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Pharmacology > CVS > Flashcards

CVS Flashcards

1
Q

-
They act on……,…….,………

Their C.U are
1
2
3
4
5

Their s.e are
1.
2.
3.p

A

-Asetazolamide
-prozolamide
Act on PCT, CNS, eyes

C. U.
1 mild hypertension
2 glaucoma
3 acute mountain sickness
4 adjuvant therapy for epileptic
5 basic drugs

S. E.
1. Hypokalemia
2. Metabolic acidosis
3. Hypersensitive reaction ( Stephen Johnsons like syndrome)

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2
Q

Osmotic diuretics such as…………
Its s.e. is………….

A

Mannitol
Hyponatremia

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3
Q

Hypertension + >55 pt, we start treating him by……..
If not controlled use……….
And if not controlled use…….

A

CCB
ACEI
Diuretics

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4
Q

Hypertension +<55 pt start treating by…………. If not controlled use……….. And if not controlled use……….

A

ACEI
CCB
Diuretics

If also not controlled, it means that pt developed resistant hypertension, so we treat the cause

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5
Q

Hypertension + any Heart disease use………

A

Selective or Non-selective B-blockers

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6
Q

Hypertension + BPH use

A

a1-blockers( parzosin )

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7
Q

Only Hypertension without Diabetes or Heart disease use…….

A

Aliskiren and stop ACEI

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8
Q

Hypertension + Diabetes mellitus use
……

A

DOC is ACEI in adult and even eldery

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9
Q

Hypertension + asthmatic avoid…..

A

B-blockers

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10
Q

Isolated systolic hypertension (common in eldery) tt by :
1st line is…………….
2nd line is…………

A

1st. Dihydropyridine (second class of CCB)
2nd. Thiazide e.g. Clorthalidone and indapamide

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11
Q

Hypertension + hypokalemia (d.t. Cushing syndrome) tt by……

A

DOC is Spironolactone
2nd choice is ACEI or ARB

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12
Q

Hypertension + hypokalemia (d.t. Liddle’s syndrome) tt by…….

A

DOC is Amiloride or Triamlerene
2nd choice is ACEI or ARB

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13
Q

Hypertension + hyperkalemia tt by…..

A

Thiazide and loop diuretics

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14
Q

Preexisting hypertension in pregnancy is tt by………

A

a-methyl dopa

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15
Q

Gestational hypertension(no proteinuria) in pregnancy is tt by………..

A

Oral Labetolol

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16
Q

Pre-eclampsia hypertension( with proteinuria) in pregnancy is tt by……

A

Labetolol
Hydralazine
Nifedipine

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17
Q

Eclampsia hypertension (with proteinuria and seizures) is tt by……..

A

i.v MgSO4

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18
Q

Drug used in asthma abd break down of cGMP is

A

Caffeine

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19
Q

S.E of Sildenafil :

A

Hypotension (⬆️cGMP)
Reflex tachycardia
VISUAL DISTRIBUTION 🤔

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20
Q

Different between Pulm. embolism and MI is checked by……….

A

CTPA diagnostic test

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21
Q

ttt of pulm. arterial hypertension (remember 5 choices) :

A
  1. CCB (vascular selective) e.g amlodipine
  2. Phosphodiesterase enzyme 5 inhibitors e.g Sildenafil or tadalafil (s.e of Sildenafil are 3 look at card 18)
  3. Prostacycline derivatives (PGI2) e.g epoprostenol, treprostinil, iloprost (causing VD and Anti-platelet)
  4. Endothelin receptor blockers e.g Bosentan or ambrisentan
  5. Anticoagulant to prevent thrombosis
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22
Q

Pulmonary embolism is diagnosed by…….. But if pt has history of allergy to iodinated contrast media we diagnosed by……..

A

CTPA

V/Q SPECT

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23
Q

Thrombus of the heart caused by :
1.
2.
3.

A
  1. HF
  2. Cardiac arrhythmia
  3. Endocarditis
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24
Q

Ttt of pulmonary embolism is……….

