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Cardiovascular > Cardiovascular Pharmacology > Flashcards

Cardiovascular Pharmacology Flashcards

1
Q

What is the heart’s primary function?

A

The heart acts as a pump, circulating blood through the body’s vascular system.

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2
Q

What is heart failure?

A

Heart failure occurs when the heart cannot pump enough blood to meet the body’s metabolic needs, often due to myocardial injury from ischemia, inflammation, or chronic hypertension.

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3
Q

What is hypertension?

A

Hypertension is a condition where blood pressure is elevated due to increased blood volume or peripheral resistance.

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4
Q

What are arrhythmias?

A

Arrhythmias are irregular heartbeats caused by disruptions in the heart’s electrical conduction system.

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5
Q

What are angina and myocardial infarction?

A

Angina is chest pain due to insufficient blood flow to the heart, while myocardial infarction occurs when heart tissue dies due to prolonged lack of oxygen.

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6
Q

What do thiazide diuretics do?

A

Thiazide diuretics reduce blood pressure by inhibiting sodium and chloride reabsorption in the distal tubule, increasing urine output.

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7
Q

What do loop diuretics do?

A

Loop diuretics inhibit chloride reabsorption in the thick ascending loop of Henle, causing significant diuresis and often used in emergencies.

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8
Q

What do potassium-sparing diuretics do?

A

Potassium-sparing diuretics enhance sodium excretion while retaining potassium, often used to counteract potassium loss from other diuretics.

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9
Q

How do central antiadrenergics work?

A

Central antiadrenergics reduce sympathetic outflow from the brain, decreasing heart rate and blood pressure.

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10
Q

How do peripheral antiadrenergics work?

A

Peripheral antiadrenergics deplete norepinephrine in nerve terminals, reducing vasoconstriction and heart rate.

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11
Q

What do ACE inhibitors do?

A

ACE inhibitors block the production of angiotensin II, a potent vasoconstrictor, thereby reducing blood pressure.

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12
Q

How do thiazide diuretics work?

A

Thiazide diuretics inhibit sodium and chloride reabsorption in the distal tubule, leading to mild diuresis and potential potassium loss.

Thiazide diuretics are commonly used to treat hypertension and edema.

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13
Q

What is the effect of loop diuretics?

A

Loop diuretics inhibit chloride reabsorption in the thick ascending loop of Henle, causing a high loss of potassium and water.

Loop diuretics are often used in cases of heart failure and renal impairment.

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14
Q

How do potassium-sparing diuretics work?

A

These diuretics enhance sodium and water excretion while retaining potassium, often used in combination with other diuretics to prevent hypokalemia.

Common potassium-sparing diuretics include spironolactone and eplerenone.

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15
Q

What do osmotic diuretics do?

A

Osmotic diuretics draw water into the urine without affecting ion secretion or absorption, used in acute conditions like brain edema.

Mannitol is a widely used osmotic diuretic.

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16
Q

How do central antiadrenergics work?

A

Central antiadrenergics reduce sympathetic outflow from the brain by activating inhibitory α2 receptors, promoting parasympathetic dominance.

Examples include clonidine and guanfacine.

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17
Q

What do peripheral antiadrenergics do?

A

Peripheral antiadrenergics prevent norepinephrine release from nerve terminals, reducing blood pressure by decreasing peripheral resistance.

These medications can be used in the treatment of hypertension.

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18
Q

What is the effect of alpha blockers?

A

Alpha blockers inhibit vasoconstriction by blocking α1 receptors, reducing peripheral resistance and blood pressure.

Common examples include prazosin and doxazosin.

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19
Q

How do beta blockers work?

A

Beta blockers prevent adrenergic stimulation of the heart by blocking β1 receptors, reducing heart rate and contractility.

They are often prescribed for hypertension and heart conditions.

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20
Q

What do vasodilators do?

A

Vasodilators widen blood vessels, reducing blood pressure by decreasing peripheral resistance.

Examples include hydralazine and nitroglycerin.

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21
Q

How do ACE inhibitors work?

A

ACE inhibitors suppress the synthesis of angiotensin II, a potent vasoconstrictor, and may induce vasodilator production.

Common ACE inhibitors include lisinopril and enalapril.

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22
Q

How do ARBs work?

A

ARBs block the action of angiotensin II at its receptors, reducing vasoconstriction and blood pressure.

Examples include losartan and valsartan.

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23
Q

What is the mechanism of action of Lidocaine?

A

Na+ channel blockage, preferentially binds to Na+ channels in the deactivated state

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24
Q

What is a key indication for Lidocaine?

A

Acute ventricular arrhythmia secondary to myocardial infarction, digitalis toxicity, cardiac manipulation

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25
Q

What are the key toxicities associated with Lidocaine?

A
  • Cardiotoxicity: arrhythmia, bradycardia
  • Neurotoxicity: excitation/depression
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26
Q

What is the mechanism of action of Procainamide?

A

Na+ channel blockage, preferentially binds to Na+ channels in the deactivated state

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27
Q

What is a key indication for Procainamide?

