Drugs Flashcards
Quinidine (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antiarrythmic
CLASS: IA
MOA: Na channel blocker. Also blocks K channels. Decreases phase 0 depolarization
PHYSIOLOGIC EFFECT: decrease myocardial CV, excitability, and contractibility. Prolongs AP
INDICATIONS: Atrial arrhythmias, PSVT, WPW
SIDE EFFECTS: Torsades de pointes, cinchonism, thrombocytopenia, anticholinergic effects
Procainamide (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antiarrythmic
CLASS: IA
MOA: Na channel blocker; also blocks K channels. Decreases phase 0 depolarization
PHYSIOLOGIC EFFECT: decrease myocardial CV, excitability, and contractibility. Prolongs AP
INDICATIONS: refractory ventricular fibrillation; pulseless ventricular tachycardia
SIDE EFFECTS: SLE like symptoms
Lidocaine (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antiarrhythmic
CLASS: IB
MOA: Na channel blocker. Inhibits influx of Na through fast Na channels
PHYSIOLOGIC EFFECT: Purkinje fibers - depress automaticity; higher affinity for ischemic tissue. Suppresses spontaneous depolarization in ventricles by blocking reentry
INDICATIONS: Acute treatment of ventricular arrhythmia from MI; suppress ventricular tachycardia
SIDE EFFECTS: neurotoxicity including seizures
Metoprolol (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antiarrhythmicCLASS: II MOA: β-1 adrenergic receptor antagonist (β-blocker)
PHYSIOLOGIC EFFECT: reduces HR and lessens contractility
INDICATIONS: treatment and prophylaxis of PSVT; prevent recurrent MI in pt recovering from MI; decrease myocardial O2 demand to lessen angina, HF
SIDE EFFECTS: fewer CNS effects than nonselective beta blockers, hypotension, bradycardia
Esmolol (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antiarrhythmic
CLASS: II
MOA: β-blocker
PHYSIOLOGIC EFFECT: reduces HR and lessens contractibility
INDICATIONS: short-term control of sinus, tachycardia, PSVT, and ventricular rate in pt with atrial fibrillation/flutter
SIDE EFFECTS: AV block and cardiac arrest
Amidarone (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antiarrhythmicCLASS: IIIMOA: Blocks Na, K, and Ca channels; blocks beta-1 receptorsPHYSIOLOGIC EFFECT: properties of all 4 classes of antiarrhythmic drugsINDICATIONS: atrial and ventricular arrhythmiasSIDE EFFECTS: Torsades de pointes, pneumonitis, pulmonary fibrosis
Digoxin (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antiarrhythmicCLASS: Misc.MOA: inhibits the Na/K-ATPasePHYSIOLOGIC EFFECT: Increased intracellular Na followed by greater Ca influx and greater contractionINDICATIONS: Antrial fibrillation (first-line with HF or sedation); SVTSIDE EFFECTS: N&V, mental status change, vision color and EKG changes
Antenolol (type, class, MOA, physiological effect, indications, and side effects)
TYPE: AntihypertensiveCLASS: sympatholiticMOA: β receptor agonistPHYSIOLOGIC EFFECT: decreases BP, renin release, and sympathetic outflow from the brainINDICATIONS: decrease myocardial O2 demand to lessen angina, HFSIDE EFFECTS: fewer CNS effects than nonselective β-blockers, hypotension, bradycardia
Diltiazem (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antihypertensiveCLASS: vasodilatorMOA: Ca-channel blockerPHYSIOLOGIC EFFECT: prevent vascular SM contractionINDICATIONS: arrhythmia, Prinzmetal’s anginaSIDE EFFECTS: edema, constipation, flushing, and dizziness
Nifedipine (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antihypertensiveCLASS: vasodilatorMOA: Ca-channel blockerPHYSIOLOGIC EFFECT: prevent vascular SM contractionINDICATIONS: arrhythmia, Prinzmetal’s anginaSIDE EFFECTS: edema, constipation, flushing, and dizziness