A

Start with low molecular Heparin(e.g Fondaparinux or Enoxaparin) then maintain by Warfarin

We also give thrombolytics, fibrinolytics, plasminogen activators.

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25
Q

In case of MI, Stroke, pt use………for life.

In case of pulmonary embolism, pt use………for life

A

Aspirin

Warfarin

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26
Q

S.E of heparin :
1.
2.
3.

HIT is caused by :
1.
2.
3.

HIT is tt by :
1.
2.
3.

A
  1. bleeding
  2. Osteoporosis in long use
  3. HIT

HIT Caused by
1. Trauma
2. Covid-19
3. Trauma

Ttt of HIT
1. Stop heparin
2. Use direct thrombin inhibitors
3. Argatroban (anticoagulant for HIT)

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27
Q

Argatroban is used in

A

Ttt of HIT as anticoagulant

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28
Q

S.E of Warfarin :
1.
2.

A
  1. Bleeding
  2. Cerebral hemorrhage in large dose
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29
Q

Measure heparin by…..
Measure Warfarin by……

A

APTT
INR

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30
Q

Plasminogen activators are :(plase family)
1.
2.
3.

Thrombolytics are:(kinase family)
1.
2.

A
  1. Alteplase
  2. Reteplase
  3. Tenecteplase
  4. Urokinase
  5. Streptokinase
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31
Q

Never combined Sildenafil with Nitrate because they will l.t…………

A

Hypotensive shock

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32
Q

Never combined cardio selective CCB(verapamil, diltiazem) with B-blockers because they will l.t…….

A

Cardiac arrest

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33
Q

2ry causes of hypertension is pregnancy and renal disease (chronic RF or Renal stenosis)
Chronic RF is tt by…..
Renal stenosis is tt by…..

A

ACEI
Aspirin, statin & amlodipine

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34
Q

Pheochromocytoma is tt by…….

A

Phenoxybenzamine with propranolol or labetolol

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35
Q

Cushing syndrome (⬆️cortisol) is tt by
1.
2.

A
  1. Ketoconazole
  2. Metyrapone
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36
Q

Drugs that cause arrhythmia :
1.
2.
3.
4.

A
  1. 2nd generation antihistamines
  2. B1-agonist
  3. Indirect sympathomimetic( Qat, amphetamine and cocaine)
  4. Digoxin
  5. Erythromycin (metabolic inhibitor)
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37
Q

B2 presents in peripheral vessels, uterus and liver. (T or F)

A

T

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38
Q

Domperidone act as 5HT4……… And act also as D2 ……….

C.U of Domperidone :
1.
2.

A

Agonist
Antagonist
C.U is b
1. ⬆️ Gastric motility
2. Prevention of nausea and vomiting

n.b does not cross BBB

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39
Q

Na channel blockers:
A- prolonged AP such as :(amide suffex)
-
-
-

-
-

-

A

A
-disopyramide
-procainamide
-quinidine

B
- phenytoin (anti epileptic)
- lidocaine ( local anesthesia)
- mexiletine

C
-propafenone
-flecainide

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40
Q

-
-

A

Atenolol
Metoprolol
Bisoprolol

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41
Q

CHF AND ANGINA is tt by……… But in asthmatic pt we use…….

A

Selective B1-blockers

Ivabradine which block funny channels in SA node

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42
Q

HF is tt by :
. Bioprolol (T or F)
. Metoprolol (T or F)
. Carvedilol (T or F)

A

All are true

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43
Q

K channel blockers : (darone family)
.
.
.

A

. Amiodarone (contain 4% of iodine so it affect thyroid gland)
. Dronedarone
. Sotalol

They increase AP by ⬆️ ARP

44
Q

Nicornadil is K channel opener used in Angina (T or F)

A

T

45
Q

First and third class of CCB only used in ttt of arrhythmia, second is not used (T or F)

A

T

46
Q

Anti arrhythmia drugs :
1st.
2nd.
3rd.
4th.

Others :
.
.
.
.
.
.