A
  • Ventricular arrhythmia
  • Supraventricular arrhythmia
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28
Q

What is a key toxicity associated with Procainamide?

A

SLE-like syndrome, increased incidence in slow acetylators

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29
Q

What is the mechanism of action of Quinidine?

A

Na+ channel blockage, preferentially binds to Na+ channels in the activated state

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30
Q

What are the key indications for Quinidine?

A
  • Ventricular arrhythmia/tachycardia
  • Atrial fibrillation/flutter
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31
Q

What are the key toxicities associated with Quinidine?

A
  • Cinchonism
  • ↑ QT interval
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32
Q

What is the mechanism of action of Amiodarone?

A

K+, Ca2+, and Na+ channel blocker: broad-spectrum anti-arrhythmic

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33
Q

What are the key indications for Amiodarone?

A

Most types of arrhythmias

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34
Q

What are the key toxicities associated with Amiodarone?

A
  • Pulmonary fibrosis
  • Hyper- or hypothyroidism
  • Blue pigment of the skin
  • Corneal deposits
  • Hepatotoxic
  • Photophobia
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35
Q

What is the mechanism of action of Bretylium?

A

Unknown

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36
Q

What is a key indication for Bretylium?

A

Ventricular arrhythmia resistant to typical antiarrhythmic therapy

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37
Q

What are the key toxicities associated with Bretylium?

A
  • Orthostatic hypotension
  • Nausea
  • Vomiting
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38
Q

What is the mechanism of action of Sotalol?

A

β-blocker and K+ channel blocker

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39
Q

What are the key indications for Sotalol?

A
  • Ventricular arrhythmia
  • Atrial fibrillation/flutter
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40
Q

What is a key toxicity associated with Sotalol?

A

Torsades de pointes

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41
Q

What is the mechanism of action of Amlodipine?

A

Ca2+ channel blocker preferentially in vasculature

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42
Q

What are the key indications for Amlodipine?

A
  • Angina
  • Hypertension
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43
Q

What are the key toxicities associated with Amlodipine?

A
  • Peripheral edema
  • Pulmonary edema
  • Flushing/dizziness
  • Reflex tachycardia
  • Gingival hyperplasia
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44
Q

What is the mechanism of action of Diltiazem?

A

Ca2+ channel blocker preferentially in vasculature

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45
Q

What are the key indications for Diltiazem?

A
  • Supraventricular tachycardia
  • Angina
  • Hypertension
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46
Q

What are the key toxicities associated with Diltiazem?

A
  • Cardiac depression
  • Constipation
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47
Q

What is the mechanism of action of Adenosine?

A

Adenosine receptor agonist: ↓ cAMP via Gi

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48
Q

What is a key indication for Adenosine?

A

AV nodal arrhythmia, paroxysmal supraventricular tachycardias

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49
Q

What are the key toxicities associated with Adenosine?

A
  • Impending doom
  • Vasodilation
  • Dyspnea secondary to bronchoconstriction
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50
Q

What is the mechanism of action of Atropine?

A

Muscarinic antagonist

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51
Q

What is a key indication for Atropine?

A

Sinus bradycardia, AV block

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52
Q

What are the key toxicities associated with Atropine?

A

Antimuscarinic/cholinergic effects

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53
Q

What is the mechanism of action of Digoxin?

A

Cardiac Na+/K+ ATPase inhibitor

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54
Q

What are the key indications for Digoxin?

A
  • Heart failure
  • Atrial fibrillation
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55
Q

What are the key toxicities associated with Digoxin?

A
  • Arrhythmia
  • Nausea
  • Vomiting
  • Diarrhea
  • Blurry yellow vision
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56
Q

What is the mechanism of action of Epinephrine?

A

β- and α-agonist: β > α

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57
Q

What is a key indication for Epinephrine?

A

Anaphylactic reactions, hypotension

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58
Q

What are the key toxicities associated with Epinephrine?

A
  • Hypotension secondary to β- and α-adrenergic receptor effects
  • Anxiety
  • Respiratory difficulties
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59
Q

What is the mechanism of action of Atenolol?

A

β-blocker, β1 > β2

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60
Q

What are the key indications for Atenolol?

A
  • Hypertension
  • Angina
  • Post-MI secondary prevention
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61
Q

What are the key toxicities associated with Atenolol?

A
  • Bradycardia
  • Heart failure
  • AV block
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62
Q

What is the mechanism of action of Esmolol?

A

β-blocker, β1 > β2

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63
Q

What is a key indication for Esmolol?

A

Supraventricular tachycardia

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64
Q

What are the key toxicities associated with Esmolol?

A
  • Bradycardia
  • Hypotension
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65
Q

What is the mechanism of action of Metoprolol?

A

β-blocker, β1 > β2

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66
Q

What are the key indications for Metoprolol?

A
  • Hypertension
  • Angina
  • Acute myocardial infarction in hemodynamically stable patients
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67
Q

What are the key toxicities associated with Metoprolol?

A
  • Hypotension
  • Bradycardia
  • AV block
  • Dyslipidemia
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68
Q

What is the mechanism of action of Benazepril?

