CVS Pharm Flashcards
Beta-blockers must be used cautiously in ____ and are contraindicated in ____
decompensated HF,
cardiogenic shock.
HTN in DM and Asthma
ABCD
HTN in HF
HI-ABD’s
CCB used in hypertensive urgency or emergency
Nicardipine, clevidipine
angina (including vasospastic type)
DHP CCB
Hydralazine contraindication?
Compensatory tachycardia (contraindicated in angina/CAD),
Nitrates Contraindicated
Contraindicated in right ventricular infarction
Anti HTN in renal failure:
Avoid?
Use?
Avoid: ACE inh/ ARBs, K+ sparing, others diuretics
(↓ ECV → ↓GFR)
Give: Fenoldopam, CCB, Beta blocker
Ranolazine adverse effects?
Constipation, dizziness, headache, nausea
Sacubitril
Adverse effect:
contraindication:
hyperkalemia, cough, dizziness;
contraindicated with ACE inhibitors due to angioedema.
Effects of drugs when used with statins?
Gemfibrozil
Cholestyramine
impairs hepatic clearance of statins
↓ GI absorption of statins
Recommendation about LFTs and statin use?
LFTs recommended before starting statin therapy, but not usually require routine monitoring unless symptoms of hepatotoxicity develop
Effwet of digoxin on action potential duration?
↓ action potential duration and cause QT interval shortening
Adverse effect of
disopyramide?
1A:
HF
Thrombocytopenia
digitalis-induced arrhythmias treated with:
Class 1B
Affect of 1C on ERP and AP duration?
Significantly prolongs ERP in AV node and accessory bypass tracts.
No effect on ERP in Purkinje and ventricular tissue.
Minimal effect on AP duration.
IC is Contraindicated in
structural and ischemic heart disease
Class 1C drug dissociate from Na receptors during ______?
effect of HR?
Diastole.
So, at ↑ HR Heart spends more time in systole (use state) than diastole
1A binds Na channels in _____ state
1B binds Na channel in ____ state
Open
inactivated.
(ischemic cells spend more time in ‘‘inactivated’’ state due to delayed recovery of Na channels from “inactivated” to “resting” state)
MD
VP
Metoprolol can cause dyslipidemia.
Propranolol can exacerbate vasospasm in vasospastic angina.
Beta blocker will mask all the effects of hypoglycemia except?
Sweating (mediated by M receptors)
Reverse use dependance:
Dofetilide, Sotalol
More effective in bradycardia
Amiodarone safe in renal failure?
Yes
it is lipophiiloc, excreted through biliary secretion
Affect of 1A, 1B, 1C, class III on QRS, QT interval, ERP, AP duration?
☼ QRS ↑ in all Class I drugs ☼ 1A: All increased ☼ 1B ↓ AP duration ☼ 1C ↑ ERP in AV and bypass path, ↔ AP duration ☼ III: All ↑ except QRS complex
SVTs prevented by?
Non-DHP CCB
____ masks ischemia during stress testing? Why?
CCB
↓ O2 myocardial demand
↑ Coronary blood flow
Adenosine causes bronchospasm by?
Stimulating release of histamine and leukotrienes from mast cells.
