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CVS Flashcards

1
Q

Name of vasodilators ?

A

Na-nitroprusside
hydralazine
minoxidil
diazoxide
fenol-dopam

374

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2
Q

M/A of Na nitroprusside ?

A

Release NO + Direct stimulation to enzyme
= activate guanyl cyclase
= inc cAMP
= relax vascular smooth muscle
= dilate A & V
= dec PVR
= dec Venous return

375

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3
Q

classification of anti-anginal drugs ?

A

384

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4
Q

nitroglycerin drugs name ?

A

GTN
isosorbide di-nitrate
amyl nitrite

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5
Q

which nitroglycerin for unstable angina ?

A

GTN

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6
Q

which one for stable angina ?

A

Isosorbide di nitrate

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7
Q

which beta blocker in angina ?

A

propranolol
atenolol
metoprolol

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8
Q

which CCB in angina ?

A

cardio & vessel selectuve

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9
Q

adjuvent drugs in angina ?

A

anti-platelet & anti-coagulant

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10
Q

common anti-HTN + anti-angina ?

A

CCB + Beta blocker

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11
Q

how to avoid extensive 1st pass metabolism of GTN ?

A

sublingual / transdermally as patch disc / ointment

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12
Q

angina pain kemon ?

A

sudden severe stabbing agenising radiating to neck jaw thumb

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13
Q

main molecular action of salbutamol ?

A

2nd messenger activate kore

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14
Q

drug of choice in angina ?

A

organic nitrate

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15
Q

M/A of GTN ?

A

387

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16
Q

A/E of GTN ?

A

throbbing type of headache
postural hypotension
tachycardia
nitrate tolerance
inc ICP
pallor
dizziness
restlessness

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16
Q

feeling of throbbing headache ?

A

mathay haturi diye bari marar moto

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17
Q

actions of GTN ?

A

dec preload
dec afterload
inc coronary vasodilation

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18
Q

why throbbing headache?

A

streching of the pain sensitive tissue around the meningeal arteries resulting in inc pulsation and accompanies the local vasodilation

389

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18
Q

indication of organic nitrate ?

A

Angina
HF

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19
Q

Formulations of GTN ?

A

oral
parental
inhalation
suppository/ointment

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20
Q

what is nitrate intolrance ?

389

A

an atteenuation / total loss hemodynamic and anti-ischemic effects during continuous nitrate medication

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21
Q

how to prevent nitrate tolerance ?

A

it can be overcome by providing a daily nitrate free intervel to restore sensitivity to the drug
this intervel is typically 10-12 hrs usually at night

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22
Q

procedure of taking GTN ?

A

TO avoid postural hypotension
GTN should be taken in lying position
legs should be raised above the head to restore venous return

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23
Q

merits of using sublingual GTN ?

A

in case of throbbing headache – Pt - split out kore dibe

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24
Q

molecular mechanism of GTN ?

A

388

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24
Q

demerits of spray in Throbbing H ?

A

kichu korar nai
barbar ulcer korle - ulcer hote pare

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25
Q

can beta blokcer cause coronary perfusion ?

A

NO
they cannot cause coronary vasodilation

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26
Q

reflex tachycardia by GTN can be minimize by whichdrug ?

A

beta blocker

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27
Q

beta blockers in Angina M/A ?

A

binds with beta1 on heart
dec HR dec FOC
dec cardiac work
less O2 demand
releif on angina pain

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28
Q

CCB in angina ?

A

dec afterload

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29
Q

cardiac failure e heart er kon kon function impair hoy ?

A

venous pressure +
capillary filtration + = edema
cardiac output -
BP -
RBF -
renin +
angiotension 2 +
Na water retention +

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30
Q

drugs used in HF ?

A

397

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31
Q

Reduction of preload which drugs ?

A

diuretics
nitrates
SGLT-2 empagliflozin

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32
Q

both after & pre load reduction ?

A

ACEi
ARB
Beta blokcer
spironolcatione

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32
Q

reduction of afterload which drug ?

A

vasodilators

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33
Q

stimulation of myocardium which drugs ?

A

digoxin
digitoxin

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34
Q

reduction of heart rate ?

A

ivabradine

397

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34
Q

Digoxin toxicity when develops ?