Sodium Nitroprusside (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antihypertensiveCLASS: vasodilatorMOA: direct action relaxing arterioles and venules via NOPHYSIOLOGIC EFFECT: peripheral vasodilation - lowers preload and afterloadINDICATIONS: hypertensive emergency, acute MI, aortic dissection, HFSIDE EFFECTS: hypotension, tachycardia, cyanide toxicity
Losartan (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antihypertensiveCLASS: ARBMOA: antagonizes angiotensin II receptorsPHYSIOLOGIC EFFECT: lowers TPR, reduces plasma volumeINDICATIONS: HF and diabetic neuropathy SIDE EFFECTS: acute renal failure; NO angioedema and coughing associated with ACE inhibitors
Hydrochlorothiazide (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antihypertensive CLASS: diuretic MOA: inhibits Na reabsorption in distal tubulesPHYSIOLOGIC EFFECTS: lowers plasma and ECF volume, thus decreasing workload on heart and TPRINDICATIONS: first therapy for managing HTN; HFSIDE EFFECTS: hypokalemia, sexual dysfunction, hyperglycemia/lipidemia
Fenoldopam (type, class, MOA, physiological effect, indications, and side effects)
TYPE: antihypertensive CLASS: Misc. MOA: selective D1-receptor (DA) antagonistPHYSIOLOGIC EFFECT: decreases TPR with increased renal blood flowINDICATION: acute treatment for severe HTNSIDE EFFECTS: flushing, hypotension, headache, nausea
Nitroglycerin (type, class, MOA, physiological effect, indications, and side effects)
TYPE: anti-anginalCLASS: nitrateMOA: activates GC which raises cGMP and lowers intracellular Ca in SMPHYSIOLOGIC EFFECT: increases venous capacitance; decreases arteriole resistance; redistributes blood to ischemic areaINDICATIONS: angina attack and prophylaxis, HF, HTN emergencySIDE EFFECTS: transient dizziness, hypotension, flushing, severe headaches but tolerance occurs
ending for all ARBs
-sartan
ending for all ACE inhibitors
-pril
Statins in order of potency, physiologic effect, and side effects
Lovostatin, Pravastatin, Simvastatin, Fluvastatin, Atorvastatin, Resuvastatin
PHYSIOLOGIC EFFECT: LDL lowering and modest HDL raising and triglyceride lowering effects
SIDE EFFECTS: myalgias and possible blood sugar raising, memory impairment
PCSK9 normal function, PCSK9 inhibitors physiologic effect and side effects
NORMAL F(x): binds the LDL receptor and facilitates it’s degradationPHYSIOLOGIC EFFECT: monoclonal Ab that lowers LDLSIDE EFFECTS: nasopharyngitis, injection site rxns, joint pains
Fibrates physiologic effect and side effects
PHYSIOLOGIC EFFECT: HDL raising, TG lowering, modest LDL benefitSIDE EFFECTS: myopathy, especially in combo with statins
Niacin physiologic effect and side effects
PHYSIOLOGIC EFFECT: LDL lowering, good HDL and TG effectsSIDE EFFECTS: flushing (most common reason for discontinuation) and hepatotoxicity
Fibrinolytics
Ex: Alteplase, reteplase, tenecteplase, streptokinaseMOA: converts proenzyme plasminogen to plasmin
Heparin (UFH)
ancillary to fibrinolytic therapy. Used for high risk embolization Pts after STEMI
Low Molecular Weight Heparin (LMWH)
Ex: enoxaparin, dalteparin, tinzaparinalternative to UFH
Aldosterone Blockade
Ex.. Spironolactone, eplerenoneadd-on therapy to ACEI/ARB and β-blockers for HFSpironolactone has estrogenic effects and can cause gynecomastia
Hydralazine/Isosorbide Dinitrate
used in African American pts in combo with ACEI/ARB therapySIDE EFFECTS: dizziness, headache, and lupus-like syndrome at high doses
Loop Diuretics
Ex. furosemide, torsemide, bumetanideimprove renal performance to remove excess salt and H2O retention- provides symptomatic relief, but no proven mortality benefit
Drug classes with proven mortality benefit for HF patients
- β-blockers2. ACEI’s or ARBs3. Aldosterone antagonists4. hydralazine/isosorbide dinitrate combo
Drug classes for symptomatic relief, but nor mortality benefit in HF patients
- Vasodilators2. Loop Diuretics3. Nitrates4. Digoxin5. Inotropes/infusion therapy
