CV2 Pharm Table Flashcards
what is the Drug class of Procainamide
Class 1A-arrythmic Na Channel blockade
what are the indications of Procainamide
Life threatening ventricular arrhythmias
What are the MOA of Procainamide
Decreases myocardial excitability and conduction velocity and may depress myocardial contractility, by increasing the electrical stimulation threshold of ventricle, His-Purkinje system and through direct cardiac effects (UtD)
Drug class of Lidocaine
Class 1B arrythmic Na Channel blockade
Indications of Lidocaine
Suppression of existing ventricular arrhythmias
MOA of Lidocaine
blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane’s permeability to sodium ions, suppresses automaticity of conduction tissue, by increasing electrical stimulation threshold of ventricle, His-Purkinje system, and spontaneous depolarization of the ventricles during diastole (UtD)
Drug class of Flecainide
Class 1C Na Channel
indications of Flecainide
ventricular arrhythmias (prevention); paroxsysmal SVT (prevention); paroxsysmal a fib/flutter
MOA of Flecainide
slows conduction in cardiac tissue by altering transport of ions across cell membranes; causes slight prolongation of refractory periods; increases electrical stimulation threshold of ventricle, His-Purkinje system (UtD)
Drug class of Propranolol
Class 2 Beta Blockers Nonselective (B1; B2) -or- Sympatholytics: Peripheral Adrenergic ‘R’ Blockers – Beta Blocker
Indications of Propranolol
Angina, HTN, tachyarrhythmias, essential tremor, migraine Px, anxiety
MOA of Propranolol
Adrenergic B1 and B2 receptor inhibitor; reduction in myocardial oxygen demand, HR, cardiac contractility, BP
Drug class of Metoprolol Tartrate
[Lopressor]
Metoprolol Succinate
[Toprol XL]
Beta Blockers Cardioselective (B1) Class II -or- Sympatholytics: Peripheral Adrenergic ‘R’ Blockers – Beta Blockers
Indications of Metoprolol Tartrate
[Lopressor]
Metoprolol Succinate
[Toprol XL]
Angina, HTN, hemodynamically stable MI
MOA of Metoprolol Tartrate
[Lopressor]
Metoprolol Succinate
[Toprol XL]
Selective B1 adrenergic receptor inhibitor
Drug class of Atenolol
Beta Blockers Cardioselective without ISA (B1) Class II -or- Sympatholytics: Peripheral Adrenergic ‘R’ Blockers – Beta Blockers
Atenolol indications
- Angina
- HTN
- hemodynamically stable post-MI supraventricular tachyarrhythmias (catecholamine induced, dig toxicity)
MOA of Atenolol
B1 adrenergic receptor inhibitor
Drug class of Amiodarone
Class 3
Repolarization delay
indications of Amiodarone (5)
- life-threatening recurrent VF
- unresponsive or unstable VT refractory to other anti-arrhythmics
- Off-label for AF
- PSVT
- adjunct to ICD to suppress ventricular tachyarrhythmias in otherwise optimally treated patients with heart failure
MOA of Amiodarone
inhibits adrenergic stimulation (alpha and beta) affecting Na, K, and Ca channels; prolongs action potential and refractory period in cardiac tissues; decr AV conduction and sinus node function
Drug class of Verapamil and Diltiazem
Class 4
Calcium channel Blockers
Nondihydropyridine
Indications of Verapamil and Diltiazem (5)
Angina, HTN, PSVT, A fib, A flutter
MOA of Verapamil and Diltiazem
Dilate coronary arteries & decrease myocardial oxygen demands
Drug class of Adenosine
Naturally occuring nucleoside
Indication of Adenosine
new arrhythmias, chest pain, headache, flushing, dyspnea, bronchospasm
MOA of Adenosine
In PSVT: Slows conduction time through the AV node, interrupting the re-entry pathways through the AV node, restoring normal sinus rhythm; In Stress testing: causes coronary vasodilation and increases blood flow in normal coronary arteries with little to no increase in stenotic coronary arteries
Drug class of Digoxin
Other:
Cardiac Glycoside
indications of Digoxin
- Mild to moderate HF;
2. A fib rate control
MOA of Digoxin
Inhibits Na/K ATPase pump in myocardial cells promoting influx Ca++ leading to increased contractility; also direct suppressor of AV node which decr ventricular rate
Drug class of Mg SO4 (IV)
electrolyte
indications of Drug class of Mg SO4 (IV)
Digitalis induced arrhythmias with low serum Mg; low Mg induced arrhythmias (VF, VT); OFF-LABEL: torsades de pointes; (Severe exacerbation asthma in children)
MOA of Mg SO4 (IV)
unknown
Drug class of Prazosin
alpha-blockers
Indications of Prazosin
hypertension;
off-label for PTSD, Raynaud’s Phenomenon
MOA of Prazosin
selective alpha 1 blocker which relaxes smooth muscle in arteries and veins and the prostate
Drug class of Carvedilol
B1, B2, A1 Blockers
indications of Carvedilol
angina (off-label),
HTN,
stable HF,
stable post-MI
MOA of Carvedilol
Mixed alpha, beta receptor inhibition
drug class of Clonidine
Centrally Acting
A2 agonist
Indications of Clonidine
- Hypertension (immediate release form),
- ADHD (extended release form); 3. Narcotic addiction;
- multiple off-label uses
MOA of Clonidine
stimulates alpha 2 receptors in brain stem, which stimulates an inhibitory neuron resulting in reduced sympathetic outflow from CNS, which results in a reduction in TPR
Drug class of Methyldopa
