia

A

kussmal breathing

hyperventilation –> decreased CO2

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13
Q

Furosemide

A

inhibit Na. K. 2 Cl

increases excretion of Na, Cl ,Ca, Mg

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14
Q

Ethacrynic acid

A

inhibit Na, K, 2 Cl

does not cause sulf allergies

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15
Q

What are the side effects of loop diuretics

A 
hypokalemia 
metabolic alkalosis 
hyperurecemia 
interstitial nephritis 
Hyp Mg & Ca
ototoxcity
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16
Q

What is the effect of NSAIDs on loop diuretics

A

decrease efficacy

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17
Q

Thiazides

A

Block the Na/Cl cotransport

increase the reabsorption of Ca

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18
Q

Triamterne & Amiloride

A

Block eNac pumps
decrease Na reabsorption
K spairing

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19
Q

Spironolactone & Eplerenone

A

bind mineralocorticoids receptors

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20
Q

What are the side effects of K pairing drugs ?

A

hyperkalemia

renal tubule acidosis

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21
Q

What are the side effects of spirnalactone ?

A

gynecomastia
block of 17-OH
decrease libido
is beneficial in PCOS

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22
Q

Dihyropyridine -CCB

A

“dipine”

block Ca channel in vascular smooth muscle

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23
Q

Non- dihydropyridine -CCB

A

diltiazem -medium effect
verapamil- strong effect
block Ca channel in cardiac muscle

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24
Q

What are the side effects of Calcium channel blockers ?

A

headache, flushing, lightheadness, peripheral edema, reflex tachycardia, gingival hyperplasia ( dihydropyridine )

constipation - verapamil

contraindicated in heart block & heart failure

25
Q

Hydralazine

A

Safe in pregnancy
may cause SLE
can exacerbate hypotension
decrease mortality

26
Q

Nitrorusside

A

causes vasodilation of arteries and veins

when metabolized causes cyanide–> toxicity especially with renal insufficiency ( almond smell)

27
Q

Fenoldopam

A

selective dopamine 1 receptor agonist –> increased cAMP

dilates renal arteries
increases naturesis

28
Q

Nitrates

A

TX: heart failure

29
Q

Quinidine

A

block Na channel
prolong phase 2 & 3
tx: SvT & ventricular arrhythmia

30
Q

What are the side effects of quinidine ?

A

Thrombocytopenia
Cinchonism (tinnitus, headache, dizziness)
Torsade de pointe

31
Q

Procainamide

A

block Na channels

can prolong phase 2 & 3

32
Q

What is the side effects of procainamide ?

A

drug induced lupus

33
Q

Disopyramide

A

block Na channels

strong anticholinergic

34
Q

What is the side effect os disopyramide ?

A

exacerbate heart failure

35
Q

What is a side effect of Class IA drugs?

A

Torsade de pointes

36
Q

What are the characteristics of Class IB?

A

low binding affinity
shortened phase 3
tx: arrhythmia with ischemic damage

37
Q

What are the class IB drugs?

A

Lidocaine
Phenytoin
Mexiletine

38
Q

What is the side effect of class IB?

A

Seizures
paresthesia
convulsions

39
Q

What are the characteristics of class IC

A 
greater binding affinity
decrease phase 0
Prolong QRS 
do not affect the AP 
used to tx SVT & ventricular arrhythmia 
tx:atrial fibrillation & flutter
40
Q

Who cannot receive class IC drugs ?

A

those with structural or ischemic heart disease

41
Q

Class II - beta blockers

A

decrease SA node firing & AV node conduction
decrease cAMP–>closure of Ca channels –> decrease contractility
Tx: atrial fibrillation & flutter

42
Q

What are the side effects of Class II?

A

can exacerbate heart block

prolong PR interval

43
Q

What are the class II drugs given IV ?

A

Esmolol- IV only
Metoprolol
Propanolol

44
Q

Class III antiarrythmics?

A

block K channel & delay repolarization
prolong AP–> prolonged QT
tx: SVT & ventricular arrhythmia , atrial fibrillation & flutter

45
Q

Amiodarone

A 
acts as a class I, II, III, IV 
very long half life 
increased tissue protein binding
46
Q

What are the side effects of amiodarone

A 
neurologic effects 
blue grey deposits in the skin and cornea 
thyroid dysfunction 
exacerbate heart block  & HF
 hypersensitivity hepatitis 
torsade de pointes 
P450 inhibitor 
pulmonary fibrosis
47
Q

not including amiodarone what other class III drugs are there ?

A

dofetilide & ibutilide

sotalol

48
Q

Class IV drugs

A

decrease phase 0 & phase 4 –> SA & AV node conduction decreased

tx: SVT , atrial fibrillation & flutter

increase PR interval

49
Q

What are the side effects of Class IV drugs

A 
reduced BP
reduced cardiac output
lower extremity deem 
constipation 
increases heart block
50
Q

Class IV drug interaction

A

verapamil displaces digoxin

51
Q

What does digoxin treat?

A

SVT & fibrillation & flutter

52
Q

How does digoxin work?

A

Vagal innervation

parasympathetic

53
Q

What is the benefit of using magnesium in arrhythmia?

A

tx : torsades de pointes

54
Q

What can induce arrhythmia?

A

HyperKalemia

HypoKalemia

55
Q

Adenosine

A

rapid acting
tx: PSVTs
half life is less than 30 sec
increase coronary dilation by A2 receptors

56
Q

What are adenosine receptors

A

A1- Gi coupled , decrease SA, AV rate

A2: Gs coupled , vasodilator

A2B: Gq coupled , bronchoconstriction

57
Q

What are the side effects of adenosine ?

A

flushing
shortness of breath
chest pain–> sense of impending doom

58
Q

What are the drug interactions of adenosine ?

A

Theophylline (caffeine) antagonize adenosine receptors

Pharmacology (15 decks)

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