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CVPR Drugs Flashcards

1
Q

Group 1 Antiarrhythmics

A
  • Sodium channel blockers
  • local anesthetics that prolong the QRS duration
  • divided into Groups 1A, 1B, 1C
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2
Q

Group 1A - Procainamide, quinidine, disopyramide, amiodarone

A
  • prolong the action potential
  • reduce phase 0 and 4 sodium currents
  • reduce phase 3 potassium current
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3
Q

Group 1B - lidocaine, mexiletine, phenytoin

A
  • most selective, have significant effects on sodium channels in depressed ischemic tissue
  • no effect of atrial tissue
  • phenytoin can be used to reduce digitalis-induced arrhythmias
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4
Q

Group 1C - Flecainide

A
  • no effect on ventricular AP duration or QT interval
  • powerful depressants of sodium current, slow conduction velocity in atrial and ventricular cells
  • increase QRS duration
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5
Q

Group 2 - Beta Blockers

A
  • Propanolol, esmolol, metoprolol, timolol
  • cardiac beta adrenoreceptor blockade and reduction in cAMP
  • AV node is sensitive to these and PR interval is prolonged
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6
Q

Group 3 - Dofetilide, ibutilide, sotalol, amiodarone

A
  • potassium blockers
  • prolong action potential duration caused by blockade of Ik channels
  • increase QT interval
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7
Q

Group 4 - Calcium L-type Channel Blockers

A
  • Verapamil, diltiazem
  • cause selective depression of calcium current, decrease AV conduction velocity, PR interval and refractory period is increased
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8
Q

Adenosine

A
  • when given in high doses as IV bolus, the drug slows or completely blocks conduction in the AV node by hyper-polarizing, and reducing calcium current
  • found naturally in body, low toxicity
  • short duration of action
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9
Q

Potassium ion

A
  • depresses ectopic pacemakers, caused by digitalis toxicity
  • hypokalemia=increased arrhythmia incidence
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10
Q

Magnesium ion

A
  • Mg appears to have similar depressant effects as potassium
  • also effective in some cases of torsades de pointes arrhythmia
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11
Q

Albuterol, terbutaline, metaproterenol

A
  • short acting B2 agonist
  • treat acute bronchospasm
  • last 3-4 hours
  • SE: hypokalemia, cardiac tachycardia, tachyphylaxis, hypoxaemia, NVD
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12
Q

Salmeterol, Formoterol

A
  • long acting Beta2 agonist
  • use for moderate/severe persistent asthma
  • lasts 12 hours
  • SE: hypokalemia, cardiac tachycardia, tachyphylaxis, NVD
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13
Q

Iprtropium bromide

A
  • inhalation treatment for COPD
  • muscarinic antagonist
  • inhibits bronchoconstriction, tracheobronchial secretions
  • use for asthma pts intolerant to B-agonists
  • SE: dry mouth, palpitations, constipation, blurry vision, hallucinations, tachycardia, issues with glaucoma
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14
Q

Zarfirlukast, montelukast

A
  • leukotriene receptor antagonist
  • inhibits CYP3A4 and CYP2C9 increased warfarin 1/2 life
  • mild/ moderate asthma
  • SE: eosinophilia, hepatotoxicity, infections
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15
Q

Ziluteon

A
  • inhibits 5-lipooxygenase
  • inhibits CYP3A4 and can influence metabolism of terfenadine, warfarin, theophylline
  • mild/moderate asthma
  • SE: hepatotoxicity
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16
Q

Theophylline

A
  • bronchodilator
  • blocks PDE, inhibits breakdown of cAMP and activity of adenosine receptors on bronchial smooth muscle cells
  • relieving and controller drug
  • SE: cortical arousal, stimulates secretion of gastric acid and digestive enzyme, hypokalemia, hyperglycemia, tachycardia
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17
Q

Roflumilast

A
  • PDE type 4 inhibitor
  • for severe COPD, controller drug
  • SE: tachycardia, not with pregnancy, depression, muscle spasm, avoid with CYP3A4 inhibitors
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18
Q

