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Human disease and therapeutics 2020 > CVS Therapeutics > Flashcards

CVS Therapeutics Flashcards

1
Q

What are the mechanisms of antianginals?

A
  • Vasodilation (nitrates and Nitrites)

- Decrease O2 consumption

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2
Q

What class of antianginals decrease O2 consumption?

A

-Ca2+ channel blockers

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3
Q

What do nitrates/nitrites do?

A

-Metabolize nitric oxide to increase cGMP that relaxes smooth muscle and dilates cardiac vessels

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4
Q

What are some examples of Nitrates/nitrites?

A
  • Nitroglycerin

- Amyl nitrate

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5
Q

What are the properties of nitroglycerin?

A
  • Give sublingual
  • Volatile
  • Long lasting patches
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6
Q

What are properties of amyl nitrate?

A

-Crushed ampule and fumes inhaled (short acting)

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7
Q

What are the side effects of Nitrates/nitrites?

A
  • Orthostatic hypotension
  • Tachycardia
  • Throbbing headache
  • Tolerance
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8
Q

What are the mechanisms of Ca2+ channel blockers?

A

-Blocks contraction of smooth and cardiac muscle and reduce O2 demand

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9
Q

What are the uses of Ca2+ channel blockers?

A

-Prophylaxis of angina

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10
Q

What is the duration of Ca2+ channel blockers?

A

-4-8 hrs

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11
Q

What are examples of Ca2+ channel blockers?

A
  • Verapamil
  • Nifedipine
  • Diltiazem
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12
Q

What type of toxicity do you see with Ca2+ channel blockers?

A
  • Cardiac depression and bradycardia leading to heart failure
  • Flushing and dizziness
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13
Q

What is the mechanism of Beta blockers?

A
  • Not a vasodilator
  • Reduce output by decreasing HR, BP, and contractility
  • decreases O2 requirements
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14
Q

What is the use of Beta blockers in angina?

A

-Prophylactic

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15
Q

What are some beta blocker drugs?

A
  • Propranolol (nonselective)
  • Atenolol
  • Metoprolol
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16
Q

What type of toxicity do you see with Beta blockers?

A
  • Asthma

- Acute heart failure

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17
Q

What types of drugs do you use to treat angina?

A
  • Beta blockers
  • Ca2+ blockers
  • Nitrates
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18
Q

What are non-drug treatments to manage lipid and cholesterol-lowering drugs?

A
  • Dietary

- Exercise

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19
Q

What should you include in your diet to manage lipid and cholesterol levels?

A
  • Include complex carbs and fiber
  • Avoid red meats
  • Avoid alcohol if VLDL elevated
  • Fat 15-20% daily intake calories
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20
Q

What are basic considerations when doing drug treatments for lipid and cholesterol-lowering drugs?

A
  • Diet always be managed

- Avoid pregnancy

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21
Q

What is the mechanism of Statins?

A

-Competitive inhibitors of HMG-CoA reductase (this synthesizes cholesterol)

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22
Q

What are some examples of Statins?

A
  • Lovastatin (Mevacor)
  • Atorvastatin (Lipitor)
  • Simvastatin (Zocor)
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23
Q

What are the actions of Statins?

A

-Reduce synthesis of cholesterol with most effect on LDL

24
Q

What is the toxicity/side effects of Statins?

A
  • Liver damage

- Weakness in skeletal muscles (increase creatine kinase)

25
Q

What is the mechanism of fibrates?

A

-Increases lipolysis in liver and muscles

26
Q

What are the actions of fibrates?

A
  • Reduce VLDL
  • Modest effect on LDL
  • Moderate increase in HDL
  • Reduce triglycerides
27
Q

What is a fibrate drug?

A

-Fenobrate (Tricor)

28
Q

What are the side effects of Fenobrate?

A

-GI symptoms

29
Q

What is the action of Niacin (nicotinic acid)?

A

-Decreases triglyceride and LDL

30
Q

What are the side effects of Niacin (Nicotinic acid)?

A
  • Flushing (red face)

- Headaches

31
Q

What is the mechanism of Bile acid binding agents?

A

-Reduce reabsorption of bile acids and metabolite

32
Q

What is a bile acid binding agent drug?

A

-Cholesteramine

33
Q

What are the side effects of Bile-acid biding agents?

A
  • Constipation

- Bloating

34
Q

What is an inhibitor of intestinal sterol absorption?

A

-Exetimibe

35
Q

What does Exetimibe do?

A

-Reduce LDL

36
Q

What are some positive ionotropic drugs that can treat Heart failure?

A
  • Digitalis

- Milrinone (bipyridines)

37
Q

What are the side effects of positive ionotropic drugs?

A
  • Premature depolarization/arrhythmias
  • Ectopic beats
  • Affects all excitable tissues
38
Q

What is a Beta 1 Adrenoceptor agonist drug?

A

-Dobutamine

39
Q

What is the side effect of Dobutamine?

A

-Can cause arrhythmias

40
Q

Can you use Diuretics to treat heart failure?

A

-yes

41
Q

What is a diuretic used to treat heart failure?

A

-Furosemide

42
Q

T/F Diuretics have a positive ionotropic effect

A

False

43
Q

What is the mechanism of ACE inhibitors?

A

-Reduce peripheral resistance by reducing salt and water

44
Q

What ACE inhibitor is used for heart failure?

A

-Captopril

45
Q

What is a vasodilator drug used for heart failure?

A

-Hydralazine

46
Q

What is a Beta-adrenoceptor blocker drugs used to treat heart failure?

A

-Metoprolol

47
Q

What is the mechanisms of Metoprolol?

A

-Reduce HR and block Sympathetic nervous system

48
Q

What is a non-drug treatment to manage heart failure?

A

-Na+ restriction

49
Q

What is the mechanism of Na+ channel blockers used for cardiac arrhythmias?

A

-Slow action potential conduction

50
Q

What is the action/use for Na+ channel blockers?

A

-Effective for most atrial and ventricular arrhythmias

51
Q

What are some Na+ channel blocker drugs used to treat cardiac arrhythmias?

A
  • Procainamide (almost never first choice)
  • Quinidine
  • Lidocaine (first choice for ventricular arrhythmias)
52
Q

What are Beta adrenergic blocking drugs used to treat cardiac arrhythmias?

A

-Propranolol

53
Q

What is a prolong refractory drug used to treat cardiac arrhythmias?

A

-Amiodarone

54
Q

What do you use Amiodarone for?

A

-Ventricular arrhythmias and atrial fibrillation

55
Q

What is the side effect of Amiodarone?

A

-Pulmonary fibrosis

56
Q

What are Ca2+ channel blocker drugs used to treat cardiac arrhythmias?

A
  • Verapamil

- Diltiazem

Human disease and therapeutics 2020 (60 decks)

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