A

serum D level >2ng/ml

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35
Q

Digoxin A/E ?

A

Anorexia
vomiting
gynecomastia
visual distrubance
color vision

cardiac - bradycardia AV conduction defect
ventricular fibrilation
bigeminy
trigeminy

403

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36
Q

which drugs increase HR ?

A

βœ… Ξ²-agonists: Epinephrine, Isoproterenol, Dobutamine
βœ… Anticholinergics: Atropine, Glycopyrrolate
βœ… Sympathomimetics: Ephedrine, Amphetamines
βœ… Phosphodiesterase Inhibitors: Milrinone, Theophylline
βœ… Calcium Channel Blockers (DHPs): Nifedipine, Amlodipine (reflex tachycardia)

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36
Q

most common sign of digoxin toxicity ?

A

βœ… GI symptoms (nausea, vomiting, anorexia) β†’ Most common early sign of digoxin toxicity.

@usmlereviews

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37
Q

which metabolic drugs dec HR ?

A

thyroxin
glucagon

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38
Q

digoxin HR baray naki komay ?

A

komay

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39
Q

which factors precipitate D T ?

A

hypokalemia
hypomagnesemia
hypercalcemia

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40
Q

management of digoxin toxicity ?

A

stop the drug
correct electrolyte imbalance
K supplement
anti-arrythmatic drug ?- phenytoin lidocain

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40
Q

Digoxin er sathe dibo kon drug ?

A

ACEi
ARB
spironolactone

41
Q

dibo na kon drug ?

A

K loosing diuretics
loop d
t diuretics
beta blokcers

41
Q

M/A of digoxin ?

42
Q

Digoxin + BEta blocker ???

A

more bradycardia
Heart block

43
Q

Digoxin + CCB ?

A

D toxicity

44
Q

ACEi effect on CCF ?

45
Q

Anti-arrhythmic drugs name ?

46
Q

which CCB in arthymia ?

A

verapamil
deltiazem

46
Q

which K channel blocker ,

A

amiodarone
dronedarone

47
Q

which Na channel blocker ?

A

quinidine
lidocaine

48
Q

In case of heart rate is increase , when i will call it tachycardia and when arrhythmia?

A

βœ… Tachycardia = HR >100 bpm (can be normal or abnormal)
βœ… Arrhythmia = Irregular or abnormal rhythm, may include tachycardia but also bradycardia, fibrillation, flutter, blocks

πŸ“Œ Example:
- Sinus tachycardia β†’ Normal rhythm, HR >100 bpm (fever, exercise, stress)
- Atrial fibrillation β†’ Arrhythmia (irregularly irregular rhythm, rapid HR)
- Ventricular tachycardia β†’ Both tachycardia & arrhythmia (abnormal rhythm + HR >100 bpm)

@usmlereviews

49
Q

which beta blockers ?

A

esmolo
stenolol
sotaolol
pindolol
propranolol

50
Q

in Arrhythmia HR bare naki kome ?

A

HR - irregular

51
Q

when postural hypotension in ACEi ?

A

initial dose

51
Q

what is arrythmia ??

A

βœ… Arrhythmia = Abnormal heart rhythm (irregular rate, conduction, or impulse formation).

52
Q

which beta blocker is used in angina ?

A

propranolol
atenolol

53
Q

what is corrected by digoxin in HF ?

A

respiratory distress
edema
tachycardia
cardiomegaly

54
Q

mechanical mechanism of digoxin ?
401

12-2-2025
11.28AM

A

inc cardiac contractility
inc CO
dec residual blood
dec diastolic pressure and size
dec cardiac congestion

enhance complete ventricular emptying = dec ventricular size

55
Q

Minoxidil use let alone HTN >

A

Vasodilation
alopecia

56
Q

is propranolol is given in a asthmatic and diabetic patient ?

A

🚫 Propranolol (Non-selective β-blocker) AVOID in:

βœ… Asthma β†’ Blocks Ξ²β‚‚, causes bronchospasm
βœ… Diabetes β†’ Masks hypoglycemia symptoms (blocks tremor, tachycardia)

πŸ“Œ Safer alternatives:
- Asthma β†’ Cardioselective β₁ blockers (Metoprolol, Atenolol)
- Diabetes β†’ Cardioselective β₁ blockers OR Ξ±/Ξ² blockers (Carvedilol)

@usmlereviews

57
Q

urine of diabetic nephropathy ?

