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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
merits of using sublingual GTN ?
in case of throbbing headache -- Pt - split out kore dibe
24
molecular mechanism of GTN ?
388
24
demerits of spray in Throbbing H ?
kichu korar nai barbar ulcer korle - ulcer hote pare
25
can beta blokcer cause coronary perfusion ?
NO they cannot cause coronary vasodilation
26
reflex tachycardia by GTN can be minimize by whichdrug ?
beta blocker
27
beta blockers in Angina M/A ?
binds with beta1 on heart dec HR dec FOC dec cardiac work less O2 demand releif on angina pain
28
CCB in angina ?
dec afterload
29
cardiac failure e heart er kon kon function impair hoy ?
venous pressure + capillary filtration + = edema cardiac output - BP - RBF - renin + angiotension 2 + Na water retention +
30
drugs used in HF ?
397
31
Reduction of preload which drugs ?
diuretics nitrates SGLT-2 empagliflozin
32
both after & pre load reduction ?
ACEi ARB Beta blokcer spironolcatione
32
reduction of afterload which drug ?
vasodilators
33
stimulation of myocardium which drugs ?
digoxin digitoxin
34
reduction of heart rate ?
ivabradine 397
34
Digoxin toxicity when develops ?
serum D level >2ng/ml
35
Digoxin A/E ?
Anorexia vomiting gynecomastia visual distrubance color vision cardiac - bradycardia AV conduction defect ventricular fibrilation bigeminy trigeminy 403
36
which drugs increase HR ?
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)
36
most common sign of digoxin toxicity ?
βœ… **GI symptoms** (**nausea, vomiting, anorexia**) β†’ **Most common** early sign of **digoxin toxicity**. @usmlereviews
37
which metabolic drugs dec HR ?
thyroxin glucagon
38
digoxin HR baray naki komay ?
komay
39
which factors precipitate D T ?
hypokalemia hypomagnesemia hypercalcemia
40
management of digoxin toxicity ?
stop the drug correct electrolyte imbalance K supplement anti-arrythmatic drug ?- phenytoin lidocain
40
Digoxin er sathe dibo kon drug ?
ACEi ARB spironolactone
41
dibo na kon drug ?
K loosing diuretics loop d t diuretics beta blokcers
41
M/A of digoxin ?
401
42
Digoxin + BEta blocker ???
more bradycardia Heart block
43
Digoxin + CCB ?
D toxicity
44
ACEi effect on CCF ?
407
45
Anti-arrhythmic drugs name ?
410
46
which CCB in arthymia ?
verapamil deltiazem
46
which K channel blocker ,
amiodarone dronedarone
47
which Na channel blocker ?
quinidine lidocaine
48
In case of heart rate is increase , when i will call it tachycardia and when arrhythmia?
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
which beta blockers ?
esmolo stenolol sotaolol pindolol propranolol
50
in Arrhythmia HR bare naki kome ?
HR - irregular
51
when postural hypotension in ACEi ?
initial dose
51
what is arrythmia ??
βœ… Arrhythmia = Abnormal heart rhythm (irregular rate, conduction, or impulse formation).
52
which beta blocker is used in angina ?
propranolol atenolol
53
what is corrected by digoxin in HF ?
respiratory distress edema tachycardia cardiomegaly
54
mechanical mechanism of digoxin ? 401 12-2-2025 11.28AM
inc cardiac contractility inc CO dec residual blood dec diastolic pressure and size dec cardiac congestion enhance complete ventricular emptying = dec ventricular size
55
Minoxidil use let alone HTN >
Vasodilation alopecia
56
is propranolol is given in a asthmatic and diabetic patient ?
🚫 **Propranolol (Non-selective Ξ²-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
urine of diabetic nephropathy ?
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
which one has larger half life ?
lisinopril
59
how ACEi dec preload and afterload ?
no vasoconstriction = dec preload bradykinin +++ ===== dec preload aldosteroine - no retention of Na & H2O edema --- afterload ---------
60
which drugs used in compensation of reflax tachycardia and postural hypotension ?
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
advantages of sublingual GTN ?
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
vasoconstrictor drug name ?
