Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Cardiovascular Pharmacology Part II > Flashcards

Cardiovascular Pharmacology Part II Flashcards

1
Q

What is the main purpose of drugs used to treat angina?

A

To restore the balance between myocardial 02 supply and demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 MOAs of nitrates?

A
  1. Dilates vascular smooth muscle-veins and arteries (especially coronary arteries)
  2. Decreases cardiac preload and afterload
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

No more than _____ sublingual nitrate doses may be taken within _____ minutes.

A
  1. 3 doses

2. 15 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should be monitored between each administration of sublingual nitrate?

A

Vital signs

If BP < 100, nitro should be withheld.
Call for ambulance if pain is not relieved in the first five minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List 5 ADRs associated with nitrates.

A
  1. Reflex tachycardia from drop in BP
  2. Dizziness
  3. Orthostatic hypotension
  4. Headache
  5. Burning under the tongue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

True or False: Nitrates have a long shelf life.

A

FALSE

Nitrates have a short shelf life

Must be stored in the original container (shields from sunlight);
destroy any unused tabs 6 months after bottle is opened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When does one take short acting versus long acting nitrates?

A
  1. Short acting: for patients with angina during exertion or immediately before exercise
  2. Long acting: patients who remain symptomatic despite taking aspirin, statins, CCD and beta blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of drug is aspirin?

A

Platelet Aggregator Inhibitor (prevents clot formation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the MOA of aspirin? How long does it last?

A

Blocks thromboxane A2 (makes platelets sticky) synthesis from AA in platelets.

Lasts for life of platelet 7-10 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the dosing of aspirin?

A

Administer single loading dose followed by daily dose of 81 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List 2 ADRs associated with the use of platelet aggregator inhibitors (i.e. aspirin).

A

Bleeding (GI, cerebral)

Bruising (precaution for STM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

_____ breaks down fibrin.

A

Plasminogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the MOA of anticoagulants (heparin)?

A

Inactivates factors involved in normal coagulation preventing the conversion of prothrombin to thrombin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List 4 indications for the use of anticoagulants (heparin).

A
  1. when anticoagulant is needed immediately
  2. DVT
  3. Pulmonary embolism
  4. Acute MI (NSTEMI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If used for over 3 months, anticoagulants can lead to ______.

A

Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List ADRs associated with the use of anticoagulants (heparin).

A
  1. Bleeding
  2. Thrombocytopenia
  3. Thrombosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Low weight molecular heparin (LWMH) is typically prescribed following _____ and _____ surgery. Why?

A

Hip and Knee surgery

Prevents clotting of blood to decrease likelihood of DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the MOA for warfarin (Coumadin)?

A

Interfere with liver synthesis of the vitamin K-dependent clotting factors: II (prothrombin), VII, IX, and X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List 6 indications for the use of warfarin (Coumadin).

A
  1. Prophylaxis
  2. DVT
  3. Pulmonary embolism
  4. Prevent strokes in AFib
  5. Acute MI
  6. Mechanical heart valves
20
Q

The degree of anticoagulation is measured with ____.

A

INR

21
Q

What is an acceptable INR for DVT? For heart valves?

A

DVT = 2.0-3.0

Heart valves= up to 3.5

22
Q

It takes up to ___ days for warfarinization to occur so the patient must continue on _____ until they reach this state.

A

3 days

HEPARIN

23
Q

Warfarin dosing is highly dependent upon ______ levels.

A

Vitamin K levels (potassium)

24
Q

What are 2 major ADRs associated with warfarin?

A
  1. Bleeding

2. Skin necrosis

25
Q

Describe the food and drug intereaction between warfarin and cruciferous vegetables.

A
  1. Warfarin dosing is highly dependent on K+ levels
  2. Potassium (K+) is vital for the blood to clot
  3. Warfarin is taken to prevent the blood from clotting
  4. Thus, eating cruciferous vegetables (i.e. broccoli), increases the level of potassium in the body, which makes warfarin LESS EFFECTIVE
26
Q

What drug has a MOA that DIRECTLY inhibits thrombin to prevent the formation of clots? What are 3 advantages of using this drug over warfarin?

A

Dabigatran

Advantage over warfarin: fewer major bleeds, no interacting with vitamin K containing foods, does not need anticoagulant monitoring.

27
Q

Thrombolytic drugs convert _____ to _____ which breaks down fibrin clots.

A

Plasminogen to plasmin

28
Q

What are 2 indications for the use of thrombolytic drugs?

A
  1. Immediate treatment of a STEMI

2. CVA (given 3-4.5 hours after to reestablish blood flow)

29
Q

What is the MOA of a statin?

A

Competitive inhibitors of HMG-CoA reductase, an enzyme necessary for cholesterol synthesis-reduces LDL 30-40%

30
Q

Statins can reduce LDL cholesterol by _____ %.

A

30-40%

31
Q

What organ to statins target? Why?

A

Target the LIVER

Inhibit the production of cholesterol by the liver to reduce overall cholesterol levels in the body

32
Q

What food is prohibited in patients taking statins? Why?

A

Grapefruit/grapefruit juice

Why? Grapefruit juice inhibits the enzymes that metabolize drugs in the liver. So, consuming grapefruit juice can increase the levels of statins in the blood, increasing the risk of ADRs.

33
Q

List 5 ADRs associated with statins.

A
  1. Gas, stomach cramps, nausea, headaches
  2. New onset diabetes (1 in 5 new cases attributed to statins)
  3. Peripheral neuropathy
  4. Tendon Ruptures
  5. Rhabdomyolysis
34
Q

Statins can increase the level of _____ in the blood, which can lead to rhabdomyolysis (muscle breakdown).

A

Creatine Kinase (CK)

35
Q

What is the difference between myalgia, myositis, and rhabdomyolysis?

A

Myalgia: muscle ache or weakness without elevated CK levels

Myositis: muscle symptoms with elevated CK (inflammation)

Rhabdomyolysis: Muscle symptoms with CK elevation greater than 10 times the upper limit of normal, creatinine elevation with brown urine and urinary myoglobin

36
Q

The higher the statin the dose, the greater the risk for ______.

A

Myalgia (muscle pain)

37
Q

What 5 questions should be asked to determine whether myalgia is caused by exercise or statin use?

A
  1. Does pain correspond with change in activity?
  2. Is pain related to a dose change or addition of another drug?
  3. Is pain commensurate with activity?
  4. Is pain bilateral?
  5. Is patient elderly (over 70) with multiple co-morbidities?
38
Q

What is the MOA of digoxin?

A

Blocks Na/K-ATPase pump
which enhances the Na+/Ca2+ pump increasing force of contraction (inc ejection fx) without decreasing BP or HR;

Parasympathomimetic action at SA node

39
Q

List 2 indications for the use of digoxin.

A

CHF

AFib

40
Q

List 6 ADRs associated with digoxin.

A
  1. Arrhythmias
  2. CNS effects
  3. Nausea
  4. Vomiting
  5. Diarrhea
  6. Digitalis toxicity
41
Q

What are the 2 hallmark signs of digitalis toxicity?

A
  1. Bradycardia

2. Visual disturbances (halo vision)

42
Q

Why are antiarrhythmic drugs not very effective?

A

The have pro-arrhythmic actions and extra cardiac side effects.

43
Q

What is the most effective treatment for arrhythmias currently?

A

Ablation

44
Q

Some antiarrhythmic drugs work by increasing the _____ so that no action potentials can be generated

A

Effective refractory period

45
Q

List 4 ADRs associated with antiarrhythmic drugs.

A
  1. Faintness
  2. Dizziness
  3. Visual disturbances
  4. INCREASED ARRHYTHMIAS

Pharmacology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions