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SUMPHARM > CVCAD - CVCAD > Flashcards

CVCAD - CVCAD Flashcards

1
Q

This drug stimulates cGMP activates guanylate cyclase, which INC intracellar cGMP that dephosporlates myosin. Myosin leaves the cell, Musle relaxes?

A

Nitrates on smooth muscle

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2
Q

What vessel do Nitroglycerin work on?

A

Veins

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3
Q

Do nitrates affect preload or afterload?

A

preload, dec. vein capacitance, dec. filling pressue, dec CO, dec O2 demand

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4
Q

Which forms of nitrate are short acting. 3-60min during w/ 1-3mn onset?

A

Nitroglycerin-IV, sublingual, transligual spray

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5
Q

Which long acting dosage are long term in nitrates?

A

Oral,SR,ointment, transdermal, Isosorbride monontiredd. ORAL- onset 20-60min, 2-24hr

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6
Q

What is differnce btwn short and long nitrates?

A

Abort-anginal episodes. Long term- prevent STABLE angina

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7
Q

If Angina persist, what to do?

A

Take NTG sublingual, if not better w/in 5min. Take another dose and call 911. Take every 5min for 15min

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8
Q

What is major SE of NTG?

A

Orthostatic hypertension, take sitting. Rebound tach, Headache

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9
Q

What is most important with administration of NTG?

A

Have 12-14hr breaks d/t tolerance. Don’t inhale. Keep dry

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10
Q

What is dose for Isosorbide monitrate?

A

Oral SR, 30-60mg QD

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11
Q

Which drugs are deadly interaction with Nitrates?

A

PDE5 inbitors, sildenafil, and ETOH. Sever hypotension

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12
Q

What binds to L-type calcium channel in cardiac and smooth msk, to dec calcium binding which, relaxes, reduces contractiliyt in heart, DEC sinus node, AV vode conduction?

A

Calcium Channel blockers

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13
Q

Which CCB agents have most affect on cardia msk, arrhythmias?

A

Diltazem, Verapimil-NON DIHYDROPYRIDINES-very vanila, red stripes

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14
Q

Which Dihydropyridine has smooth msk affect in migraine HA and Raynads?

A

Nifedipine

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15
Q

Which CCB affect cerebral arterial status. CVA, SAH?

A

Nicardipine, Verapamil

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16
Q

What is the most concerning with CCB ADR?

A

Reflex tachycardia. Other, yellow vision, peripheral edema-D, hypotension, constipation

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17
Q

Which CCB agents have dose around 2.5g-20mg QD

A

MC uses amlodipine, Felodipine

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18
Q

Which CCB agents have dose around 120-360 QD

A

Diltizem, Verapamil

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19
Q

Which CCB has DI with grapefruit juice?

A

Felodipine elevated.Aslo, erythromycin and cimetidine

20
Q

This agent will be INC if used with melatonin?

A

Nifedipine

21
Q

When compbined with ETOH this agent prolongs CNS Etoh induced side effects?

A

NO drinking with Verapamil. NO drinking and driving.

22
Q

These agents should be avoided with CCB non-dihyrdo?

A

Beta Blockers-INC hypotension, HMG Coa INC rhabdo. INCs DIGOXIN

23
Q

These agents inhibit Beta1 receptors in heart to lower BP, dec contractily, and dec HR- causing reduced CO?

A

Beta blockers

24
Q

What should be avoid in pt with asthma, COPD?

A

Beta blocker, will block SABagonist, cause contraction

25
Q

What other organ do BB work?

A

Lung, Eye- Dec IOP via dec. aqueous humor production

26
Q

Why is BB avoided in DM w/ inuslin or sulfureas?

A

Impairs recovery form hypoglycemia. SNS induce signs of hypoglycemia. w/o SNS will not know

27
Q

Why are lipids inc w/ BB?

A

Inhibit SNS stimulation of lipolysis

28
Q

What are BB main affect on treating angina?

A

DEC workload of heart, less O2 demand, improves filling of coronary aa, some survival

29
Q

Which med is most effective at dec angina episodes, nitrates, CCB, or BB?

A

BB! Gernerally 1st, No EVM, prevent silent ischemia. Dec mortiality for HTN, CHF, MI

30
Q

What BB are best for angina?

A

NPAM, nad, propan, aten, metopr.-olol,

31
Q

Which shold not be used for HTN?

A

Sot, Esm-olo

32
Q

If your pt has a migraine what my be a proplylaxis?

A

Propran- tim- PT

33
Q

What are ideal BB post MI?

A

T. PAM

34
Q

The ideal for HF?

A

M.C.B.

35
Q

What psycholocigal condtion can dec sysmptosm with BB?

A

Parkinsos, akathsia, GAD

36
Q

Which two agents have alpha effects where hydrostatic tension is a problem?

A

Carve and Lab- Labetaol both beta an alpha

37
Q

MC BB?

A

M.A. metop and aten-olol

38
Q

These drugs have high lipid solulbity which may affect depression, due to crossing of blood brain barrier?

A

Propranol and Carvediol.(Policical Correct Mood syndrome)

39
Q

Worsening bradycardia and agina w/ d/c, mask hypoclycemia, MDD, and DEC exercise tolerane are ADR of what Drug?

A

BB! Gernerally 1st

40
Q

What should be done to manage affect of clonidine if pt on BB?

A

Monitor BP. Discontine both gradually. BB 1st. NSAIDs dec BB. Avoid cocaine, ergot, sympatomimetics. NO BB and CCB together

41
Q

What is the dose for metopronol?

A

50-300 BID, high due to HIGH 1st pass, IV 5m x 3

42
Q

What is the does for propranol?

A

40-480 BID, high due to HIGH 1st pass, IV 1-3

43
Q

What is the does for carvedilol?

A

3-25mg BID, TID

44
Q

What is the does for atenolol?

A

25-100 BID

45
Q

Which agent is used for chronic agina, when nothing else work. Not for acute episode, reduces diastolic tension, reduce calcium entry, Prolongs QT, DI- Cy3A4, LIVER and Renal ADE, chewed?

A

Ranolzaline

46
Q

What are other antianginal diff from BB and CCB?

A

Ivabradine, Adensoine, Regadonos

47
Q

This drug affect the Na/Ca pump cardioselective BB?

A

Nebivolol

SUMPHARM (26 decks)

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