A

Angiotensin-converting enzyme (ACE) inhibitor

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69
Q

What are the key indications for Benazepril?

A
  • Hypertension
  • Heart failure
  • Diabetic kidney disease
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70
Q

What are the key toxicities associated with Benazepril?

A
  • Cough
  • Hyperkalemia
  • Teratogen
  • Angioedema
  • ↓ Glomerular filtration rate (GFR)
  • Hypotension
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71
Q

What is the mechanism of action of Losartan?

A

Angiotensin receptor blocker (ARB)

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72
Q

What are the key indications for Losartan?

A
  • Hypertension
  • Heart failure
  • Diabetic kidney disease
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73
Q

What are the key toxicities associated with Losartan?

A
  • Hyperkalemia
  • Teratogen
  • ↓ Glomerular filtration rate (GFR)
  • Hypotension
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74
Q

What is the mechanism of action of Clonidine?

A

α2-agonist

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75
Q

What are the key indications for Clonidine?

A
  • Hypertension
  • Attention deficit hyperactive disorder (ADHD)
  • Tourette syndrome
  • Opioid withdrawal
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76
Q

What are the key toxicities associated with Clonidine?

A
  • Depression of the CNS
  • Respiratory depression
  • Bradycardia
  • Hypotension
  • Miosis
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77
Q

What is the mechanism of action of Amrinone?

A

Phosphodiesterase (PDE) inhibitor

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78
Q

What is a key indication for Amrinone?

A

Heart failure

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79
Q

What are the key toxicities associated with Amrinone?

A

Arrhythmia

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80
Q

What is the mechanism of action of Dobutamine?

A

β- and α-agonist, β1 > β2, α

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81
Q

What is a key indication for Dobutamine?

A

Heart failure

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82
Q

What are the key toxicities associated with Dobutamine?

A

Tachyarrhythmia, hypotension

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83
Q

What is the mechanism of action of Norepinephrine?

A

β- and α-agonist, α > β

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84
Q

What are the key indications for Norepinephrine?

A
  • Hypotension
  • Cardiac arrest
  • Septic shock
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85
Q

What are the key toxicities associated with Norepinephrine?

A
  • Hypertension
  • Bradycardia
  • Arrhythmia
  • Anxiety
  • Dyspnea
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86
Q

What is the mechanism of action of Hydralazine?

A

↑ cGMP, leading to smooth muscle relaxation

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87
Q

What are the key indications for Hydralazine?

A
  • Severe hypertension
  • Heart failure
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88
Q

What are the key toxicities associated with Hydralazine?

A
  • Tachycardia
  • SLE
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89
Q

What is the mechanism of action of Bumetanide?

A

Inhibit Na+/K+/2Cl− transporter of thick ascending limb of loop of Henle

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90
Q

What are the key indications for Bumetanide?

A
  • Hypertension
  • Edema due to heart failure, liver failure, nephrotic syndrome
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91
Q

What are the key toxicities associated with Bumetanide?

A
  • Ototoxicity
  • Metabolic hypokalemic alkalosis
  • Hypovolemia
  • Sulfa allergy
  • Interstitial nephritis
  • Gout
  • Efficacy is decreased when used with NSAIDs
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92
Q

What is the mechanism of action of Acetazolamide?

A

Carbonic anhydrase inhibitor

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93
Q

What are the key indications for Acetazolamide?

A
  • Edema
  • Mountain sickness
  • Glaucoma
  • Idiopathic intracranial hypertension
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94
Q

What are the key toxicities associated with Acetazolamide?

A
  • Metabolic acidosis
  • Hyperammonemia
  • Paresthesias
  • Sulfa allergy
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95
Q

What is the mechanism of action of Atorvastatin?

A

HMG-CoA reductase inhibitor

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96
Q

What are the key indications for Atorvastatin?

A

Vascular disease secondary to atherosclerosis

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97
Q

What are the key toxicities associated with Atorvastatin?

A
  • Myopathy
  • Hepatotoxicity
  • Potential for teratogenicity, contraindicated in pregnancy
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98
Q

What is the mechanism of action of Aspirin?

A

Irreversible COX inhibitor

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99
Q

What are the key indications for Aspirin?

A

Treatment and prevention of arterial thrombosis

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100
Q

What are the key toxicities associated with Aspirin?

A
  • Tinnitus
  • Gastrointestinal toxicity
  • Renal toxicity
  • Reye syndrome in children with viral infection
  • Metabolic acidosis-respiratory alkalosis
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101
Q

What is the mechanism of action of Alteplase?

A

Aids in conversion of plasminogen to plasmin

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102
Q

What are the key indications for Alteplase?

A
  • Early myocardial infarction
  • Ischemic stroke
  • Pulmonary embolism
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103
Q

What are the key toxicities associated with Alteplase?

A

Bleeding

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104
Q

What is the mechanism of action of Digoxin-Immune Fab?

A

Binds excess digoxin or digitoxin

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105
Q

What is a key indication for Digoxin-Immune Fab?