A

1st. Na Channel blockers
2nd. Selective B1-blockers
3rd. K channel blockers
4th. CCB

Others
. Atropine
. Digoxin
. MG. Sulphate( in emergency)
. Adenosine
. K in some kinds of arrhythmia

47
Q

Paroxysmal Supraventricular tachycardia is tt by:
. DOC is……..
. In asthmatic pt we use…….. Instead of adenosine

A

Adenosine ( cause Bronchial construction)

Verapamil (not Nifedipine because it l.t reflex tachycardia)

48
Q

Incase of AV block we tt by……..

A

Asymptomatic (not tt)
Symptomatic ( use atropine or pacemaker)

49
Q

In case of Wolf Parkinson white syndrome (AV is fast d.t bundle of Kent) is tt by :
1st. DOC is………
2nd. DOC is……..

A

1st. Catheter ablation
2nd. Flecainide

50
Q

Thrombolytic drugs in case of MI should taken before 4 hours of MI starting, while in case of pulmonary embolism it should be taken before 12 of starting

A

True

51
Q

Fibrinolytics are :
1.
2.
3.
4.
5.

A
  1. Urokinase
  2. Streptokinase
  3. Alteplase
  4. Tretiplase
  5. Retiplase
52
Q

Urokinase and streptokinase antidote is………. &………..

A

Tranexamic acid & aminocaproic (snake venom)

53
Q

In case of tursades de point we use……

A

Mg. Sulphate

54
Q

Quinidine toxicity causes CINCHONISM (headache, tennitus, thrombocytopenia)…. T or F

A

True

55
Q

Ttt of vent. Tachycardia :
1st choice is…………..
2nd choice is…………..
Prophylactic drugs such as…..

S.E of amiodarone :
1.
2.
3.
So that we give pt………….to prevent s.e of amiodarone.

A

Amiodarone
Lidocaine (used as local anesthetic)
Sotalol

  1. Photosensitivity
  2. Pulmonary fibrosis
  3. Hyper or hypothyroidism

We give dronedarone

56
Q

Atrial fibrillation and atrial flutter are tt by :

Eldery pt :
Use…………. +……………
Adult pt :
1st choice is………… +………… If pt without heart disease
2nd choice is………… +……….. If pt with heart disease (e.g. MI)

A

Selective B-blockers ( bisoprolol, Atenolol, Metoprolol) + anticoagulant
If asthmatic pt DOC is IVABRADINE

Flecainide + anticoagulant

Amiodarone + anticoagulant

57
Q

Embolism that may be formed in atrium during atrial fibrillation or flutter will l.t
. MI
. Stroke
. Peripheral Ischemic disease

A

True

58
Q

Ectopic foci are usually asymptomatic, so we don’t tt, but If was Symptomatic we tt by……….

A

B-blockers

59
Q

Drugs that can lead to torsade de point :
.
.
.
.
.
.
.

A

. 1st and 3rd class of anti arrhythmic drugs
. 2nd generation antihistamines (also ketotifen)
. Amiodarone
. Erythromycin
. Domperidone
. Anti-psychotic drugs (phenothiazine)
. Anti-depressants drugs

60
Q

Atrial fibrillation + HF is tt by………
Atrial fibrillation + MI is tt by……….

A

Digoxin
Amiodarone

61
Q

Mg. Sulphate uses:
1.
2.
3.
4.
5.

A
  1. Torsade de point
  2. Severe asthma
  3. Antacids MgOH
  4. Laxative
  5. Eclampsia
62
Q

Vent. Fibrillation is tt by
1………… Very fast
2…………
3…………

A
  1. Mg. Sulphate بسرعة
  2. De flutter
  3. De fibrillation
63
Q

Stable angina occurs d.t………
Unstable angina occurs d.t……….
Vasospastic angina occurs d.t……….

