Cardiovascular System Flashcards
1
Q
4 main classes of drugs used for primary HTN
A
- Thiazide Diuretics
- ACEI
- ARBS
- Calcium Channel Blockers Dihydropyridine
2
Q
5 main classes of drugs to treat HTN with Heart Failure
A
- Diuretics
- ACEI
- ARBS
- Beta Blockers
- Aldosterone Antagonist
3
Q
5 main classes of drugs to treat HTN with diabetes mellitus
A
- ACEI
- ARBS
- Calcium Channel Blockers
- Thiazide Diuretics
- Beta Blockers
4
Q
4 drugs to treat HTN in pregnancy
A
nifedipine
methyldopa
labetolol
hydralazine
5
Q
name the non dihydropyreidine CA channel blockers
A
Diltiazem
Verapamil
6
Q
name the Dihydropyridine Ca blockers
A
Amlodipine Celvidipine Nicardipine Nifedipine Nimodipine
7
Q
the type of channel that calcium channel blockers block
A
l-type
8
Q
main ca blocker used on the heart
A
verapamil
9
Q
main CA blocker used on vascular smooth muscle
A
amlodipine
10
Q
use for nimodipine
A
subarachnoid hemorrhage
11
Q
use for clevidipine
A
HTN urgency or crisis
12
Q
4 UDE for non-dihydropyridines
A
- cardiac depression
- AV block
- hyperprolactinemia
- constipation
13
Q
4 UDE for dihydropyridines
A
- gingival hyperplasia
- peripheral edema
- dizziness
- flushing
14
Q
HYDRALAZINE
mechanism
clinical use
UDE
A
- increases cGMP = smooth muscle relaxation
vasodialtes arterioles before veins
reduces after load - Severe HTN (safe for pregnancy use )
- compensatory tachycardia and LUPUS LIKE SYMPTOMS
15
Q
coadminister hydralazine with what
A
Beta blocker so you don’t get reflex tacky
16
Q
5 drugs for HTN Emergency
A
clevidipine fenoldopam labetaolol nicradipine nitroprusside
17
Q
NITROPRUSSIDE
mechanism
UDE
A
- increases cGMP by releasing NO
2. can cause cyanide toxicity
18
Q
FENOLDOPAM
mechanism
UDE
A
- D1 receptor agonist - coronary, peripheral, renal and splanchnic vasodilation.
decreases BP and increases natriuresis - hypotension and tachycardia
19
Q
drug of choice for malignant HTN
A
nitroprusside
20
Q
name the three nitrates
A
nitroglycerin
isosorbide dinitrate
isosorbide mononitrate
21
Q
Nitrates (NITROGLYCERIN, ISOSORBIDE DINITRIE AND MONONITRATE)
mechanism
clinical use
UDE
A
- use NO to vasodilator and increase cGMP. Dilates veins before arteries
- Acute coronary syndrome, angina and pulmonary edema
- Monday Disease- tolerance to the vasodilation effect during the work week and loss of tolerance over the weekend causing tacky, dizzy and headache on re-exposure
22
Q
Effects of nitrates on EDV BP contractility HR Ejection time MVO2
A
dec dec - inc dec dec
23
Q
Effects of beta blockers on EDV BP contractility HR Ejection time MVO2
A
- dec dec dec inc dec
24
Q
effects of nitrates plus B Blocers on EDV BP contractility HR Ejection time MVO2
A
- dec little/no effect dec little/no effect really decrease!
25
name the two partial beta blockers that are contraindicated in angina
pindolol
| acebutolol
26
RANOLAZINE
mechanism
use
UDE
1. inhibits the late phase of the sodium channel so reducing o2 consumption
2. anigina brought about by other medication
3. QT prolongation
27
name two HMG CoA reductase inhibitors
lovastatin
| pravastatin
28
STATINS
mechanism
use
UDE
1. decreases LDL l
2. inhibiting conversion of HMG-CoA to mevalonate (cholesterol precursor)
3. Hepatotoxic
29
name the three bile acid resisn
cholestyramine
colestipol
colesevelam
30
BILE ACID RESINS
use
mechanism
UDE
1. lowers LDL
2. prevents the intestinal absorption of bile acids so the liver has to use cholesterol to make more
3. decreased absorption of other drugs and fat soluble vitamins
31
EZETIMIBE
mechanism
use
UDE
1. stops cholesterol absorption in the small bowel
| 2. decreases LDL
32
3 fibrate drugs
gemfibrozil
bezafibrate
fenofibrate
33
FIBRATES
use
mechanism
ude
1. decreases TGs
2. upregulates LPL so increases the clearance of TG and activates PPAR-alpha to cause HDL synthesis
3. myopathy and cholesterol gallstones
34
NIACIN
use
mechanism
ude
1. increases HDL
2. stops hormone sensitive lipase and reduces VLDL synthesis
3. flushed face, hyperglycemia and hyperuricemia
35
DIGOXIN
mechanism
use
ude
1. inhibits the sodium potassium pump and also inhibits the sodium calcium pump so calcium increases in the cell and causes positive ionotropy
2. HF and atrial fib
3. hyperkalemia
36
antidote for digoxin
normalize k+ and give anti-digoxin Fab fragments
37
drugs that displace digoxin from binding to tissue binding sites
Verapamil
amiodarone
quinidine
38
Class 1A antiarrhytmics
names
mechanism
use
ude
1. Quinidine
2. Procainamide
3. Disopyramide
2. increase AP duration
3. atrial/ventricular arrhythmia
4. cinchonism (headache, tinnitus - quinidine) and HF (dysopyramide)
39
Class 1B
name
mechanism
use
ude
Lidocaine
Mexilitine
Phenytoin
1. decrease AP duration
2. post MI acute ventricular arrhythmia
3. CNS stimulation or depression and cardiac depression
40
Class 1C
name
mechanism
use
ude
Flecainide
Propefenone
1. prolongs ERP in AV node ad AP is normal
2. SVTs
3. contraindicated in structural and ischemic heart disease
41
Class 2 Antiarrhytmics BETA BLOCKERS
name
mechanism
use
ude
```
Metoprolol
propanolol
esmolou
atenolol
timolol
carvedilol
```
1. decreases SA and AV nodal activity by decreasing cAMP
2. SVT, flutter and fib
3. impotence
dyslipidemia (metoprolol)
vasospasm (propranolol)
42
treat B Blocker over dose with?
atropine
glucagon
saline
43
shortest acting B blocker
esmolol
44
Class 3 Antiarrhytmics (potassium blockers)
name
mechanism
use
ude
Amiodarone
Ibutilide
Dofetilide
Stall
1. increase AP and QT and ERP
2. atrial fib, flutter and v tach
3. stotalol-torsades de pointes
ibutilide - torsades de pointes
amiodarone - pulm fibrosis
45
cals 4 antiarrhytmics CALCIUM CHANNEL BLOCKERS
name
name
mechanism
use
ude
verapamil and diltiazem
1. decreases conductive velocity
2. prevent SVT
3. flushing and edema
46
ADENOSINE
mechanism
UDE
1. decreases cAMP and increases K out of the cell so hyper polarizes the cell
2. sense of impending doom
3