A

Digoxin toxicity

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106
Q

What are the key indications for Albumin?

A

Blood volume expander, acts as an oncotic agent

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107
Q

What are the key toxicities associated with Albumin?

A
  • Hypovolemia
  • Subacute bacterial peritonitis
  • Cirrhosis
  • Heart failure
  • Edema
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108
Q

What is the mechanism of action of Digoxin-Immune Fab?

A

Binds excess digoxin or digitoxin

Used primarily to treat digoxin toxicity.

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109
Q

What is the key indication for using Digoxin-Immune Fab?

A

Digoxin toxicity

Specifically for patients with elevated levels of digoxin.

110
Q

What is a key toxicity associated with Digoxin-Immune Fab?

A

Heart failure exacerbation

111
Q

What is the mechanism of action of Albumin?

A

Acts as an oncotic agent and binds to various substances in the blood

Includes bilirubin and drugs.

112
Q

What are the key indications for Albumin?

A

Hypovolemia, subacute bacterial peritonitis, cirrhosis, heart failure, edema

113
Q

Fill in the blank: Digoxin-Immune Fab is used to treat _______.

A

Digoxin toxicity

114
Q

Fill in the blank: Albumin acts as a _______ agent.

115
Q

True or False: Albumin is used to treat heart failure.

116
Q

What effect does Albumin have on blood volume?

A

Expands blood volume

117
Q

What is the mechanism of action of Lidocaine?

A

Na+ channel blockage preferentially binds to Na+ channels in the deactivated state

Used primarily for acute ventricular arrhythmia

118
Q

What is a key indication for using Lidocaine?

A

Acute ventricular arrhythmia secondary to:
* myocardial infarction
* digitalis toxicity
* cardiac manipulation (i.e., catheterization, surgery)

Important for treating arrhythmias in various cardiac situations

119
Q

What are the key toxicities associated with Lidocaine?

A

Cardiotoxicity:
* arrhythmia
* bradycardia
Neurotoxicity:
* excitation/depression

These toxicities can lead to serious complications

120
Q

What is the mechanism of action of Procainamide?

A

Na+ channel blockage preferentially binds to Na+ channels in the deactivated state

Similar to Lidocaine in its action

121
Q

What is a key indication for using Procainamide?

A

Ventricular arrhythmia and supraventricular arrhythmia

Effective in treating various types of arrhythmias

122
Q

What is a key toxicity associated with Procainamide?

A

SLE-like syndrome: increased incidence in slow acetylators

This can lead to autoimmune-like symptoms

123
Q

What is the mechanism of action of Quinidine?

A

Na+ channel blockage preferentially binds to Na+ channels in the activated state

Distinct from Lidocaine and Procainamide in its binding state

124
Q

What is a key indication for using Quinidine?

A

Ventricular arrhythmia/tachycardia and atrial fibrillation/flutter

Used in more complex arrhythmias

125
Q

What are the key toxicities associated with Quinidine?

A

Cinchonism and ↑ QT interval

Cinchonism includes symptoms like tinnitus and headache

126
Q

What is the mechanism of action of Amiodarone?

A

K+, Ca2+, and Na+ channel blocker: broad-spectrum anti-arrhythmic

Amiodarone acts on multiple ion channels, making it effective for various arrhythmias.

127
Q

What is a key indication for Amiodarone?

A

Most types of arrhythmias: secondary due to broad mechanism of action

Amiodarone is used for a wide range of arrhythmias due to its diverse action.

128
Q

What are the key toxicities associated with Amiodarone?

A
  • Pulmonary fibrosis
  • Hyper- or hypothyroidism
  • Blue pigment of the skin (‘smurf skin’)
  • Corneal deposits
  • Hepatotoxic
  • Photophobia

These toxicities highlight the importance of monitoring patients on Amiodarone.

129
Q

What is the mechanism of action of Bretylium?

A

Unknown

The exact mechanism by which Bretylium works is not fully understood.

130
Q

What is a key indication for Bretylium?

A

Ventricular arrhythmia resistant to typical antiarrhythmic therapy: considered last-resort

Bretylium is used when other treatments fail.

131
Q

What are the key toxicities associated with Bretylium?

A
  • Orthostatic hypotension
  • Nausea
  • Vomiting

These side effects necessitate careful monitoring during treatment.

132
Q

What is the mechanism of action of Sotalol?

A

β-blocker; K+ channel blocker

Sotalol combines two mechanisms for its antiarrhythmic effects.

133
Q

What are the key indications for Sotalol?

A
  • Ventricular arrhythmia
  • Atrial fibrillation/flutter

Sotalol is used for both ventricular and atrial arrhythmias.

134
Q

What are the key toxicities associated with Sotalol?

A
  • Torsades de pointes
  • β-blockade

These toxicities require monitoring of heart rhythm and blood pressure.

135
Q

What type of drug are Amlodipine, Nicardipine, and Nifedipine?

A

Ca2+ channel blockers preferentially in vasculature

These drugs primarily target vascular smooth muscle.

136
Q

What is a key indication for using Amlodipine?

A

Angina

Amlodipine is also indicated for hypertension.

137
Q

What are some common toxicities associated with Amlodipine, Nicardipine, and Nifedipine?

A
  • Peripheral edema
  • Pulmonary edema
  • Flushing/dizziness
  • Reflex tachycardia

These side effects result from their action on vascular smooth muscle.

138
Q

What is the mechanism of action for Diltiazem and Verapamil?

A

Ca2+ channel blockers preferentially in vasculature

They also act on cardiac tissues.

139
Q

What is a key indication for using Diltiazem?

A

Supraventricular tachycardia

Diltiazem is also used for angina and hypertension.

140
Q

What are some common toxicities associated with Diltiazem and Verapamil?

A
  • Cardiac depression
  • Constipation

These side effects can occur due to their effects on cardiac function.

141
Q

Fill in the blank: Amlodipine is indicated for _______.

142
Q

True or False: Amlodipine can cause gingival hyperplasia.

143
Q

Fill in the blank: Diltiazem is used to treat _______.

A

Supraventricular tachycardia

144
Q

What is the mechanism of action of Adenosine?

A

Adenosine receptor agonist: ↓ cAMP via Gi

145
Q

What is a key indication for the use of Adenosine?

A

AV nodal arrhythmia, Paroxysmal supraventricular tachycardias

146
Q

What are the key toxicities associated with Adenosine?

A

Impending doom, Vasodilation, Dyspnea secondary to bronchoconstriction

147
Q

What type of drug is Atropine?

A

Muscarinic antagonist

148
Q

What are the key indications for Atropine?

A

Inhibit secretions, Sinus bradycardia, AV block, Adjuvant with anticholinesterase

149
Q

What are the toxic effects of Atropine?

A

Antimuscarinic/cholinergic effects

150
Q

What is the mechanism of action of Digoxin?

A

Cardiac Na+/K+ ATPase inhibitor

151
Q

What are the key indications for Digoxin?

A

Heart failure, Atrial fibrillation

152
Q

What are the toxicities associated with Digoxin?

A

Arrhythmia, Nausea, Vomiting, Diarrhea, Blurry yellow vision

153
Q

What is the mechanism of action of Epinephrine?

A

β- and α-agonist: β > α

154
Q

What are the key indications for Epinephrine?

A

Anaphylactic reactions, Hypotension

155
Q

What are the secondary effects of Epinephrine?

A

Secondary to β- and α-adrenergic receptor effects

156
Q

What is the mechanism of action of Ibutilide?

A

K+ channel blocker

157
Q

What are the key indications for Ibutilide?

A

Atrial fibrillation/flutter, Torsades de pointes

158
Q

What is the mechanism of action of Isoproterenol?

A

β-agonist

159
Q

What are the indications for Isoproterenol?

A

Heart block, Bradyarrhythmias, Bronchospasm

160
Q

What are the toxicities associated with Isoproterenol?

A

Arrhythmias, Angina, Flushing

161
Q

What is the mechanism of action of Magnesium sulfate?

A

Effect on Ca2+ and K+ fluxes

162
Q

What are the key indications for Magnesium sulfate?

A

Torsades de pointes, Digitalis-induced arrhythmia

163
Q

What are the toxic effects of Magnesium sulfate?

A

Cardiac arrest, ↓ Deep tendon reflexes

164
Q

What is the mechanism of action of Atenolol?

A

β-blocker, β1 > β2

165
Q

What are the key indications for Atenolol?

A

Hypertension, Angina, Post-MI secondary prevention

166
Q

What are the key toxicities associated with Atenolol?

A

Bradycardia, Heart failure, AV block

167
Q

What is the mechanism of action of Esmolol?

A

β-blocker, β1 > β2

168
Q

What is the key indication for Esmolol?

A

Supraventricular tachycardia

169
Q

What are the key toxicities associated with Esmolol?

A

Cardiac arrest, Bradycardia, Hypotension

170
Q

What is the mechanism of action of Metoprolol?

A

β-blocker, β1 > β2

171
Q

What are the key indications for Metoprolol?

A

Hypertension, Angina, Acute myocardial infarction in hemodynamically stable patients, ↓ Morbidity and mortality in heart failure

172
Q

What are the key toxicities associated with Metoprolol?

A

Hypotension, Bradycardia, AV block, Dyslipidemia

173
Q

What is the mechanism of action of Carteolol?

A

β-blocker

174
Q

What are the key indications for Carteolol?

A

Open-angle glaucoma, Intraocular hypertension

175
Q

What are the key toxicities associated with Carteolol?

A

Conjunctival hyperemia

176
Q

What is the mechanism of action of Propranolol?

A

β-blocker, β1 = β2

177
Q

What are the key indications for Propranolol?

A

Hypertension, Angina, Essential tremor, Migraine prophylaxis, Thyrotoxicosis, Supraventricular arrhythmias, also ventricular tachycardias

178
Q

What are the key toxicities associated with Propranolol?

A

Bradycardia, AV block, COPD and asthma exacerbation, Vasospasm exacerbation in Prinzmetal angina

179
Q

What is the mechanism of action of Sotalol?

