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AU14 Pharmacology > Exam 3; Cardiovascular Drugs > Flashcards

Exam 3; Cardiovascular Drugs Flashcards

1
Q

What is an arrhythmia

A

alternation in the normal impulse pathway

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2
Q

What can be two causes of an arrhythmia

A

alteration in the pacemaker

alteration in the transmission pathway

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3
Q

This is the source of the start of a rhythm

A

ectopic focus

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4
Q

Which is worse, ventricular or atrial fibrillation

A

ventricular; life threatening

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5
Q

What can result from ventricular fibrillation

A

decreased CO

clots may form

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6
Q

What is a major cause of sudden cardiac death

A

ventricular arrhythmias

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7
Q

Why is a non-drug treatment preferred for an arrhythmia

A

drug treatments may further cause arrhythmias

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8
Q

What are four types of non-drug treatments of arrhythmia

A

pacemaker implantation
cardioversion
automatic defibrillator implantation
surgical removal of an ectopic signal

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9
Q

This family of drugs are Na channel blockers that decrease the rate of depolarization

A

local anesthetics

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10
Q

This Na channel blocker can be used for all arrhythmias; depresses muscle function and anticholinergic effects

A

La-quinidine

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11
Q

What are three symptoms of La-quinidine

A

GI upset
vomiting
anorexia

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12
Q

What are two CNS effects of la-quinidine

A

tinnitus

altered color vision

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13
Q

This Na blocker does not enter the CNS, so no CNS effects and has a lupus like effect in low acetylators

A

procainamide

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14
Q

This Na channel blocker has strong anti-vagal effects; anti-muscarinic effects or oppostie of DUMBELLS

A

disopyramide

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15
Q

This Na channel blocker is give IV due to the first pass effect has low toxicity and is useful for treating ventricular tachycardia

A

Lb-lidocaine

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16
Q

What are two symptoms of lb-lidocaine

A

tremors and seizures

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17
Q

This Na channel blocker is given orally, has low toxicity and is useful for treating ventricular tachycardia; can result in tremors and seizures

A

mexiletine

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18
Q

What are the 5 Na channel blockers (anti-arrhythmia)

A 
la-quinidine
procainamide
disophyamide
lb-lidocaine
mexiletine
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19
Q

These three drugs are anti-arrhythmia beta blockers

A

propranolol
metaprolol
esmolol

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20
Q

What is the mechanism behind the beta blockers

A

block the beta1 receptors in the heart

effectively slows the heart rate

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21
Q

This beta blocker decreases the pacemaker firing rate

A

propranolol

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22
Q

This beta blocker is more selective and has less beta 2 effects

A

metaprolol

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23
Q

This beta blocker has a more rapid onset

A

esmolol

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24
Q

What are three symptoms of beta blockers

A

bradycardia
hypotension
if there is a beta2 effect, asthma

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25
Q

What are the three potassium channel blockers

A

sotalol
amiodarone
dronedarone

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26
Q

This is a beta blocker that also blocks K channels

A

sotalol

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27
Q

This is a Na, K, and beta blockader

A

amiodarone

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28
Q

This is the most effective anti-arrhythmic; DOC in cases of cardiac arrest

A

amiodarone

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29
Q

This is an analog of amiodarone, with fewer side effects and less efficacy

A

dronedarone

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30
Q

This drug has symptoms such as potentially fatal pulmonary fibrosis, liver damage, blue-grey skin coloration, and GI upset

A

amiodarone

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31
Q

Where are two places on the body that amiodarone can be deposited and what are its effects

A

can be deposited in the cornea; optic neuritis

can be deposited in the skin; iodine containing

32
Q

What are three Ca channel blockers

A

verapamil
diltizaem
nifedpine

33
Q

What is the mechanism behind the Ca channel blockers

A

blocks Ca transport into cardiac cells; increasing the refractory period

34
Q

This anti-arrhythmic is given IV and binds to the adenosine receptor which decreases the firing rate of the AV node

A

adenosine

35
Q

What is the half life of adenosine

A

very short; 10 seconds

36
Q

What is adenosine most useful for

A

atrial tachycardia

coronary vasodilator

37
Q

This is when there is not enough blood flow to the heart muscles

A

angina

38
Q

When is angina the most severe

A

if there is chest pain at rest and not solely after exercise

39
Q

What are the two ways in which we can treat angina

A

increasing blood flow to the heart or decreasing oxygen demand
behavior modifications

