Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardio > Drugs > Flashcards

Drugs Flashcards

0
Q

NS B blockade: eg, indications

A
  • eg: propranolol, nadolol, timolol
  • indications: angina, HTN, arrhythmias
  • phasing out for more specific drugs, lipophilic -> CNS defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

B1 blockade: eg, effects, indication,

A
  • eg: MEAN B.
  • effects: decrease HR, contractility, AV conduction velocity, renin release
  • indication: CV indications; post MI, essential HTN
  • esmolol: short acting IV only
  • note* B2 in high doses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vasodilation B blockade

A
  • eg: carvadelol, lebatelol VERY COMMONLY used
  • MOA: a/B blockade
    > vasodilation A1 mediated
  • Nebivilol B1 selective (increased NO -> vasodilation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

B-blockers adverse effects (B1 and B2)

A
  • B1: bradycardia, hypotension, worsening of acute HF
  • B2: bronchospasm, masking of hypoglycemia, hyperglycemia, PVD exacerbation, impotency
  • CNS: fatigue, depression, decreased exercise tolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

B-blockade contraindications (3) consideration(2)

A
  • abrupt cessation
  • risk of unopposed activation
  • severe bradycardia or AV block
  • cardiogenic shock or worsening HF
  • varian angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A-antagonist specific agents (a1 and NS a1,2)

A

A1 a,b and d specific eg: terazosin, doxazosin, prazosin (reversible a 1a,b and d)

  • BPH
    eg: NS a1,2 antagonists:
  • phentolamine, phenoxybenzamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A1 antagonism Sx/Cind

A 
Sx
- orthostatic HTN
- reflex tachy
- nasal congestion 
Cind
- elderly (falls) 
- additive hypotension with other hypotensives 
- start low titrate up 
- less effect at bed time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A2 specific agonists (eg, ind)

A

Clonadine
- ind: hypertensive emergency/urgency and intractable HTN
Methyldopa
- ind: prodrug for HTN in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A2 agonism Sx and considerations

A

Adverse effects

  • CNS sedation and depression
  • hypotension, bradycardia, orthostasis, rebound HTN
  • GI, drymouth
  • Methyldopa: hepatitis, hemolytic anemia
  • as always avoid in elderly and abrupt discontinuation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pressors and inotropes (eg and use)

A

pressors: maintain perfusion in hypotensive PTs.
- epi:
- norepi:
- phenylepi: a1 only
- dopamine (also inotropic)
- dobutamine (inotropic only)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pressors and inotropes Sx (4)

A
  • tachycardia
  • dysrhythmia
  • peripheral ischemia
  • hypotension (dobutamine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Atropine: CV pharmacology

A
  • MOA: M2 blockade
  • CV indication: acute symptomatic bradycardia (not for cardiac arrest)
  • Sx: anti ACh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Epinephrine MOA (low/high dose)

A
  • low dose: B1, B2 > a1 agonism

- high dose: a1 > B1,B2 agonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Isoproteronol

A
  • B1, B2 agonism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Norepi MOA

A
  • B1, a1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Phenylepherine MOA

A
  • a1 agonism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

a1, a2, B1, B2 receptor actions

A
  • a1: vasoconstriction
  • a2: decrease sympathetic outflow
  • B1: increase HR
  • B2: vasodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Chemical cardiac stress test

A
  • dobutamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Class I antidysrhythmic useful for pharm cardioversion of Afib and Aflutter
- 3 classic Sx

A
  • quinidine
  • risk of toursades
    1. Toursades, tinnitus, cinchonism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Trt for toursades

A
  • Mg
  • unknown mechanism
  • also used for resistant VT/VF and Digoxin toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Trt for dig toxicity

A
  • Mg

- arrythmias caused by digoxin toxicity: phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Class I antidysrhythmic

A
  • Na channel blockade

- quinidine, procainamide, dyspirimine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Class II antidysrhythmics

A
  • beta blockade: reduces Ca influx during phase 0, (slow current channels) and decreases automaticity (phase 4) esp in SA/AV nodes
  • reduces nodal reentry tachydysrhythmias; reduces AV node conduction velocity and increases ERP
  • metoprolol, propranolol et al
  • not or use in acute HF: better for prevention (doesn’t terminate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Na/K pump inhibitor

A

In crease in intracellular Na -> increase calcium influx -> increase contractility

