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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
What is the mechanism of fibrates?
-Increases lipolysis in liver and muscles
26
What are the actions of fibrates?
- Reduce VLDL - Modest effect on LDL - Moderate increase in HDL - Reduce triglycerides
27
What is a fibrate drug?
-Fenobrate (Tricor)
28
What are the side effects of Fenobrate?
-GI symptoms
29
What is the action of Niacin (nicotinic acid)?
-Decreases triglyceride and LDL
30
What are the side effects of Niacin (Nicotinic acid)?
- Flushing (red face) | - Headaches
31
What is the mechanism of Bile acid binding agents?
-Reduce reabsorption of bile acids and metabolite
32
What is a bile acid binding agent drug?
-Cholesteramine
33
What are the side effects of Bile-acid biding agents?
- Constipation | - Bloating
34
What is an inhibitor of intestinal sterol absorption?
-Exetimibe
35
What does Exetimibe do?
-Reduce LDL
36
What are some positive ionotropic drugs that can treat Heart failure?
- Digitalis | - Milrinone (bipyridines)
37
What are the side effects of positive ionotropic drugs?
- Premature depolarization/arrhythmias - Ectopic beats - Affects all excitable tissues
38
What is a Beta 1 Adrenoceptor agonist drug?
-Dobutamine
39
What is the side effect of Dobutamine?
-Can cause arrhythmias
40
Can you use Diuretics to treat heart failure?
-yes
41
What is a diuretic used to treat heart failure?
-Furosemide
42
T/F Diuretics have a positive ionotropic effect
False
43
What is the mechanism of ACE inhibitors?
-Reduce peripheral resistance by reducing salt and water
44
What ACE inhibitor is used for heart failure?
-Captopril
45
What is a vasodilator drug used for heart failure?
-Hydralazine
46
What is a Beta-adrenoceptor blocker drugs used to treat heart failure?
-Metoprolol
47
What is the mechanisms of Metoprolol?
-Reduce HR and block Sympathetic nervous system
48
What is a non-drug treatment to manage heart failure?
-Na+ restriction
49
What is the mechanism of Na+ channel blockers used for cardiac arrhythmias?
-Slow action potential conduction
50
What is the action/use for Na+ channel blockers?
-Effective for most atrial and ventricular arrhythmias
51
What are some Na+ channel blocker drugs used to treat cardiac arrhythmias?
- Procainamide (almost never first choice) - Quinidine - Lidocaine (first choice for ventricular arrhythmias)
52
What are Beta adrenergic blocking drugs used to treat cardiac arrhythmias?
-Propranolol
53
What is a prolong refractory drug used to treat cardiac arrhythmias?
-Amiodarone
54
What do you use Amiodarone for?
-Ventricular arrhythmias and atrial fibrillation
55
What is the side effect of Amiodarone?
-Pulmonary fibrosis
56
What are Ca2+ channel blocker drugs used to treat cardiac arrhythmias?
- Verapamil | - Diltiazem

Human disease and therapeutics 2020 (60 decks)

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