Methylprednisone, fluicasone, mometasone

A
  • corticosteroids
  • reduces bronchial reactivity, increases airway caliber
  • increases beta 2 receptors
  • inhibit cytokine production
  • SE: glucose intolerance, immunosuppressive, weight gain, increase by, throat thrush, oral hoarseness
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19
Q

Cromolyn sodium

A
  • only prophylactically
  • inhibit antigen and exercise induced asthma
  • no effect on airway smooth muscle tone
  • inhibits calcium influx into mast cells caused by cross linking of IgE on cell surface
  • Se: throat irritation, cough, bronchospasm, mouth dryness
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20
Q

Omalizumab

A
  • Anti IgE, inhibits binding of IgE to mast cells
  • long term reduces serum levels of free IgE
  • reduces magnitude of early and late bronchospasm
  • SE: anaphylaxis,
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21
Q

Epoprostenol, treprostinil, remodulin

A
  • prostanoids
  • PGI2 inhibits platelet activation and vasodilates
  • dosing never changes even if weight does
22
Q

Treprostinil, selexipag

A
  • oral prostacyclins

- antiplatelet and vasodilatory actions

23
Q

Bosentan, Ambrisentan, Macitentan

A

-ET1 levels are increased in PAH, these block ET1 receptor

24
Q

Sildenafil, Tadalafil

A

-PDE5 inhibitor - blocks the degradation action of PDE5 on cyclic GMP in smooth muscle cells resulting in vasodilation of the vessels

