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Cardio Exam 2 > Drug review > Flashcards

Drug review Flashcards

1
Q

Epinephrine mech?

A

activate a1, a2, B1, B2, B3 [B2 > a1]

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2
Q 
Epinephrine effect on:
HR
SBP
DBP
MAP
TPR

in low dose vs normal dose

A

Low dose → decrease diastolic and mean BP
o Increase HR/SBP/slightly MAP and decrease TPR/DBP

Normal dose
o Increase all HR/SBP/DBP/MAP/TPR

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3
Q

Norepinephrine mech?

A

activates a1, a2, B1 [NOT B2]

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4
Q 
Norepinephrine effect on:
HR
SBP
DBP
MAP
TPR
A

increase DBP/MAP/SBP/TPR; decrease HR
o Strong baroreceptor decreases HR
o Increases BP more than Epi due to lack of B2

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5
Q

Use of norepinephrine?

A

cardiogenic shock, septic/hypovolemic shock

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6
Q

adverse of norepi?

A

severe hypertension

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7
Q

Isoproterenol mech?

A

activates B1/B2/B3 [not As]

B agonist

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8
Q 
Isoproterenol effect on:
HR
SBP
DBP
MAP
TPR
A

decrease DBP/MAP/TPR; increase SBP slightly/HR

o Biggest increase HR b/c direct same direction as reflex

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9
Q

Dobutamine mech?

A

selective B1 agonist

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10
Q

Dobutamine effect?

A

increase HR and contractility

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11
Q

Dopamine mech?

A

low dose = D1
moderate = D1 + B1
high = D1 + B1 + a1

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12
Q

Dopamine effect at low, medium high dose?

A 
low = more renal flow + urine output, decrease BP a little
moderate = decrease BP a little, increase HR/CO, no change in TPR
high = increase BP, a1 effect outweighs D1 effect
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13
Q

Fenoldopam mech?

A

selective D1 agonist

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14
Q

Fenoldopam effect?

A

decrease BP –> used to treat severe HTN

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15
Q

Albuterol Mech?

A

selective B2 agonist

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16
Q

Albuterol effect?

A

vasodilate + bronchodilate + increase HR

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17
Q

Side effects/adverse of albuterol?

A

tachycardia, N/V, hypokalemia, hypotension

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18
Q

Phenylephrine mech?

A

a agonist, slightly selective for a1

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19
Q

Clonidine mech?

A

a2 agonist = sympatholytic adrenergic agonist

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20
Q

What is action of tyramine?

A

NE releaser = indirect sympathomimetic

in aged cheese/meat/fish/wine

avoid with MAO inhibitor

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21
Q

What is mech of propanolol?

A 
non-selective B blocker
also a class II anti-arrhythmic
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22
Q

What is use of B blockers?

A
  • angina, SVT, slowing ventricular rate during AFib/flutter
  • HTN
  • MI
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23
Q

What is mech of nadolol?

A

non-selective B blocker

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24
Q

What is mech of metoprolol?

A

selective B1 blocker

25
Q

What is mech of atenolol?

A

selective B1 blocker

26
Q

What is mech of bisoprolol?

A

selective B1 blocker

27
Q

What is mech of action of pindol?

A

partial B1/B2 agonist

  • in absence of normal physiologic agonist it is an agonist
    when high sympathetic drive –> its a beta antagonist
28
Q

What is black box warning with B blockers?

A

don’t withdraw quickly b/c upregulated B receptors cause unsafe increase in HR and contractility

29
Q

What B blocker does not have black box warning?

A

pindol

30
Q

WHat is mech carvedilol?

A

antagonist at B1, B2

partial antagonist at a1

31
Q

What is effect of carvedilol?

A

vasodilate, inhibits cardiac remodeling

use in HF

32
Q

What is mech of labetalol?

A

antagonist at B1/a1

partial agonist at B2 with ISA activity [aka antagonist when high intrinsic sympathetic activity]

33
Q

What is mech of phentolamine?

A

competitive a antagonist

34
Q

What is effect of phentolamine?

A

decrease BP due to a1 blockade

35
Q

What is mech of acetylcholine?

A

full agonist at M and N receptors

higher affinity for M than N

36
Q

What is effect of ACh with small vs large dose?

A 
small = quick drop in BP, reflex tachycardia
big = direct effect on SA node --> drop in BP + bradycardia
37
Q

What is mech of bethanechol?

A

M agonist

38
Q

What is mech of nicotine?

A

N agonist –> at ganglia activates sympathetic/parasympathetic branches whichever is dominant for the most part

39
Q

What is effect of nicotine?

A
  • increase BP
  • increase HR [in part due to Epi released from adrenal]

at high dose –> ANS activation then depolarizing blockade

40
Q

What is mech of neostigmine? does it cross BBB?

A

AChe inhibitor

does not cross BBB

41
Q

What is mech of physostigmine? does it cross bbb?

A

AChe Inhibitor

crosses BBB

42
Q

What is mech of donepezil?

A

AChe inhibitor, relatively selective for brain ACh

43
Q

What is mech of rivastigmine?

A

AChe inhibitor, relatively selective for brain ACh

44
Q

What is mech of galantamine?

A

AChe inhibitor

45
Q

What is use of donepezil/rivastigmine/galantamine?

A

used to treat dementia

46
Q

What is mech of atropine?

A

M receptor antagonist

47
Q

What is mech of scopalamine?

A

M receptor antagonist

48
Q

What is mech of ipratroprium?

A

competitive non-selective muscarinic antagonist

inhalational only

49
Q

What is use of ipratroprium?

A

acute asthma exacerbation

bronchospasm w/ COPD

50
Q

What type of drug is quinidine?

A

class 1A

51
Q

What type of drug is lidocaine?

A

class iB

52
Q

What type of drug is flecainide?

A

class 1C

53
Q

What type of drug is amiodarone?

A

class 3

54
Q

What type of drug is sotolol?

A

class 3

55
Q

What type of drug is dilitiazem?

A

class 4

56
Q

What type of drug is procainamide?

A

class 1A

57
Q

What type of drug is propafenone?

A

class 1C

58
Q

What type of drug is dofetilide?

A

class 3

59
Q

What type of drug is verapamil?

A

class 4

Cardio Exam 2 (19 decks)

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