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Cardio Block - CPR > DRUGS CARDIO > Flashcards

DRUGS CARDIO Flashcards

1
Q

what is lidocaine used for for arrhythmia

A

VT/VF

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2
Q

what drugs can increase the levels of serum digoxin?

A

verapamil and diltiazem

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3
Q

what is amiodarone used for?

mechanism?

A

anti-arrhythmia - VT and VF (off-label Afib)

unknown - but class 3 - inhibits K channels - thought to prolong the action potential

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4
Q

what antiarrhythmics can prolong the QT interval

A

K channel blockers

amiodarone
quinidine

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5
Q

norepinephrine

receptors
effect on HR, BP

A

alpha-1, alpha-2, beta-1

Increase BP, bradycardia (reflex - the beta-1 stimulation is not strong enough to overcome the relfex)

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6
Q

nicotine:

mechanism
effects (heart, GI, vessels)
A

nicotinic agonist

tachycardia, vasoconstriction, increased GI motility

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7
Q

what type of stable angina drug increases coronary flow?

A

calcium channel blockers (verapamil and diltiazem)

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8
Q

phenylephrine

receptors
what does it do to BP? HR?

A

alpha-1 agonist

hypertension, bradycardia (reflex)

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9
Q

prazosin

receptors
effect on BP

A

competitive alpha-1 blocker

decrease BP, orthostatic hypotension (“first-dose syncope”)

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10
Q

when an agonist binds to an alpha-2 receptor, what is the intracellular pathway?

A

usually Gi –> decrease cAMP

presynaptic, regulate the reslease of NE, really.

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11
Q

main hemodynamic goal of antiischemic (antiangina) drugs

A

restore dynamic balance between O2 supply and O2 demand

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12
Q

propranolol

receptors
what does it do to HR? BP? lungs?

A

beta blocker (1 and 2)

increases HR, decreases BP, bronchoconstriction

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13
Q

_________, if give after an MI, have been shown to increase survival

A

beta-blockers

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14
Q

class one antiarrhythmic drugs

general mechanism
example

A

sodium channel blockers

lidocaine

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15
Q

dobutamine

receptors
what does it do to HR?

A

beta-1 direct agonist

increases HR

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16
Q

atropine

mechanism
what does it do to HR? pupils? mouth?

A

muscarinic receptor antagonist

tachycardia, dilated pupils, dry mouth

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17
Q

what drug would you give to treat out-of-hospital show-resistant ventricular fibrillation?

A

amiodarone

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18
Q

downside of nitroglycerin -

A

headache and tolerance to the drug

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19
Q

how are beta blocker successful at treating stable angina?

A

decrease myocardial oxygen demand (limit HR

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20
Q

what antipsychotics can prolong the QT interval

A

haloperidol

chlorpromazine

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21
Q

as an antiarrhythmic, what does metoprolol treat?

mechanism

A

A-fib, atrial flutter, SVTs

unknown - automaticity decreased, cardiac slowing

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22
Q

isoproterenol

receptors
effect on lungs, HR, BP?

A

beta 1 and beta 2 agonist

bronchodilator, increase HR, decrease BP (reflex)

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23
Q

what are the calcium channel blockers that can help treat arrhythmias?

A

verapamil and diltiazem

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24
Q

describe muscarinic receptor activation in the heart:

decrease c_______, decrease _______

A

decrease cAMP, decrease PKA

  1. increases K+ effluc
  2. Decreases Na pacemaker activity

(just kind of goes against everything NE did)

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25
Q

class three anriarrhythmic drugs

general mechanism
example

A

potassium channel blockers

amiodarone

26
Q

atropine

mechanism
side effects

A

muscarinic receptor antagonist

dry mouth, urinary retention, constipation, dilated pupils, tachycardia, dilated pupils

27
Q

class two anriarrhythmic drugs

general mechanism
example (2)

A

beta blockers

metoprolol
propranolol

28
Q

when an agonist binds to an alpha-1 receptor, what is the intracellular pathway?

A

Gq –> IP3 –> Ca++ (contraction)

29
Q

side effect of adenosine:

A

flushing, may cause asthma attacks

30
Q

________________ are the first line therapy for stable angina (along with mitroglyerin)

A

beta-blockers

31
Q

what antibiotics can prolong the QT interval

A

Macrolides (erythromycin, azithromycin)

Fluoroquinolones (ciprofloxacin, levofloxacin)

32
Q

metoptrolol

receptors
what does it do to HR? BP? lungs?