25
Riociguat
- Guanylate cyclase stimulator - synergistic with endogenous nitric oxide and directly stimulates guanylate cyclase - use for PAH and CTEPH
26
Acetazolamide
- carbonic anhydrase inhibitors - blocks NaHCO3 reabsorption - increase in urine pH, body pH decreases - use for: open angle glaucoma, urine alkalinization, metabolic alkalosis, acute mountain sickness, idiopathic intracranial hypertension - adverse: hyperchloremic metabolic acidosis, Ca3 stones, hyperammonemia, hypokalemia, sulfa allergy
27
Mannitol
- osmotic diuretics - IV admin, eliminated by renal excretion - use for: reduction of intracranial and intraocular pressure, increase in H2O excretion/maintain urine volume - toxicity: extracellular volume expansion, Hyponatremia, dehydration, hypernatremia, hyperkalemia
28
Furosemide, bumetanide, torsemide
- loop diuretics - blocks NKCC2 symporter, increases renal blood flow - use: edematous states, acute pulmonary edema, increase urine flow in renal failure, hypertensive emergencies, hypercalcemia, hyperkalemia - toxicity: ototoxicity, hypo-K,Ca,Mg, hyperglycemia, hyperlipidemia, dehydration, allergy, nephritis, gout (Ohh dang)
29
Hydrochlorothiazide, chlorthalidone, metolazone
- thiazide diuretics - increase NaCl excretion, decreases ability to dilute urine - use: hypertension (alone or with other agents), congestive heart failure, nephrolithiasis, osteoporosis, diabetes insipidus - decrease Ca excretion - toxicity: Hypo-Na,K, Mg, hyperglycemia, hyperlipidemia, allergy, impotence, gout
30
Spironolactone, amiloride
- potassium sparing diuretics - use: treat hypokalemia caused by other diuretics - toxicity: hyperkalemia, metabolic acidosis
31
Conivaptan
- ADH antagonist - use: Syndrome of inappropriate ADH secretion, CHF, AD Polycystic kidney disease - Toxicity: nephrogenic diabetes insipidus, dry mouth, thirst, polyuria
32
Metoprolol (for RAAS)
- beta blocker for renin release inhibition - use for heart failure, cardiomyopathy, coronary disease - side effects: bronchospasm, bradycardia, heart failure, sedation, sleep disturbance, depression, rebound hypertension, dyslipidemia, hypoglycemia
33
Aliskiren
- renin inhibitors - use for hypertension - side effects: teratogen, increase creatinine, hyperkalemia, hypotension
34
Captopril, enalapril, lisinopril
- ACE inhibitor - use: heart failure, hypertension, chronic kidney disease, diabetic nephropathy - side effects: cough, angioedema, teratogen, increase creatinine, hyperkalemia, hypotension
35
Losartan
- ARBs - use for heart failure, hypertension, chronic kidney disease, diabetic nephropathy - side effect: angioedema, teratogen, increase creatinine, hyperkalemia, hypotension
36
Spironolactone, eplerenone
- aldosterone antagonists - use for hyperaldosteronism (2nd to heart failure, renal disease, MI) - side effects: Increase potassium, gynecomastia, impotence and menstrual abnormalities
37
Amlodipine, clevidipine, nicardipine, nifedipine (dihydropyridines)
- act on vascular smooth muscle - block voltage-dependent L type calcium channels, decrease muscle contractility - use for hypertension, angina, Raynaud syndrome - adverse: peripheral edema, flushing, dizziness
38
Diltiazem, verapamil (non-dihydrapyridines)
- act on heart - block voltage-gated L-type calcium channels - use for hypertension, angina, atrial fibrillation/flutter - adverse: cardiac depression, AV block, hyperprolactinemia, constipation, gingival hyperplasia
39
Hydralazine
- increases cGMP, causes smooth muscle relaxation - use for severe (acute) HTN, HF, safe for pregnancy - adverse: tachycardia, fluid retention, headache, angina, SLE-like syndrome
40
Clevidipine, fenoldopam, labetalol, nicardipine, nitroprusside
-use to treat hypertensive emergency Nitroprusside: short acting, increase cGMP, can cause cyanide toxicity Fenoldopam: DA D1 receptor agonist, vasodilation, decreased BP, increase natriuresis, can cause hypotension and tachycardia
41
Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate
- vasodilation by increase NO in vascular smooth muscle - decrease preload, increase cGMP in smooth muscle - use for angina, acute coronary syndrome, pulmonary edema - adverse: reflex tachycardia, hypotension, headache, contraindicated in right ventricular infarction
42
What drug classes are used to treat primary hypertension?
Thiazide diuretics, ACE inhibitors, ATII receptor blockers (ARB), dihydropyridine, Ca2+ channel blockers
43
What drugs are used to treat HTN with heart failure?
Diuretics, ACE inhibitors/ARBs, beta blockers, aldosterone antagonists
44
What drugs treat hypertension with diabetes mellitus?
ACE inhibitors, ARBs, Ca2+ channel blockers, thiazide diuretics, beta blockers
45
What drugs treat hypertension with asthma?
ARBs, Ca2+ channel blockers, thiazide diuretics, selective beta blockers
46
What drugs treat hypertension in pregnancy?
Hydralazine, labetalol, methyldopa, nifedipine
47
Digoxin
- direct inhibition of Na/K ATPase - use for HF, atrial fibrillation, (decreased conduction AV node and depression of SA node) - adverse: cholinergic, arrhythmia, AV block, hyperkalemia
48
Ethacrynic acid
- Nonsulfonamide inhibitor of cotransport system (Na/K/2Cl) - use for pts allergic to sulfa, diuretic - more ototoxicity than furosemide
49
Diphenhydramine, dimenhydrinate, chlorpheniramine
- histamine H1 inhibitor, 1st gen - use for allergy, motion sickness, sleep aid - adverse: sedation, antimuscarinic, Anti alpha Adrenergic
50
Loratidine, fexofenadine, desloratadine, cetirizine
- reversible inhibitors of histamine receptors - use for allergy - less sedating than 1st gens, less entry into CNS
51
Theophylline
- bronchodilation by inhibiting phosphodiasterase - limited usage from narrow therapeutic window - cardiotoxicity and neurotoxicity - blocks action of adenosine

Drugs/Immuno (9 decks)

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