A

β-blocker, K+ channel blocker

180
Q

What are the key indications for Sotalol?

A

Ventricular arrhythmia, Atrial fibrillation/flutter

181
Q

What are the key toxicities associated with Sotalol?

A

Torsades de pointes, β-blockade

182
Q

What is the mechanism of action of Carvedilol?

A

α- and β-blocker

183
Q

What are the key indications for Carvedilol?

A

Congestive heart failure, Hypertension, Antiarrhythmic

184
Q

What are the key toxicities associated with Carvedilol?

A

Hypotension, Cardiovascular effects: bradycardia, etc.

185
Q

What is the mechanism of action of Labetolol?

A

α- and β-blocker

186
Q

What are the key indications for Labetolol?

A

Hypertension, Hypertensive emergencies such as in pregnancy

187
Q

What are the key toxicities associated with Labetolol?

A

Orthostatic hypotension

188
Q

What are Angiotensin II Antagonists also known as?

A

Angiotensin receptor blockers (ARBs)

ARBs are a class of medications that inhibit the action of angiotensin II.

189
Q

Name three examples of Angiotensin II Antagonists.

A
  • Losartan
  • Candesartan
  • Valsartan

These medications are commonly used to treat various cardiovascular conditions.

190
Q

What is the key indication for Angiotensin II Antagonists?

A
  • Hypertension
  • Heart failure
  • Diabetic kidney disease

These conditions are commonly treated with ARBs to manage blood pressure and protect kidney function.

191
Q

What is a potential toxicity associated with Angiotensin II Antagonists?

A
  • Hyperkalemia
  • Teratogen
  • ↓ Glomerular filtration rate (GFR)
  • Hypotension

These toxicities can arise from the use of ARBs and require monitoring.

192
Q

True or False: Angiotensin II Antagonists can cause hypotension.

A

True

Hypotension is a known side effect of ARBs due to their blood pressure-lowering effects.

193
Q

What is the mechanism of action for Clonidine?

A

α2-agonist

Clonidine primarily works by stimulating alpha-2 adrenergic receptors in the brain.

194
Q

List the key indications for Clonidine.

A
  • Hypertension
  • Attention deficit hyperactive disorder (ADHD)
  • Tourette syndrome
  • Opioid withdrawal

Clonidine is used in various conditions, including management of ADHD and withdrawal symptoms.

195
Q

What are the key toxicities associated with Clonidine?

A
  • Depression of the CNS
  • Respiratory depression
  • Bradycardia
  • Hypotension
  • Miosis

The toxic effects can lead to severe complications if not monitored.

196
Q

What is the mechanism of action for Doxazosin and Terazosin?

A

α1-blocker

These medications block alpha-1 adrenergic receptors, leading to vasodilation.

197
Q

List the key indications for Doxazosin and Terazosin.

A
  • Hypertension
  • Benign prostatic hyperplasia symptoms

These drugs are often prescribed for hypertension and urinary issues related to prostate enlargement.

198
Q

What is a key toxicity associated with Doxazosin and Terazosin?

A
  • Orthostatic hypotension
  • Urinary incontinence

Patients may experience dizziness upon standing due to blood pressure changes.

199
Q

What is the mechanism of action for Amrinone and Milrinone?

A

Phosphodiesterase (PDE) inhibitor

200
Q

What is the key indication for Amrinone and Milrinone?

A

Heart failure

201
Q

What is a key toxicity associated with Amrinone and Milrinone?

A

Arrhythmia

202
Q

What type of agonist is Dobutamine?

A

β- and α-agonist

203
Q

What are the key indications for Dobutamine?

A

Heart failure, Tachyarrhythmia, Hypertension

204
Q

What is a key toxicity associated with Dobutamine?

A

Tachyarrhythmia

205
Q

What are the mechanisms of action for Dopamine?

A

Dopamine, β- and α-agonist

206
Q

What is the key indication for Dopamine?

A

Low cardiac output/poor perfusion

207
Q

What is a key toxicity associated with Dopamine?

A

Arrhythmia, Angina

208
Q

What is the mechanism of action for Epinephrine?

A

β- and α-agonist

209
Q

What are the key indications for Epinephrine?

A

Type I hypersensitivity reactions, Hypotension secondary to septic shock, Cardiac arrest

210
Q

What are the key toxicities associated with Epinephrine?

A

Angina, Arrhythmia, Anxiety, Respiratory difficulties

211
Q

What is the mechanism of action for Norepinephrine?

A

β- and α-agonist

212
Q

What is the key indication for Norepinephrine?

A

Hypotension, Cardiac arrest, Septic shock

213
Q

What are the key toxicities associated with Norepinephrine?

A

Hypertension, Bradycardia, Arrhythmia, Anxiety, Dyspnea

214
Q

What is the mechanism of action for Phenylephrine?

A

α-agonist

215
Q

What is a key indication for Phenylephrine?

A

Hypotension, Decongestant

216
Q

What are the key toxicities associated with Phenylephrine?