Vasoconstrictors: Phenylephrine Norepinephrine Epinephrine Vasopressin (ADH) Angiotensin II
63
cardiotropic drugs name ?
Cardiotropic Drugs: Digoxin Dobutamine Milrinone Isoproterenol Dopamine
64
drugs that decrease HR ?>
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
ARB + Thiazide = ??
T = hypokalemia ARB = hyperkalemia T Antagonize the Hyperkalemic effects of ARB
66
Pregnancy safe Anti-HTN ?
labetalol alpha M D hydralazine atenolol nifedipine
67
minoxidil indication without HTN ?
Alopecia
68
Nifedipine indication ?
🀰 + HTN raynauds phenomenon
68
CCF e CCB dibo kina ??
NO Due to (-) heart effect 7.43PM 8 8.4.2025?
68
Hydralazine & Na-N kon condition e dibo ?
?
69
nimodipine indication ?
subarachnoid hemorrhage Vasospasm is prevented by Nimodipine 6.43 10.4.2025
70
ARB in CCF ?
407
71
why ARB >> ACEi ?
ARB = no bradykinin + no dry cough
72
anti-anginal beta blockers ?
Atenolol metoprolol propranolol
73
which one commonly use ?
atenolol metoprolol
74
ACEi contraindication ?
hyperkalemia renal failure preganancy bilateral renal artery stenosis bronchial astham
75
alpha methyl dopa - agonist tao BP komay kemne ??
receptor - brain e thake but peripheral e kaj kore - Peripheral vasodialtion
76
neprilysin function in ARNI ?? 397
responsible for breaking ANP BNP CNP reduce HTN & cardiac hypertrophy
77
time intervel to reduce nitrate tolerance ?
10-12 hrs 389
78
which drug is used now in CCF most commonly ?
angiotension receptor and neprilysin inhibitors Sacubitril + Valsartan
79
which CCB in arrhytmia ?
Verapamil
80
non-cardiac use of beta blockers <
hyperthyroidism pheochromocytoma cushing disease melenoma' glaucoma migraine esophageal varices
81
which beta blockers in migraine ?
propranolol timolol metoprolol
82
indications of ACEi ?
354
83
which beta blokcers in glaucoma?
timolol betaxolol carteolol
84
maximum beta blokcer use in non-CVS is ?
propranolol
85
Which beta blockers in DM ?
selective beta blockers
86
why selective beta blockers in DM ? 280
DM htn pt - good who are taking anti-DM drugs
87
what is raynauds phenomenon ? is there vasoconstriction or vasodilation ? which drugs cause it ? by which drugs we can reduce it ?
🩸 **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
what is Digoxin ?
cardio glycoside + cardiotonic
89
which type of arrythmia in Digoxin toxicity ??
⚑ **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
HTN + DM = ?
D + ACEi + ARB + CCB
91
anti-anginal split out kokhon korba ?
throbbing headache
92
emergency te kon preparation e anti-anginal ?
spray
93
why anti-anginal drug sublingual ?
390
94
dhoro tomar throbbing headche + bukeo betha - tokhon ki split out korba anti-anginal drugs ??
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
indications of clonidine ?
HTN used to minimize the symptoms that accompany withdrawal from -Opiates / BDZ
96
drugs for raynauds phenomenon ?
nifedipine reserpine epoprostonol prazosin 365
96
HTN + angina which CCB ?
diltiazem
96
nimodipine dose <
60 mg every 4 hours 364
96
which CCB in 🀰?
nifedipine
97
why Clinidipine doesnot cause Ankle edema ?
Sure! Here's a short version: **Cilnidipine doesn't cause ankle edema** because it blocks both **L-type and N-type calcium channels**. - **L-type** causes arteriole dilation. - **N-type** reduces sympathetic activity β†’ dilates **both arterioles and venules**. This balanced dilation prevents increased capillary pressure, so **less fluid leaks into tissues**, avoiding ankle edema. ## Footnote 6.57 10.4.2025
97
97
which CCB in subarachnoid hemoorhage ?
nimodipine
98

Pharmacology-PROF (38 decks)

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