Centrally Acting
A2 agonist
Indications of Methyldopa
HTN in PG
MOA of Methyldopa
central alpha-adrenergic inhibition decr sym outflow to heart, kidneys, periph vasculature
What are the three Renin-Angiotnesin Inhibitors:
ACE I
Captopril
Lisinopril
Fosinopril
Indications of Captopril
Lisinopril
Fosinopril
- Hypertension
- heart failure
- left ventricular dysfunction after MI
- diabetic nephropathy
MOA of Captopril
Lisinopril
Fosinopril
Competitive inhibitor of ACE preventing conversion Angiotensin I to Angiotensin II decreasing vasoconstriction by Angiotensin II & decreases aldosterone secretion
Drug class of Losartan
Angiotensin Receptor Blockers:
ARBs
Indications of Losartan
- Hypertension
- diabetic nephropathy in T2DM
- stroke risk reduction in HTN
- LVH
MOA of Losartan
Selectively & competitively blocks AT 1 (1000x greater) & AT2 receptors
Drug class of Aliskirin
Direct Renin Inhibitor
Indications of Aliskirin
Hypertension
MOA of Aliskirin
Direct renin inhibitor preventing conversion of angiotensinogen to angiotensin I (AT1) which reduces conversion to angiotensin II (AT2) producing arteriolar vasodilation
which two drugs are Vasodilators:
DHP CCBs
- DHP: Amlodipine
2. DHP: Nifedipine
Indications of
DHP: Amlodipine
-and-
DHP: Nifedipine
- Angina (chronic stable and vasospastic)
2. HTN
MOA of
DHP: Amlodipine
-and-
DHP: Nifedipine
Vasodilation due to blocking calcium channels in vascular smooth muscle and myocardium
2 drugs that are
Vasodilators: NDHP CCBs
- NDHP: Diltiazem
2. NDHP: Verapamil
Indications of
NDHP: Diltiazem
-and-
NDHP: Verapamil
- Angina,
- HTN,
- PSVT,
- A fib,
- A flutter
MOA of
NDHP: Diltiazem
-and-
NDHP: Verapamil
Dilate coronary arteries & decrease myocardial oxygen demands
Drug class of Hydralazine
Vasodilators: Direct acting
Indications of Hydralazine
- Urgent to Emergent BP reduction (no longer used for chronic therapy due to short half-life)
- pre-eclampsia/eclampsia
MOA of Hydralazine
Direct acting arteriolar vasodilator
Drug class of Hydrochlorothiazide HCTZ
Diuretics: Thiazides
Indications of Hydrochlorothiazide
HCTZ
- HTN
- edema in nephrotic syndrome
- Off-label: Lithium induced diabetes insipidus
MOA of Hydrochlorothiazide
HCTZ
Na-Cl symporter inhibition in the DCT increasing Na and Cl excretion max 5% of filtered NaCl
what is the drug class of Chlorthalidone
Diuretic “Thiazide-Like”
what are the indications of Chlorthalidone
- HTN
- edema in nephrotic syndrome
- off-label: Lithium induced diabetes insipidus
what is the MOA of Chlorthalidone
Na-Cl symporter inhibition in the DCT increasing Na and Cl excretion max 5% of filtered NaCl
what is the drug class of Triamterene
Diuretic Adjunct: K+ Sparing
what are the indications of Triamterene
Hypokalemia
what is the MOA of Triamterene
Direct inhibitor of Na+ influx in DCT & CCT
What is the drug class of Furosemide
Loop Diuretic
what are the indications of Furosemide
- Edema sec to CHF
- Renal Failure
- Liver Failure
what is the MOA of Furosemide
Na+-K+-2Cl- symporter in TAL of Loop & distal tubule
What are the 6 drugs under the drug class HMG-CoA Reductase Inhibitors
- Atorvastatin
- Lovastatin
- Pravastatin
- Rosuvastatin
- Simvastatin
- Fluvastatin
What are the indications of the HMG-CoA Reductase Inhibitors
Hyperlipidemia
what is the MOA of HMG-CoA Reductase Inhibitors
Inhibits cholesterol synthesis
What are the drug under the class Bile-acid sequestrants
- Cholestyramine
2. Colesevelam
what is the MOA of
- Cholestyramine
- Colesevelam
Binds bile acids inhibiting enterohepatic circulation of cholesterol
what are the indictions of Cholestyramine
Hypercholesterolemia
what are the indications of Colesevelam
- LDL reduction
- DM2
- usually adjunct
What are the 2 drugs under the Fibric Acids
- Gemfibrazil
2. Fenofibrate
What are the indications of Gemfibrazil and Fenofibrate
- Hypertriglyceridemia
2. low HDL
what is the MOA of Gemfibrazil and Fenofibrate
Not known; theories on changes in various enzymes involved in VLDL and IDL metabolism
What is the drug class of Niacin
Nicotinic Acid Vitamin B3
What are the indications of Niacin
- Hypertriglyceridemia
- low HDL
- high LDL
What is the MOA of Niacin
Inhibits fatty acid release from adipose tissue and hepatic trig production
What is the drug class of Exetimibe
Cholesterol Absorption Inhibitor
What are the indications of Exetimibe
Hypercholesterolemia
What is the MOA of Exetimibe
Decreases absorption of cholesterol from GI tract
What is the drug class of Omega 3 Fatty Acids
other
What are the indications of Omega 3 Fatty Acids
- high Trig despite diet
- alcohol restriction
- fibrates
What is the MOA of Omega 3 Fatty Acids
unknown
what is the drug class of Evolocumab
PCSK9 Inhibitor
what are the indications of Evolocumab
- drug resistant hyperlidemia
2. especially homozygous familial hypercholesterolemia
what is the MOA of Evolocumab
human monoclonal antibody that binds to proprotein convertase subtilisin kexin type 9 (PCSK9) inhibiting the degradation of LDLR; this increases the number of LDLRs available to clear LDL from the blood, thereby lowering LDL-C levels.