  • positive inotrope/negative chronotrope, slows SA/AV conduction increase absolute refractory period
  • Sx: GI, arrythmias, yellow halos (dig Abs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
First line drug for SVT
- adenosine - cAMP mediated Ca influx -> inhibits AV/SA node; essentially restarts the heart by induction of 3rd degree block but it's 1/2 life is 10 ~ sec
25
Cass IV antidysrhythmic used as first line foratrial dysrhythmias. It may cause HF, hypotension or AV block
Verapamil/Diltiazam
26
Class III antidysrhythmic convert atrial flutter conversion and Risk
- ibutalide: prolongs APD | - Sx: toursades de points
27
Class III antidysrhythmic used in atrial and atrioventricular dysrhythmias. Sx
- Sotalol: atrial and ventricular arrythmias - B blocking: proarrhythmic - prolongs QT interval
28
First line for venticular dysrhythmias, biphasic 10/53 day 1/2 life
- amniodarone - class III K channel blocking; also, Na, Ca, and B blocking - prolong QT interval
29
Class III antidysrhythmic
- bretylin - Sotalol - ibutalide - amniodarone
30
Class Ib antidysrhythmic
- phenytoin/lidocaine: prolongs ERP but shortens APD - for ventricular dysrhythmias - CNS effects, liver damage, CHF - CIND: elderly - primarily effects diseased/ischemic myocardium **
31
Class Ia antidysrhythmic (3)
- Na channel blockade (phase 0 decrease slope) k channel (phase 4 increase) - dysopyramide (ACh effects) - procainamide (SLE) - quinidine (Torsades)
32
SLE induction
- procainamide | - hydralazine
33
Drugs that are associated with increased survival in HF PTs. (5)
- ACEIs - B-blockers (carvedilol, metoprolol, bisprolol) - spironolactone - ARBs - hydralazine + nitrates
34
Steps in managing systolic HF with drugs
1. Loop diuretic 2. Add ACEIs 3. Add B-blocker 4. Add spironolactone (K sparing) 5. Add digoxin 6. Add ARB, hydralazine, nitrite
35
Diastolic HF management
- control HTN, HR and ischemic heart disease | - avoid inotropes
36
Recombinant natriuretic peptide used in acute decompensating HF to decrease pre and after load
- Nesiritide
37
Arteriolar vasodilator used in combo with other nitrates in PTs who cannot tolerate ACEis
Hydralazine
38
ARBs and ACEIs
- both inhibit the renin-angiotensin pathway - ARBs don't screw with bradykinin (less cough or edema) - ACEis contra indicated in preggers - fetal injury
39
Drugs that decrease arteriolar vasoconstriction, ANP release and NaCl resorb - inhibits bradykinin breakdown
- ACEis | - decrease afterload AND preload
40
Sx: cyanide poisoning
- Na Nitroprusside - rare, more commonly hypotension is only Sx due to vasodilation MOA (NO) - contraindicated in pregnancy
41
Drugs of acute decompensating HF
- NO - Na Nitroprusside - phosdi inhibitors (Milrinone)
42
K sparing drugs for HF (3) MOAs and Sx
- spironolactone: aldosterone antagonist - amiloride and Triamterene: blocks Na channel in DCT > Na/K/H exchanger is inhibited - hyperkalemia and acidosis
43
Diuretic location of action: PCT, DLOH, ALOH, DCT
- PCT: Carbonic anhydrase inhibitors and osmotic diuretics - descending: osmotic diuretics - ascending LOH: loop diuretics - DCT: thiazide diuretics K sparing
44
HF: drugs effecting vascular tone
- NO donors - ACEis - ARBs - hydralazine - Nesiritide - B-blockers
45
Vasodilators used in acute decompensating HF
``` - Nitroglycerin > Sx: HA, hypotension - Na Nitroprusside > hypotension, cyanide poisoning > contraindication for prego ```
46
Drugs that decrease preload and afterload
- ACEis: block activation of bradykinin (prils) > inhibit conversion angiotensin II - ARBs: don't interfere with bradykinin
47
ACEis: MOA, effects, Sx
- inhibition of conversion to angiotensin I - increase pre and afterload, inhibition of bradykinin > decreases arteriolar vasoconstriction, NaCl resorption and ADH - Catopril prototypical ACEi - Sx: cough and angioedema (most serious), hypokalemia > fetal injury > renal insufficiency