40
Q

This drug rapidly dilates all blood vessels; arteries and veins, including the coronary arteries

A

glyceryl trinitrate (nitroglycerin)

41
Q

What is the mechanism of nitroglycerin

A

activates cGMP which leads to vascular dilation

42
Q

How long do the effects of nitroglycerin last

A

30 mins to an hour

43
Q

What are three side effects of nitroglycerin

A

hypotension
skin flushing
headache

44
Q

This becomes of nitroglycerin if you take it continuously within a day

A

rapid tolerance; after even a day there will be no effect

45
Q

nitroglycerin is given which method

A

patch or paste

in order to divert the 1st pass metabolism

46
Q

This drug is a slow release nitrate formulation and can be given orally

A

isosorbide dinitrate

47
Q

This family of drugs is used to decrease heart rate via being a beta blocker

A

-olol’s

48
Q

This family of drugs is used to decrease heart rate via being a Ca channel blocker

A

-ipine

49
Q

What is the concept behind congestive heart failure

A

cardiac muscles are not contracting as much
blood comes to the heart but doesn’t leave fast enough
heart enlarges
tissues become anoxic

50
Q

The blood back up from congestive heart failure can go to wear and lead to what

A

can back up into the lungs and lead to pulmonary congestion, decreasing the ability to breathe

51
Q

What happens to the kidney during congestive heart failure

A

the kidney is not well perfused; causing retention of Na and fluids leading to peripheral edema

52
Q

The heart responds to congestive heart failure in what way

A

release of EPI, NE, and angiotension II

53
Q

What effects do EPI, NE, and angiotension II have on the heart during congestive heart failure

A

increases blood pressure
increases heart rate
vasoconstriction

54
Q

Angiotension II causes an increase in what

A

blood volume; increased Na retention and increased aldosterone secretion leads to increased Na/K exchanger

55
Q

This occurs in response to the force of contraction due to stretching of cardiac muscles

A

enlargement of the heart

56
Q

The heart will work harder to compensate for its failing mechanisms which is bad, why?

A

its already damaged so working harder makes it even more damaged

57
Q

What is the mechanism behind digoxin

A

inhibits the Na/K ATPase which results in Na remaining high in the cardiomyocyte thus preventing Ca from leaving the cell increasing the contractility

58
Q

What are two toxic effects of digtoxin

A

cardiac arrhthymia

CNS effects

59
Q

What are the three CNS effects of digtoxin

A

vision; yellow/green tinting (VanGogh)
hallucinations
activation of chemoreceptor trigger zone; nausea

60
Q

The effects of digoxin are associated with what condition

A

hypokalemia

61
Q

How would you treat digoxin poisoning

A

with anti-digoxin antibodies

62
Q

What is the mechanism behind dobutamine

A

it is a beta1 agonist and also increases the amount of Ca in the heart muscle

63
Q

Dobutamine may increase the force of contraction but may not necessarily increase what

A

the rate

64
Q

These four drugs are the best treatment of CHF; the use of agents that inhibit the body’s compensatory changes in heart failure

A

ACE inhibitors
beta blocketers
vasodilators
diuretics

65
Q

This drug decreases blood pressure and fluid retention

A

ACE inhibitors

66
Q

This drug decreases heart rate

A

beta blockers

67
Q

This drug decreases blood pressure

A

vasodilators

68
Q

What are four agents that increase blood flow to selected organs (penis)

A 
sildenafil
vardenafil
tadalafil
avanafil
"-fil's"
69
Q

What is the mechanism behind the drugs that increase blood flow to the penis

A

inhibitors of type 5 cGMP phosphodiesterases; strong vasodilator

70
Q

What should you not take with the drugs that increase blood flow to the penis

A

nitrates they also increase cGMP leading to vasodilation
alpha-1 blockers
can lead to a severe decrease in blood pressure

71
Q

What are two side effects of the drugs that increase blood flow to the penis

A

stroke or myocardial infarction

72
Q

How can drugs that increase blood flow to the penis cause visual disturbances

A

impaired blue/green color discrimination

NAION; damage to the retina; induced by cGMP phosphodiesterase inhibitors

73
Q

What are the drugs that increase blood flow to the penis metabolized by

A

P450

74
Q

What other condition can drugs that increase blood flow to the penis treat

A

pulmonary hypertension

75
Q

This is injectable prostaglandin E1 which leads to vasodilation when injected directly into the penis

A

alprostadil

AU14 Pharmacology (29 decks)

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