A

Atherosclerosis
Embolism
VC of coronary artery

64
Q

Ttt of angina :

  1. ⬇️ Cardiac work drugs such as :
    - B-blockers (selective & Non-selective)
    - CCB (heart selective e.g verapamil)
  2. ⬆️ O2 supply (VD) such as :
    - CCB (vascular selective)
    - Nitrates
    - new drugs e.g Nicornadil
  3. Adjuvant therapy
A

All are true

65
Q

Ex of Nitrates include…………and………
They act by ⬆️ cGMP

Their s.e :
.
.
.
.

A

Nitroglycerin and isosorbide dinitrate

S.E :
. Hypotension
. Reflex tachycardia
. Headache
. Flushing
. TOLERANCE
. methemoglobinemia

66
Q

Nitroglycerin is used for ttt of…………

A

Acute angina only

67
Q

Isosorbide dinitrate is used for ttt of………

A

Resistant chronic angina as the last line of defense against chronic angina

68
Q

Ttt of methemoglobinemia by………..and…………

A

Vit. C and methylene blue

69
Q

Nicorandil used in ttt of………..

Its s.e :
.
.
.

A

Resistant chronic angina

S.E
. Hypotension
. Reflex tachycardia
. Oral and anal ulcer (same behcet’s disease)

70
Q

Mechanism of action of nicorandil drug is :
1.
2.

A
  1. K channel opener (on vascular sm.m of peripheral and coronary arteries)
  2. Nitrate like action
71
Q

Types of Adjuvant therapy of angina
1. Anticoagulant /antiplatelet e.g :
-
-
2. Anti-hyperlipidemia e.g :
-
-

A
  • anticoagulant (Warfarin and heparin)
    -antiplatelet (Aspirin and clopidogrel)

-statin
-fibrates

72
Q

Aspirin and clopidogrel are antiplatelet (T or F)

A

True

73
Q

Ttt of acute angina depends on……….

A

Nitroglycerin

74
Q

In case of Vasospastic angina, we avoid………..and instead we use……….as DOC.

A

B-blockers( especially Non-selective which found in coronary artery)

CCB (vascular selective)

75
Q

Ttt of chronic angina depends on……..,…………. &……..

A

⬇️ Cardiac work
Vasodilators
Adjuvant therapy

76
Q

Clinical uses of Nitrates :
.
.
.
.

A

. Angina
. Cyanide POISONING (using amyl Nitrate)
. MI
. Acute HF

77
Q

Ttt of cyanide poisoning :

  1. Hydroxycobalamine
  2. Nitrate
  3. Na thiosulphate
  4. Vit. C and methylene blue
A

All are true

78
Q

Ttt of MI :
1st line : give Aspirin
2nd line :
- morphine for pain
- meteclopramide or ondansetron for nausea and vomiting
- thrombolytic drugs if MI was not pass more than 12 hours
- anti anginal drugs (nitroglycerin)
- CCB and B-blockers

A

All are true

79
Q

Acute heart failure is tt by…………if pt doesn’t have another problem. But if pt have RF, we tt by………..

If dobutamine is not give benifit, we use………instead of it.

A
  • dobutamine
  • dopamine
  • Adrenaline
80
Q

Chronic heart failure is tt firstly by………which ⬇️ preload and afterload, then give……………which ⬇️ afterload and finally give…………..which ⬇️ preload.

A

ACEI / ARB

B-blockers

K sparing diuretics (Spironolactone)

81
Q

In ttt of HF by ACEI, if resistant appears to them, we give ARB with……… Which inhibits neprilysin enzyme

A

Sacubitril

82
Q

In ttt of HF by B-blockers, if resistant appears, we give…………orally which is funny channel blockers

A

Ivabradine

Its s.e :
⬇️ Visual acuity
Severs bradycardia

83
Q

Digoxin is positive inotropic and negative chronotropic (T or F)

S.E of it :
.
.
.
.

Management of s.e by :
.
.
.

A

True

S.E
. Low dose : bradycardia and hypotension
. Large dose : TACHYARRHYTHMIA
. Convulsions
. Headache
. GIT disturbances

Management :
. KCL (it inh. influx of calcium)
. Lidocaine (prevent TACHYARRHYTHMIA)
. Antidote for digoxin

84
Q

TACHYARRHYTHMIA is prevented by…………..