48
ARB
- same effect as ACEis, except doesn't inhibit upstream bradykinin act - Losartan, valsartan - second line to ACEi
49
Hydralazine
- arteriolar vasodilator: decrease after load - unknown mechanism - often used in conj with nitrates
50
HF drug used for PTs who cannot tolerate ACEi
- hydralazine - arteriovasodilator - used in conj with nitrates
51
IV only recombinant BNP
- Nesirtide - continuous IV infusion in acute decompensating HF - may be associated with worse outcomes in renal failure and potentially worsen HF mortality
52
Steps in treating systolic dysfunction HF (5 + other)
1: loop diuretic 2. ACEi 3. B blocker 4. K sparing (spironolactone) 5. Digoxin Other: hydralazine + nitrate
53
Treating diastolic HF control and Rx
- control HTN - control HR - control ischemia - Rx: B blocker, Ca channel blocker, ACEi, ARB * AVOID INOTROPES like digoxin
54
B blockade important mechanism in HF
- attenuates cytotoxicity and signaling effect of catecholamines by upregulation of B1 receptors - ** improves myocardial remodeling ** - carvedilol, metoprolol, bisprolol, (improve survival) esp when added to ACEi
55
Digoxin indication in CHF
- only used in cases of CHF with Afib | - it's actually a fifth line drug for CHF
56
Indications in acute decompensating HF
- O2 - loop diuretic (furosemide) - vasodilator (NO,nitro prusside) - inotrope (dobutamine, Milrinone) - morphine reduces preload and pain
57
Milrinone
- Phosphodiesterase inhibitor -> increases cAMP and thus is a + inotrope - acute decompensating HF
58
Furosemide
- loop diuretic - hypovolemia, hypokalemia - acidosis (due to lack of Na for the Na/H pump) - first line in acute decompensating HF
59
Bumetinide
- loop diuretic - hypovolemia, hypokalemia - acidosis (due to lack of Na for the Na/H pump) - first line in acute decompensating HF
60
Spironolactone
- aldosterone inhibitor (K sparing hence hypERkalemia)
61
Amiloride
- k sparing DCT diuretic | - not assoc with increased survival
62
Triamterene
- K sparing DCT diuretic
63
ACEi interactions (3)
- potassium supplements, K sparring diuretics | - NSAIDs
64
Losartan
- ARBi | - 2nd line to ACEi
65
Ideal antiarrythmic drug
- increases ERP, decreases RRP and adjusts QTc (no effect on a/p duration)
66
Class I antidysrhythmic effects on A/P
- a: moderate Na channel block -> prolongs phase 0 and pushes back phase 3 - b. slight Na block -> slightly prolonged phase 0 with early repolarization - c. Significant Na block -> sig prolonged phase 0 with UNAFFECTED repolarization
67
Quinidine: ind, mech (3), Sx due to mech
- class 1a antiarrythmic: chemical cardioversion** - Na/K channel blocker/alpha blocker/ACh blocker > Na/K blockade: increase ERP/APD ** > alpha blockade: reflex tachy/hypoTN > anti-ACh: increase AV node condxn
68
Procainamide: Compaired to quinidine
- similar to quinidine: less anti-ACh; more SA/AV nodal depression - ganglion blocker - less QTc prolonging
69
Dysopyramide compared to quinidine
- similar to quinidine: more pronounced anti-ACh effects
70
Indication for phenytoin
- ventricular arrythmias esp. Caused by digoxin toxicity
71
Class IC antidysrhythmics: eg, ECG effect, ind
- flecainide - propafone (B block and Ca blocker) - prolongs QRS but NOT QT - Sx: flecainide - higher risk of arrythmias - for atrial and ventricular dysrhythmias
72
Ibutalide indication and sig risk
- atrial flutter conversion | - Rick of toursades
73
Flecainide, propafone
- class 1C antidysrhythmic
74
Junctional dysrhythmias and mechs (3)
- PJC: enhanced automaticity - junctional rhythm: normal automaticity - accelerated junctional rhythm: enhanced automaticity
75
Ventricular dysrhythmias/ mechs (5)
- PVC: DAD - accelerated idioventricular rhythm: enhanced auto - Vtach: reentry - toursades: EAD - Vfib: reentry
76