A

βœ… Albuminuria (Early marker) β†’ Microalbuminuria (30-300 mg/day) β†’ Progresses to macroalbuminuria (>300 mg/day)
βœ… Glucose (if uncontrolled DM)
βœ… Kimmelstiel-Wilson nodules (histology, not urine)
βœ… Casts: Hyaline (early), Waxy, granular (late CKD)
βœ… Ξ²β‚‚-microglobulin, NAG enzyme (Tubular damage markers)

πŸ“Œ Dx: Urine albumin-to-creatinine ratio (UACR), 24h urine protein
πŸ“Œ Tx: ACEi/ARB (↓Proteinuria, slows progression)

@usmlereviews

58
Q

which one has larger half life ?

A

lisinopril

59
Q

how ACEi dec preload and afterload ?

A

no vasoconstriction = dec preload
bradykinin +++ ===== dec preload

aldosteroine -
no retention of Na & H2O
edema β€”
afterload β€”β€”β€”

60
Q

which drugs used in compensation of reflax tachycardia and postural hypotension ?

A

βœ… Drugs to compensate Reflex Tachycardia & Postural Hypotension:

πŸ“Œ For Reflex Tachycardia (due to vasodilation, e.g., DHP CCBs, nitrates):
- Ξ²-blockers (e.g., Metoprolol, Propranolol) β†’ ↓HR, ↓contractility
- Non-DHP CCBs (Verapamil, Diltiazem) β†’ ↓HR, ↓AV conduction

πŸ“Œ For Postural Hypotension (due to Ξ±-blockers, autonomic dysfunction):
- Fludrocortisone β†’ ↑Na⁺ retention, ↑BP
- Midodrine (α₁-agonist) β†’ Vasoconstriction, ↑BP
- Droxidopa (NE precursor) β†’ ↑BP in neurogenic hypotension

@usmlereviews

61
Q

advantages of sublingual GTN ?

A

rapid onset
avoid 1st pass metabolism
driect go to systemic circulation
short duration of action
highly lipid soluble
less chance of A./E
ASHORT duration of action

62
Q

vasoconstrictor drug name ?

A

Vasoconstrictors:

Phenylephrine

Norepinephrine

Epinephrine

Vasopressin (ADH)

Angiotensin II
63
Q

cardiotropic drugs name ?

A

Cardiotropic Drugs:

Digoxin

Dobutamine

Milrinone

Isoproterenol

Dopamine
64
Q

drugs that decrease HR ?>

A

Here are 5 drugs that decrease heart rate (negative chronotropes):

  1. Metoprolol (Beta-blocker)
  2. Atenolol (Beta-blocker)
  3. Diltiazem (Calcium channel blocker)
  4. Verapamil (Calcium channel blocker)
  5. Digoxin (Cardiac glycoside)

11.47AM

65
Q

ARB + Thiazide = ??

A

T = hypokalemia
ARB = hyperkalemia

T Antagonize the Hyperkalemic effects of ARB

66
Q

Pregnancy safe Anti-HTN ?

A

labetalol
alpha M D
hydralazine
atenolol
nifedipine

67
Q

minoxidil indication without HTN ?

68
Q

Nifedipine indication ?

A

🀰 + HTN
raynauds phenomenon

68
Q

CCF e CCB dibo kina ??

68
Q

Hydralazine & Na-N kon condition e dibo ?

69
Q

nimodipine indication ?

A

subarachnoid hemorrhage

70
Q

ARB in CCF ?

71
Q

why ARB&raquo_space; ACEi ?

A

ARB = no bradykinin + no dry cough

72
Q

anti-anginal beta blockers ?

A

Atenolol
metoprolol
propranolol

73
Q

which one commonly use ?

A

atenolol
metoprolol

74
Q

ACEi contraindication ?

A

hyperkalemia
renal failure
preganancy
bilateral renal artery stenosis
bronchial astham

75
Q

alpha methyl dopa - agonist tao BP komay kemne ??

A

receptor - brain e thake
but peripheral e kaj kore - Peripheral vasodialtion

76
Q

neprilysin function in ARNI ??

397

A

responsible for breaking ANP BNP CNP
reduce HTN & cardiac hypertrophy

77
Q

time intervel to reduce nitrate tolerance ?

A

10-12 hrs

389

78
Q

which drug is used now in CCF most commonly ?

A

angiotension receptor and neprilysin inhibitors
Sacubitril + Valsartan

79
Q

which CCB in arrhytmia ?

80
Q

non-cardiac use of beta blockers <

A

hyperthyroidism
pheochromocytoma
cushing disease
melenoma’
glaucoma
migraine
esophageal varices

81
Q

which beta blockers in migraine ?

A

propranolol
timolol
metoprolol

82
Q

indications of ACEi ?

83
Q

which beta blokcers in glaucoma?

A

timolol
betaxolol
carteolol

84
Q

maximum beta blokcer use in non-CVS is ?

A

propranolol

85
Q

Which beta blockers in DM ?

A

selective beta blockers

86
Q

why selective beta blockers in DM ?

280

A

DM htn pt - good
who are taking anti-DM drugs

87
Q

what is raynauds phenomenon ? is there vasoconstriction or vasodilation ? which drugs cause it ? by which drugs we can reduce it ?

A

🩸 Raynaud’s Phenomenon (RP)
Vasospastic disorder β†’ episodic vasoconstriction 🧊 in response to cold/stress β†’ ischemia of fingers/toes (white β†’ blue β†’ red).

πŸ“Œ Pathophys:
1️⃣ Vasoconstriction (white, ischemia) β†’ 2️⃣ Cyanosis (blue, deoxygenation) β†’ 3️⃣ Reperfusion (red, hyperemia).

πŸ’Š Drugs Causing RP:
- Ξ²-blockers (except carvedilol, nebivolol)
- Ergot alkaloids (migraine meds)
- Clonidine
- Cocaine, amphetamines
- Vinblastine, vincristine
- Interferons

πŸ’Š Tx (Vasodilation):
- CCBs (nifedipine, amlodipine)
- PDE-5 inhibitors (sildenafil)
- Ξ±-blockers (prazosin)
- Prostaglandins (iloprost)

@usmlereviews

88
Q

what is Digoxin ?

A

cardio glycoside + cardiotonic

89
Q

which type of arrythmia in Digoxin toxicity ??

A

⚑ Digoxin Toxicity β†’ Arrhythmias

πŸ“Œ Most Characteristic Arrhythmia:
- Atrial tachycardia + AV block (unique combo)

πŸ“Œ Other Arrhythmias:
- PVCs (earliest sign)
- Bidirectional VT (specific)
- Junctional tachycardia
- Slow AF (due to ↑ vagal tone)
- Sinus bradycardia

πŸ“Œ Mechanism:
- ↑ Vagal tone β†’ AV block
- ↑ Intracellular Ca²⁺ β†’ Triggered activity β†’ Ventricular arrhythmias

πŸ’‰ Antidote: Digoxin-specific Fab

@usmlereviews

90
Q

HTN + DM = ?

A

D + ACEi + ARB + CCB

91
Q

anti-anginal split out kokhon korba ?

A

throbbing headache

92
Q

emergency te kon preparation e anti-anginal ?

93
Q

why anti-anginal drug sublingual ?

94
Q

dhoro tomar throbbing headche + bukeo betha - tokhon ki split out korba anti-anginal drugs ??

A

πŸ“Œ Patient’s Dilemma:

Headache? β†’ Common SE, tolerance develops
Chest Pain? β†’ Possible angina relief

🚨 Advice?

DO NOT spit it out 🚫 β†’ Angina relief > headache discomfort
Manage headache: Lower dose, sit/lie down, hydration, acetaminophen
95
Q

indications of clonidine ?

A

HTN
used to minimize the symptoms that accompany withdrawal from -Opiates / BDZ

96
Q

drugs for raynauds phenomenon ?

A

nifedipine
reserpine
epoprostonol
prazosin

365

96
Q

HTN + angina
which CCB ?

96
Q

nimodipine dose <

A

60 mg
every 4 hours

364

96
Q

which CCB in 🀰?

A

nifedipine

97
Q

which CCB in subarachnoid hemoorhage ?

A

nimodipine

Pharmacology-PROF (37 decks)

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