A

Lidocaine or diltiazem

85
Q

The most common type of shock is……………and caused by………,………,……….. But it tt by :
1.
2.
3.

A

Hypovolemic shock

Caused by burn, hemorrhage, diarrhea and vomiting.

Tt by
1. Ringer’s solution
2. Normal saline
3. Blood transfusion

86
Q

Cardiogenic shock caused by :
.
.
.
.

Ttt by :
1.
2.
3.

A

. MI
. Cardiac temponade
. Vent fibrillation
. Arrhythmia

Ttt:
Dobutamine
Dopamine
Adrenaline

87
Q

Cardiac temponade is tt by :

A

1- Surgical (aspiration)
2- Drugs:
- NSAIDs
- Colchicine
- Corticosteroids

88
Q

Endocrine shock is tt by………..

A

Hydrocortisone

89
Q

Anaphylactic shock is tt by :
1.
2.
3.

A
  1. Adrenaline
  2. Chlorpheniramine
  3. Hydrocortisone
90
Q

Ttt of mild disruptive shock is……….
Ttt of severe disruptive (vascular) shock is………..and……..

A

. Midodrine

. Phenylephrine and adrenaline

91
Q

Septic shock is tt by……….

A

Antimicrobial drugs

92
Q

Neurogenic shock is tt by……….

A

Vasoconstrictor drugs

93
Q

Types of stroke :
. Ischemic
. Hemorrhagic

A

All are true

94
Q

Stroke + hypertension tt by :
A.
B.
C.

A

A. Labetalol
B. Nifedipine
C. Na - nitroprusside ( a. and v. dilation)

95
Q

In subarachidonic hemorrhage, we use………….drug.

A

Nimodipine

96
Q

Colchicine act to prevent WBC from reaching site of information (T or F)

Colchicine uses :
1.
2.
3.
4.

A

True

  1. Gout
  2. Pseudogout
  3. Familial Mediterranean Fever
  4. Pericarditis
97
Q

Ttt of endocarditis :
1- Streptococcal endocarditis tt by………..+………..
2- Staphylococcal endocarditis with native valve tt by………………….
3- Staphylococcal endocarditis with synthetic valve tt by……………+……………+………….

A

. Amoxicilin + Gentamicin
. Flucloxacillin (cloxacilin, oxacillin, dicloxacilin)
. Rifampin + Vancomycin + gentamicin

98
Q

………….acting as false catecholamine

A

Methyldopa

99
Q

Ttt of rheumatic heart fever :

A. Antibiotics :
-………………or…………….. And if recurrent, use benzathine pencilline every month for prophylaxis

B. Analgesics :
- Aspirin (if pt improves, this indicates arthritis)
- prednisolone (if pt not improved by Aspirin)

A

Benzathine pencilline or benzomethyl pencilline

100
Q

Malignant hypertension is tt by…..

A

Na-nitroprusside

101
Q

C.U of verapamil :

A

Arrhythmia
Angina
Hypertension + arrhythmia
Hypertension + angina

Not used in HF

102
Q

Prophylactic for cluster headache is…..
Prophylactic for migraine is…….

A

Verapamil

Propranolol

103
Q

C.U of dihydropyridine :
Its s.e :

A

Angina and hypertension

Not used in arrhythmia

S.E
Gingival hyperplasia
Ankle edema
Others

104
Q

C.U of diltiazem :

A

TACHYARRHYTHMIA
Topically for anal fissures

105
Q

Resistant essential hypertension is tt by…..

Its s.e :
1.
2.
3.
4.

A

Aliskiren
S.E:
1. Hypotension
2. Hyperkalemia
3. TERATOGENIC
4. angioedema

106
Q

C. U of ACEI :
1.
2.
3.

A
  1. Hypertension
  2. Diabetic nephropathy
  3. Heart failure (DOC)

Pharmacology (7 decks)

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