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Pharm test 3 > everything > Flashcards

everything Flashcards

1
Q

1st line for SVT

A

Diltiazam

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2
Q

Marked effect on AV

A

Verapamil

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3
Q

Greatest effect on art dilation

A

Nicardipine

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4
Q

the dihydropyridines

A

CCB:
Amlodipine
Nifedipine
Nicardipine

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5
Q

the non-dihydropyridines

A

CCB:
Diltiazam
Verapamil

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6
Q

who dilates art more than venous

A

CCB

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7
Q

who dilates venous more than art

A

nitrates at low doses

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8
Q

Nitrates hemodynamics

A

decrease preload/afterload, demand
increased coronary blood flow
improve LV compliance

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9
Q

BB hemodynamics

A

decrease CO, HR, contractility

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10
Q

metoprolol, atenolol SE

A

mask hypoglycemia warning signs
bronchospasms in asthmatics
do NOT abruptly dc
Atenolol not for kidney disease

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11
Q

CCB and IA cause what

A

myocardial depression and vasodilation

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12
Q

CCB hemodynamics

A 
decreased HR (sa node) 
Dromotorpic (av node) 
Decreased conductivity 
inotropic-decrased contractility 
coronary and art dilation
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13
Q

Verapamil uses

A 
SVT
vasospastic angina 
HTN
pulm HTN
hypertrophic cardiomyopathy
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14
Q

metabolized by hepatic

A 
nifedipine
verapamil
Nitro
isosorbide monoitrate
propranolol
amiodarone
phenytoin
Atropine 
lido
(Im PLAt PAm NNV)
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15
Q

metabolized by cp450

A

diltiazem

metoprolol

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16
Q

which diuretic has the most Na excretion

A

loop diuretics:
Furosemide
Bumetanide
Torsemide

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17
Q

which diuretic looses its effectiveness when creat clearance <30ml/min

A

“distat tubule” thiazide, metolaxone, Spironolactone

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18
Q

what MOA makes the diuretic a K sparing

A

decreased the Na/K exchange

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19
Q

what 2 drugs together need K monitoring bc both decreased K excretion

A

spironolactone and ACEI

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20
Q

which drug decrease mortality in HF

A

aldosterone antagonist diuretic (30%) other diuretics no.
ACEI
ARBs
hydralizine (af americ)

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21
Q

which has less decrease in Preload ACEI or ARBs

A

ARBs

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22
Q

Bidill is made up of which 2 drugs

A 
Hydralazine (vasodilator)
Isosorbide dinitrate (venodilator)
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23
Q

pts who don’t tolerate and ACEI can be on what?

A

Hydralazine

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24
Q

ARBs lack what compared to ACEI

A

lack bradykinin related vasodilation

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25
Q

the antidote to digoxin is

A

digoxin immune Fab

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26
Q

SE of digoxin bc of MOA

A

hypokalemia

MOA is: cardiac glucoside Na-Katpase inhibitor, increase PSNS activity, prolonged conductance through AV

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27
Q

increased risk of AV block with dig and…

A

bblocker

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28
Q

Abx do what to dig levels

A

decrease, speed up absorption

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29
Q

which drugs increase dig levels

A

Verapamil, Quinidine, Amiodarone

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30
Q

hemodynamics of Dobutamine

A

stimulation of B1: increased contractility

Stimulation of B2: art vasodilation Decreased afterload

31
Q

phosphodiesterase inhibitors MOA

A

inhibit breakdown of cAMP and cGMP leading to increased amt of cGMP, cAMP=relaxation

32
Q

hemodynamics of phosphodiesterase inhibitors

A

increase contractility

decrease afterload, preload, LVEDP (improved diastolic relaxation)

33
Q

why can arrhythmias be caused by amrionone?

A

bc of the increased Ca

34
Q

the phosphodiesterase inhibitor have what kind of therapeutic index

A

wide, to unlikely

35
Q

what makes the difference btwn amrionone and milrinone

A

milrinone has less tachycardia and thrombocytopenia

36
Q

hemodynamics of clonidine

A

decreased BP, CO (due to decreased HR, PVR)

37
Q

Clonidine MOA

A

alpha2 agonist, decreased SNS outflow

38
Q

Verapamil and B blockers place if risk of

A

AV block and HF.