Atrial dysrhythmias and mechs (5)
- PAC: DAD - Atrial tach: reentry - MAT: DAD - a flutter: reentry - Afib: reentry
77
Nitrate MOA
- forms free radical NO -> vasodilation (organic nitrates may dilate coronary arteries) - NO mediated cGMP also inhibits PLT aggregation
78
Organic nitrates: eg, effect
- nitroglycerin, isosorbide dinitrate/mononitrate - mostly Venodilators (decrease preload) - superior efficacy in variant angina
79
Na Nitroprusside: MOA, effect, indication, Sx
- veno/arteriodilation - decreased pre/afterload - for HTN emergency/ decomp HF NOT for angina - cyanide/thiocyanate tox, coronary steal
80
NGT: MOA, 1/2 life, indication
- organic nitrate - 1/2 life 5 minutes - high first pass: sublingual/transdermal patch
81
Isosorbide dinitrate: MOA, 1/2 life, use
- organic nitrate - 1/2 life: 1 hr - oral dose 1-3 x daily - tolerance to nitrates: tachyphylaxis (24 hrs) > nitrate free period of 8-12 > body compensates with increase in vascular tone and Na retention
82
Isosorbide mononitrate: MOA, 1/2 life, use, consideration
- organic nitrate - 1/2 life: 4 hrs - 1-2 x daily - tolerance to nitrates: tachyphylaxis (24 hrs) > nitrate free period of 8-12 > body compensates with increase in vascular tone and Na retention
83
Nitrate Sx, interactions, Cind
- HA, orthostasis, reflex tachy - PDE-5 inhibitors - contraindication: sildenafil, vardenafil, tadalafil
84
1st line monotherapy for stable angina (hr parameters)
- B blocker - decrease HR, contractility and BP - doesn't improve myocardial O2 supply (may be worse for variant) - HR target parameters: resting HR 50-60 BPM, exercise > 100
85
Ca channel blockers in angina
- dihydropyrimidine/nondihydropyridine - arterial dilation, decrease in contractility and HR - may increase blood flow via coronary arteries (superior efficacy in variant angina)
86
Dihydropyridines
- bind to N site - peripheral action - amlodipine (common), felodipine - primarily Anti-HTN but can be used for stable angina
87
Non-dihydropyridines
- Ca channel blocker that binds to V and D sites - cardiac activity - Diltiazam and verapamil - stable angina, ACS (symptom relief), Afib/Flutter
88
Calcium channel blockers + beta blockers, dig or amniodarone
- bradycardia | - additive hypotension with other anti-HTN
89
Partial FA oxidase inhibitor
- ranolazine - 5th line anti-anginal agent - QT prolongation cyp3a4 substrate
90
Anti-ischemia algorithm for stable angina
1. Blocker 2. Long acting nitrate (mono nitrate) or long acting CCB 3. Substitute 2nd line - symptoms with BB and LA nitrate -> add ranolazine
91
Variant angina algorithm
- SL NTG for acute trt - 1st line prophylaxis: long acting CCB - NO B blockers
92
Anti-HTN drug causes Hirsutism
Minoxidil | - peripheral vasodilator: act ATP mod K channels
93
PPAR activator
- fibrinates - gemfibrozil et al - can cause upper right quadrant pain due to gall stone formation
94
A drug that can substantially raise your trigs due to increase of LpL, and decrease VLDL
- niacin
95
Diuretic contraindicated in hyperuricemia
- thiazide diuretics
96
B blocker contraindicated in angina
- Acebutilol | > it has sympathomimetic activity and may exacerbate
97
Trt of HTN in polycystic kidney disease
- ACEi | - mech of HTN: cyst impair glomeruli perfusion -> renin release -> ace system act
98
Amlodipine
- vascular Ca channel blocker - it's vasodilating effect experts negative inotropy -
99
Anti-HTN drug for hair loss
Minoxidil
100
Nitrate tolerance
- tachyphylaxis | - take 8-12 hr drug holidays
101
Anti-HTN drug known for causing dyslipidemia
- B blockers: metoprolol
102
Treatment of Wolff-Parkinson-White syndrome that can result in V fib
- digoxin
103
Tinnitus chinconism (QT)
- quinidine
104
Anti-arrhythmic with class I-IV effects and toxicity
- amniodarone | - PFT, LFT

Cardio (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions