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AA_USMLE_First Aid & Qbank > CV_Pharm > Flashcards

CV_Pharm Flashcards

1
Q

Essential Hypertension - Tx?

A
  • Diuretics
  • ACE inhibitors
  • Angiotensin II Receptor Blockers (ARBs)
  • Calcium channel blockers
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2
Q

CHF - Tx?

A
  • Diuretics
  • ACE inhibitors/ARBs
  • β-blockers (compensated CHF)
  • K+ sparing diuetics

(β-blockers must be used cautiously in decompensated CHF, & are contraindicated in cardiogenic shock)

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3
Q

Diabetes Mellitus - Tx?

A
  • ACE inhibitors / ARBs
  • Calcium channel blockers
  • Diuretics
  • β-blockers
  • α- blockers
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4
Q

4 Calcium channel blockers?

A

Nifedipine, Verapamil, Diltiazem, & Amlodipine

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5
Q

CC-blockers - MOA?

A

Block voltage-dependent L-type calcium channels of cardiac & smooth muscle & thereby reduce muscle contractility

Vascular SM – Amlodipine = Nifedipine > Diltiazem > Verapamil

Heart – Verapamil > Diltiazem > Amlodipine = Nifedipine
(Verapamil = Ventricles)

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6
Q

CC-blockers - Clinical uses?

A
  • Hypertension
  • Angina
  • Arrhythmias (not nifedipine)
  • Prinzmetal’s angina
  • Raynaud’s
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7
Q

CC-blockers - Toxicity?

A
  • Cardiac depression
  • AV block
  • Peripheral edema
  • Flushing
  • Dizziness
  • Constipation
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8
Q

Hydralazine - MOA?

A
  • ↑cGMP → smooth muscle relaxation
  • Vasodilates arterioles > veins
  • Afterload reduction
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9
Q

Hydralazine - Clinical uses?

A
  • Severe hypertension
  • CHF
  • First-line therapy for hypertension in pregnancy, w/ methyldopa
  • Frequently co-administered w/ a β-blocker to prevent reflex tachycardia
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10
Q

Hydralazine - Toxicity?

A

Compensatory tachycardia (contraindicated in angina/CAD)

  • Fluid retention
  • Nausea
  • Headache
  • Angina
  • Lupus-like syndrome
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11
Q

Commonly used drugs for Malignant Hypertension?

A

Nitroprusside, Nicardipine, Clevidipine, Labetalol, & Fenoldopam

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12
Q

Nitroprusside - MOA?

A

↑cGMP via direct release of NO

short-acting

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13
Q

Nitroprusside - Toxicity?

A

Can cause cyanide toxicity (releases cyanide)

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14
Q

Fenoldopam - MOA?

A
  • Dopamine D1 receptor agonist – coronary, peripheral, renal, & splanchnic vasodilation
  • ↓BP
  • ↑Natriuresis
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15
Q

Nitroglycerin - MOA?

A
  • Vasodilate by releasing nitric oxide in smooth muscle, causing ↑ in cGMP & smooth muscle relaxation
  • Dilate veins&raquo_space; arteries
  • ↓ preload
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16
Q

Nitroglycerin - Clinical uses?

A
  • Angina

- Pulmonary Edema

17
Q

Nitroglycerin - Toxicity?

A
  • Reflex tachycardia
  • Hypotension
  • Flushing
  • Headache
  • “Monday disease” in industrial exposure: development of tolerance for the vasodilating action during the work week & loss of tolerance over the weekend results in tachycardia, dizziness & headache upon re-exposure
18
Q

Goal of anti-anginal therapy?

A

Reduction of myocardial O2 consumption (MVO2) by decreasing 1 or more of the determinants of MVO2:

  • end-diastolic volume
  • blood pressure
  • heart rate
  • contractility
  • ejection time
19
Q

Which of the calcium-channel blockers is most similar to Nitrates?
Which is most similar to β-blockers?

A

Nitrates = Nifedipine

β-blockers = Verapamil

20
Q

3 Class 1A anti-arrhythmic drugs?

Effect on AP duration?

A

Quinidine, Procainamide, Disopyramide

↑ AP duration

(also ↑ QT interval)

“A Queen Proclaims Diso’s pyramid”

21
Q

3 Class 1B anti-arrhythmic drugs?

Effect on AP duration?

A

Lidocaine, Mexiletine, Tocainide

↓ AP duration

“I’d Buy Leyla’s Mexican Tacos”

also: “IB is Best post-MI”

22
Q

2 Class 1C anti-arrhythmic drugs?

Effect on AP duration?

A

Flecainide, Propafenone

No effect on AP duration

“IC is Contraindicated in structural heart disease & post-MI”

23
Q

List the Class 1 anti-arrhythmics groups in order of sodium-channel binding strengths (A, B, & C)

A

1C > 1A > 1B

(this is why 1C anti-arrhythmics exhibit use-dependence & build up their effect in tachyarrhythmias – but over time this can cause too great a delay in conduction speed, eventually promoting a new arrhythmia)

(1B have less affinity for sodium receptors & are more selective for ischemic myocardium — thus useful post-MI)

24
Q

Which Class 1 anti-arrhythmic groups demonstrate the most & least use dependence?

A

1C = Most use dependence

1B = Least use dependence

AA_USMLE_First Aid & Qbank (22 decks)

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