39
Q

Phase 0: drug class that works here

A

class 1abc

40
Q

Phase 4: drug class that works here

A

class 2

41
Q

Phase 2: drug class that works here

A

class 4

42
Q

Phase:1,2,3 drug class that works here

A

class 3

43
Q

Ia MOA

A

Intermediate Na blocker
prolonged repolar
decreased conduction velocity, deplor
increase AP duration

44
Q

1b MOA

A

Fast Na Blocker
Shortens AP and refractory period
decrease automaticity

45
Q

1c MOA

A

Slow Na blocker
decreased depolar rate and conduction
increased AP
inhibit conduction through His-Purkinje

46
Q

which class 1a is not used bc of SE

A

procainamide

47
Q

SE of disopyramide

A

CHF, hypotension

48
Q

Lidocaine SE

A

hypotension, bradycardia

LA to effects: decreased CNS, drowsiness etc.

49
Q

Lido theraputic [ ]

A

1-5mcg/ml

50
Q

class 2 antiarrhy MOA

A 
BB
decrease depolar 
decrease SA discharge
Slow speed of conduction though AV 
increase AP in atria
decrease automaticity
51
Q

excreted renally

A 
nitro
nifedipine
dilt
dig
amrionone
milrinone 80%
clonidine 50%
phenytoin
lido 10%
ACEI
(Dig Dilt MAC Amri....then from the hepatic one PL NN)
52
Q

excreted unchanged in urine

A

verapamil 70%
hydralazine <15%
Minoxidil 10%

53
Q

esmolol is metabolized by what

A

plasma esterase

54
Q

which drug has the longed e1/2t

A

amiodarone, 29days

55
Q

class 3 MOA

A 
block K channels 
prolonged depolar, refractory period
increase AP, lengthing repolar
decrease conduction velocity 
Increased QT internal 
decrease automaticity
56
Q

amiodarone cardiac SE

A

hypotension, heart block, pro-arrhy: torsades

NOT for torsades

57
Q

class 4 includes what type of drug and MOA

A

CCB AV node
decrease conduction through AV node
shorten phase 2 of vent myocyte

58
Q

class 4 not for what arrhy

A

vent arrhy

59
Q

pt on BB which CCB would be the best option and why

A

dilt. bc unlikely to interact with BB and less cardio depressant

60
Q

which CCB has a shorter e1/2t

A

dilt

61
Q

adenosine should not be giving in what patients

A

asthma

62
Q

adensoine MOA

A

binds to A1 purine nucleotide receptor, activated receptors open K channels increases K currents, slows AV conductance

63
Q

phenytoin is like what drug and tx what

A 
resembles lido and class 1a
torsades
64
Q

atropine what type of drug

A

antimuscrinic

can penetrate BBB

65
Q

which drug is antagonized by NSAIDs

A

captopril

66
Q

what makes enalapril different from captopril

A

enalapril lacks sulfhydryl thus does not cause rash and renal insufficiency

67
Q

what makes ARBs different from ACEI

A

ARBs have no effect on ACE, just block receptor.
Have less cough as side effect.
no significant bradykinin accumulation

68
Q

hydralizine MOA

A

phthalazine derivative

activates gauntlet cyclase producing direct relaxation of vascular smooth muscle

69
Q

what combo of drugs results in less SNS activity, less tachycardia and release of renin

A

Hydralzine or Minoxidil, BB and diuretic

70
Q

Minoxidil MOA and cardiac SE

A

Directly relaxes the art of smooth muscle, little effect on venous capacitance
increase influx of K into cell causing depolar and dilation.
Can have abn ECG- flat or inverted T waves.

71
Q

what drug is used for controlled hypotension technique?

A

nitroprusside

72
Q

SNP MOA

A

DIRECT release of NO
SNP and oxyhbg dissociate to form Methemoglobin releasing NO and cyanide
NO activates gauntlet cyclase increasing cGMP
cGMP inhibits Ca entry into vascular sm but increases uptake of Ca into sER
NONselective relaxation of art and venous vascular sm

73
Q

hemodynamics of SNP

A

Direct venous and art vasodilation
decreased SBP, SVR, PVR
increased contractility—causes an intracoronary steal
Baroreceptor mediated reflex increased HR
does NOT dilated coronaries

Pharm test 3 (6 decks)

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