A

beta-1 selective ANTAGONIST

decreases BP, bradycardia

33
Q

bethanechol

receptors
what does it do to blood vessels?

A

muscarinic agonist

vasodilation

34
Q

mechanism of verapamil and diltiazem as antiarrhythmics

A

Slow SA and AV nodal conduction –> cardiac slowing

35
Q

what arrhythmias should you use verapamil and diltiazem for?

A

SVT
a-fib
atrial flutter

36
Q

what opioids can prolong the QT interval

A

methadone

37
Q

side effects of amiodarone?

A

could cause more VT/VF (exacerbation of present arrhythmia)

skin changes - blue (chronic)
pulmonary fibrosis (chronic)
38
Q

what is nitroglycerin used for sublingually?

mechanism (sublingual)? increase flow or decrease demand?

A

stable

NO –> venous relaxation (sublingual), increases coronary flow

decreases oxygen demand (decreases preload)

39
Q

what drugs can you give for a-fib?

A

beta blockers
verapamil, diltiazem
amiodarone (off-label)

40
Q

sildenafil

what is it used for?
Mechanism

A

erectile dysfunction

inhibits phosphodiesterase type 5, which degrades cGMP (allows for more vasodilation)

41
Q

class four antiarrhythmic drugs

general mechanism
examples (2)

A

calcium channel blockers

verapamil and diltiazem

42
Q

the ________________ serve as initial therapy for stable angina when ________ ________ can’t be used (along with nitroglycerin)

A

calcium channel blockers

beta-blockers

43
Q

adenosine is an _____________ drug

mechanism of action:

A

antiarrhythmic

agonist at adenosine A1 receptor (purinergic) –> K+ efflux, hyperpolarization –> cardiac slower (decreased AV node conduction)

INHIBITS AV NODE CONDUCTION

44
Q

side effects with verapamil and diltiazem

A

hypotension, bradycardia, headache, AV block

45
Q

what is amiodarone used for

A

VT and VF not responding to other medications

off-label for Afib

46
Q

side effects of lidocaine as an antiarrhythmic

A

CNS simulation - seizures

47
Q

the main way nitrates decrease angina -

A

reduction of cardiac work (venous relaxation –> reduced preload) and thus reduce oxygen demand

48
Q

who should not be given beta-blockers?

A

asthmatics/COPD (causes bronchospasm in them)

people with unstable HF (can aggravate)

49
Q

__________ _________ is the primary determinant of myocardial oxygen consumption

A

tension generation

50
Q

what calcium channel blockers can be used to treat stable angina?

A

verapamil and diltiazem

51
Q

norepinephrine

receptors
what is it used for?

A

alpha-1, alpha-2, beta-1

treatment of hypotension, shock

52
Q

use of adenosine:

A

SVT

53
Q

when an agonist binds to a beta-1 receptor, what is the intracellular pathway?

A

Gs –> increase cAMP

increase heart rate, force, renin release

54
Q

epinephrine

receptors
effect on HR, BP

A

alpha-1, alpha-2, beta-1, beta-2

increase in BP (alpha-1), and an increase in HR (Beta-1 is stronger than the reflex)

55
Q

nitroglycerine

sublingual is used for
IV is used for

A

sublingual - prophylaxis and treatment of stable angina

IV - heart failure

56
Q

drug interactions of amiodarone?

A

uses CP450 for metabolism

interacts with warfarin and digoxin

57
Q

hemodynamics of how verapamil and diltiazem relieve stable angina?

specific –> general

A

decrease rate (AV, SA node AP)
decreased contractility
increase on coronary blood flow (dilation)

increase myocardial oxygen supply and decrease demand

58
Q

what drug slows the ventricular contractions to see the P wave morphology more clearly

A

adenosine

59
Q

main mechanism (in one sentence) of verapamil and diltiazem

A

slow AV node conduction

60
Q

the main effect of nitroglycerin on hemodynamics is that it reduces __________

A

preload (venous dilation)

therefore, reduces O2 demand

61
Q

what classes of drugs can be used for stable angina?

A

calcium channel blockers
beta-blockers
organic nitrates
(statins for underlying problem)

Cardio Block - CPR (6 decks)

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