CV pharm

Question 1

amlodipine moa

Answer 1

block voltage-dependent L-type calcium channels of cardiac and smooth muscle, thereby reduce muscle contractility

Question 2

dihydropyridine CCBs (drugs)

Answer 2

amlodipine, nifedipine, nimodipine

Question 3

non-dihydropyridine CCBs (drugs)

Answer 3

diltiazem and verapamil

Question 4

CCBs for vascular smooth muscle

Answer 4

amlodipine=nifedipine>diltiazem>verapamil

Question 5

CCBs for the heart

Answer 5

verapamil>diltiazem>amlodipine=nifedipine

Question 6

hydralazine MOA

Answer 6

increases cGMP, causing smooth muscle relaxation, vasodilates arterioles > veins; reduces afterload

Question 7

clinical use for dihydropyridines

Answer 7

hypertension, angina (including Prinzmetal), Raynaud phenomenon

Question 8

clinical use for non-dihydropyridine CCBs

Answer 8

hypertension, angina, atrial fibrillation/flutter

Question 9

clinical use for nimodipine

Answer 9

subarachnoid hemorrhage; prevents cerebral vasospasm

Question 10

clinical use for hydralazine

Answer 10

severe hypertension, CHF, first line therapy for HTN in pregnancy, with methyldopa; frequently coadministered with a beta-blocker to prevent reflex tachycardia

Question 11

hydralazine adverse effects

Answer 11

compensatory tachycardia (contraindicated in angina/CAD), fluid retention, nausea, headache, angina, lupus-like syndrome

Question 12

statin adverse effect

Answer 12

hepatotoxicity, rhabdomyolysis, esp when used with fibrates

Question 13

can cause cyanide toxicity

Answer 13

nitroprusside

Question 14

fenoldopam

Answer 14

D1 agonist; causes vasodilation; decreases BP and increases natriruesis

Question 15

statin moa

Answer 15

inhibits HGM-CoA reductase, blocking conversion of HMG-CoA to mevalonate, a cholesterol precursor

Question 16

Niacin moa

Answer 16

inhibits lipolysis in adipose tissue; reduces hepatic VLDL synthesis

Question 17

niacin adverse effects

Answer 17

flushing, decreased by aspirin or long term use
hyperglycemia + acanthosis nigricans
hyperuricemia - exacerbates gout

Question 18

bile acid resins adverse effects

Answer 18

decrease absorption of fat soluble vitamins, increase incidence of cholesterol gallstones

Question 19

ezetimibe moa

Answer 19

prevents cholesterol absorption in the brush border

Question 20

ezetimibe adverse effects

Answer 20

diarrhea; increase in LFTs

Question 21

fibrates moa

Answer 21

upregulate LPL, increasing TG clearance; activates PPAR-alpha to induce HDL synthesis

Question 22

fibrates adverse effects

Answer 22

myositis; increased risk with concurrent statin use, hepatotoxicity, increase in LFTs, cholesterol gallstones (esp. when used with bile resins)