A

Hypertension, Reflex bradycardia, Anxiety, Pulmonary edema

217
Q

Fill in the blank: Dobutamine is a _______ agonist.

A

[β- and α-]

218
Q

True or False: Norepinephrine can cause bradycardia.

219
Q

What is the mechanism of action of Hydralazine?

A

↑ cGMP, leading to smooth muscle relaxation

Used primarily for severe hypertension and heart failure.

220
Q

What are the key indications for using Nitroprusside?

A

Severe hypertension
Decompensated heart failure

It works by increasing cGMP.

221
Q

What is a potential toxicity associated with Nitroprusside?

A

Hypotension
Cyanide toxicity (potential)

Careful monitoring is required due to the risk of cyanide toxicity.

222
Q

What is the primary mechanism of action for Minoxidil?

A

Arteriolar vasodilator, opens K+ channels

Also indicated for androgenetic alopecia.

223
Q

What are the key indications for Minoxidil?

A

Severe hypertension
Androgenetic alopecia

It can cause tachycardia and salt and water retention.

224
Q

What are the side effects of Minoxidil?

A

Tachycardia
Salt and water retention
Hirsutism

These effects are due to its vasodilatory action.

225
Q

What is the mechanism of action of Diazoxide?

A

Opens K+ channels in smooth muscle

It is used for severe hypertension and hypoglycemia in insulin-secreting tumors.

226
Q

What are the key indications for Diazoxide?

A

Severe hypertension
Hypoglycemia in the setting of insulin-secreting tumors

It can cause hypotension and hyperglycemia.

227
Q

What are the potential toxicities associated with Diazoxide?

A

Hypotension
Hyperglycemia

Monitoring is essential due to the risks involved.

228
Q

What is the mechanism of action for Acetazolamide?

A

Carbonic anhydrase inhibitor

Used for conditions like edema, mountain sickness, glaucoma, and idiopathic intracranial hypertension.

229
Q

What is a key indication for the use of Acetazolamide?

A

Edema
Mountain sickness
Glaucoma
Idiopathic intracranial hypertension (pseudotumor cerebri)

Acetazolamide has multiple indications including the management of mountain sickness.

230
Q

What is a key toxicity associated with Acetazolamide?

A

Metabolic acidosis
Hyperammonemia
Paresthesias
Sulfa allergy

These toxicities can occur with the use of Acetazolamide.

231
Q

What is the mechanism of action for Loop Diuretics?

A

Inhibit Na+/K+/2Cl− transporter of thick ascending limb of loop of Henle

This mechanism is crucial for their action in lowering blood pressure and reducing edema.

232
Q

List three key indications for Loop Diuretics.

A
  • Hypertension
  • Edema due to heart failure
  • Edema due to liver failure
  • Edema due to nephrotic syndrome
  • Hypercalcemia

Loop diuretics are used in various conditions related to fluid overload.

233
Q

What is a key toxicity associated with Loop Diuretics?

A

Ototoxicity
Metabolic hypokalemic alkalosis
Hypovolemia
Sulfa allergy
Interstitial nephritis
Gout

These adverse effects are important to monitor during treatment.

234
Q

What decreases the efficacy of Loop Diuretics?

A

Use with NSAIDs

The interaction between Loop Diuretics and NSAIDs can lead to reduced effectiveness.

235
Q

What is the mechanism of action for Thiazide Diuretics?

A

NaCl reabsorption inhibitor in distal convoluted tubule

This mechanism helps to control blood pressure and manage fluid retention.

236
Q

List two key indications for Thiazide Diuretics.

A
  • Heart failure
  • Edema
  • Nephrogenic diabetes insipidus
  • Calcium nephrolithiasis

Thiazide diuretics are commonly used in cardiovascular and renal conditions.

237
Q

What is a key toxicity associated with Thiazide Diuretics?

A

Sulfa allergy
Hypokalemia
Hyper-uricemia
Hyperglycemia
Hypercalcemia
Hyperlipidemia
Metabolic alkalosis

These toxicities can significantly impact patient management.

238
Q

What is the mechanism of action for Amiloride?

A

ENaC epithelial channel blocker in cortical collecting ducts

This mechanism is crucial for potassium-sparing effects.

239
Q

List two key indications for Amiloride.

A
  • Heart failure
  • Hyperaldosteronism
  • Nephrogenic diabetes insipidus
  • States of K+ depletion (i.e., use of thiazides)

Amiloride is particularly useful in conditions leading to potassium loss.

240
Q

What is a key toxicity associated with Amiloride?

A

Hyperkalemia

Hyperkalemia is a significant risk, especially in patients with renal impairment.

241
Q

What is the mechanism of action for Spironolactone?

A

Aldosterone receptor blocker in cortical collecting ducts (in their cytoplasm)

This action helps manage conditions related to excess aldosterone.

242
Q

List two key indications for Spironolactone.

A
  • Heart failure
  • Hyperaldosteronism
  • Hepatic ascites

Spironolactone is often used in heart failure and conditions with fluid overload.

243
Q

What is a key toxicity associated with Spironolactone?

A

Hyperkalemia
Gynecomastia

These side effects can affect patient compliance and treatment outcomes.

244
Q

What are HMG-CoA Reductase Inhibitors commonly known as?

A

Statins

Statins are a class of drugs used to lower cholesterol levels.

245
Q

What is the mechanism of action for Atorvastatin?

A

HMG-CoA reductase inhibitor

This mechanism reduces cholesterol production in the liver.

246
Q

What is the key indication for using Atorvastatin?

A

Vascular disease secondary to atherosclerosis

Atorvastatin is primarily prescribed to reduce the risk of cardiovascular events.

247
Q

What are the key toxicities associated with HMG-CoA Reductase Inhibitors?

A
  • Myopathy
  • Hepatotoxicity
  • Potential for teratogenicity

These side effects can vary in severity and impact patient safety.

248
Q

Which HMG-CoA Reductase Inhibitor is contraindicated in pregnancy?

A

All statins

Statins are known to have teratogenic effects.

249
Q

What is the mechanism of action for Fenofibrate?

A

PPAR-α agonist, upregulates lipoprotein lipase

This action helps to reduce triglycerides and increase HDL levels.

250
Q

What is the key indication for Fenofibrate?

A

Hypertriglyceridemia, low HDL cholesterol

Fenofibrate is used to manage specific lipid disorders.

251
Q

What are the key toxicities associated with Fenofibrate?

A
  • Myopathy
  • Gallstones (cholesterol)

Patients must be monitored for these potential side effects.

252
Q

What is the mechanism of action for Niacin?

A

Increases HDL and decreases LDL and triglycerides

Niacin is effective in improving overall lipid profiles.

253
Q

What is the key indication for Niacin?

A

Dyslipidemia

Niacin is often used in combination therapy for lipid management.

254
Q

What are the key toxicities associated with Niacin?

A
  • Flushing
  • Pruritis
  • Hepatotoxicity
  • Hyperuricemia
  • Hyperglycemia

Flushing can be alleviated with NSAIDs.

255
Q

True or False: Gemfibrozil is a PPAR-α agonist.

A

True

Gemfibrozil works similarly to Fenofibrate in lipid management.

256
Q

What is the mechanism of action of Abciximab?

A

GpIIb/IIIa inhibitor

Used in unstable angina and prevention of cardiac ischemia in percutaneous coronary intervention.

257
Q

What are the key toxicities associated with Abciximab?

A

Bleeding, Thrombocytopenia

These side effects are important to monitor in patients receiving this medication.

258
Q

What is the key indication for Anagrelide?

A

Thrombocythemia in myeloproliferative disorders

Anagrelide is specifically used to lower platelet counts.

259
Q

What are the side effects of Anagrelide?

A

Palpitations, Headache, Thrombocytopenia, Bleeding

Monitor for these effects during treatment.

260
Q

What is the mechanism of action of Cilostazol?

A

Phosphodiesterase III inhibitor

Cilostazol is used for secondary ischemic stroke prevention and intermittent claudication.

261
Q

List the key toxicities of Cilostazol.

A

Headache, Flushing, Hypotension

These side effects can impact patient compliance.

262
Q

What is the main action of Aspirin?

A

Irreversible COX inhibitor that impairs TXA2 synthesis

Aspirin is widely used for treatment and prevention of arterial thrombosis.

263
Q

What are the key toxicities associated with Aspirin?

A

Tinnitus, Gastrointestinal toxicity, Renal toxicity, Reye syndrome, Metabolic acidosis-respiratory alkalosis

Reye syndrome is a serious condition that can occur in children with viral infections.

264
Q

What is the mechanism of action of Ticlopidine and Clopidogrel?

A

ADP-receptor antagonist

This action impairs the expression of GpIIb/IIIa receptors.

265
Q

What are the key indications for Ticlopidine and Clopidogrel?

A

Acute coronary syndrome, Prevention of cardiac ischemia, Treatment and prevention of arterial thrombosis

These medications are crucial in managing cardiovascular events.

266
Q

What is a potential toxicity of Ticlopidine?

A

Leukopenia

This side effect requires monitoring of blood counts.

267
Q

What is the mechanism of action of Alteplase, Streptokinase, and Urokinase?

A

Aids in conversion of plasminogen to plasmin

These agents are used in thrombolytic therapy.

268
Q

What are the key indications for thrombolytics like Alteplase?

A

Early myocardial infarction, Ischemic stroke, Pulmonary embolism

Timely administration is critical for effectiveness.

269
Q

What is a common toxicity of thrombolytics?

A

Bleeding

Careful patient selection is essential to minimize this risk.

270
Q

What is the action of Digoxin-Immune Fab?

A

Binds excess digoxin or digitoxin

This is used in cases of digoxin toxicity.

271
Q

What is the indication for Albumin?

A

Blood volume expander, Antihyperbilirubinemic

It binds to various substances in the blood.

272
Q

What are the key toxicities associated with Albumin?

A

Hypovolemia, Heart failure, Edema

Monitoring is necessary to prevent these complications.

Cardiovascular (7 decks)

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