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Pharmacology > Exam II > Flashcards

Exam II Flashcards

1
Q

The seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

A

JNC7 Report: (2003)

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2
Q

Blood pressure Goal according to JNC7 Report

A

BP less than 140/90 Tx; Life style Modification

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3
Q

Stage 1 HTN according to JNC7 Report

A

Sys. 140-159 or Dia: 90-99 TX: Pharmacologic/ Lifestyle

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4
Q

Stage 2 HTN according to JNC7 Report

A

Sys: equal or> 160 Dia: Equal to >100

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5
Q

Hypertension Diagnosis

A

Average of 2 or more seated BP measurements from 2 or more clinical encounters

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6
Q

Optimal BP goals vary depending on:

A
  • Age
  • Concomitant Diseases
  • Demographics
  • Drug Interactions
  • Economic Considerations
  • Guidelines
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7
Q

Patient w/o CKD but w/ DM (non-black)

A

Initiate;

Thiazide, ACEI, ARB or CCB or Combo

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8
Q

Patient w/o CKD but w/ DM (black)

A

Initiate:

Thiazide or CCB Alone or Combo

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9
Q

Patient with CKD and with or without DM

A

Initiate:

ACEI: or ARB Alone or combo w/ other classes

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10
Q

Drug Treatment Titration Strategies

A

A. Maximize 1st Rx before adding 2nd
B. Add 2nd Rx before reaching Max dose of 1st Rx
C. Start w/ 2 Rxs separately or as fixed-dose combo

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11
Q

Which combination of the Guideline medications should not be combined

A

ACEI and ARBs

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12
Q

What is the drug of choice when; treating hypertension with comorbid diabetes and/or CKD?

A

ACEI or ARB (Angiotensin Receptor blocker)

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13
Q

Guideline medications contraindicated in pregnancy are

A

ACEI and ARBs

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14
Q

Largely Determines Systolic Blood Pressure

A

Cardiac Output (HR * Stroke Volume)

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15
Q

Cardiac Output is a function of

A
  • Stroke Volume
  • Heart Rate
  • Venous Capacitence
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16
Q

Largely Determines Diastolic Blood Pressure

A

Total Peripheral Resstance

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17
Q

Total Peripheral resistance is the function of

A

Vascular resistance and Heart

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18
Q

Blood Pressure fluctuations throughout the day

A

Lowest= Sleep
Rises =Awakening
Peaks =Midmorning

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19
Q

Blood pressure is a product of

A

Cardiac output X Total Peripheral Resistance

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20
Q

Diuretics Include

A
  • Thiazide and Thiazide like Rxs
  • Aldosterone Antagonists
  • Loop Diuretics
  • Carbonic Anhyrodase Inhibitors
  • Osmotic Diuretics
  • Pottasium Sparing diuretics
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21
Q

Blocker Agents include

A
  • Mixed Alpha/Beta Blockers
  • Intrinsic sympathomimetics
  • Non-selective Beta Blockers
  • Non-Dihydropyridines CCBs
  • Dihydropyridine CCBs
  • Cardio Selective Beta Blockers
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22
Q

Agonists Antagonists include

A
  • Direct Arterial Vasodialators
  • Inotropics
  • Dompamine Agonists
  • Central Alpha 2 Agonists
  • Alpha 1 Blockers
  • Peripheral Adrenergic Antagonists
  • Sodium Channel Blockers
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23
Q

Inhibitors Include

A
  • Neprylisin Inhibitors
  • Angiotensin Converting Enzyme Inhibitors (ACEI)
  • Direct Renin Inhibitors
  • Angiotensin II Receptor Blockers (ARB)
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24
Q

inhibit Na+ and Cl- reabsorption in distal convoluted tubule (DCT) resulting in water elimination

Lead to Erect D. hyperurecimia/lipidemia/glycemia; hypokalemia/natremia; promotes Ca++ reabsorption

A

Thiazide and Thiazide like Diuretics

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25
Q

Thiazide and like Diuretics medications include

A
  • Hydrochlorothiazide
  • Metolazone
  • Indapamide
  • Corthalidone (More Morbidity Benefits)
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26
Q

inhibition of Hormone; which inhibits Na retention, and retains K+ Mg++ and inhibits Sympathetic activation

Use: Pts w/ severe S/S, preserved renal fx, Norm K+ levels. Plasma K+ must be monitored-Hyperkalemia

A

Aldosterone Antagonists

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27
Q

Aldosterone

A
  • Eplerenone
  • Spironolactone
  • Spironolactone/Hydrochlorothiazide
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28
Q

Blocks reabsorption of Na+ Cl- K+@ LOH co-transporter; Most potent; w/ poor renal fx patients,Edema,hyper-K+

NOT: Sulfa allergy, cause; Hyperuricimia, hypoMg++, electrolyte disturbance NSAIDS RxI,

A

Loop Diuretics

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29
Q

Loop Diuretic drugs include

A
  • Bumetanide
  • Ethacrynic Acid
  • Torsemide
  • Furosemide
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30
Q

Inhibits Na+ proton exchange for H+ inc. elimination @ PCT. Inc HCO3 in urine=Inc pH urine–> hyperchlorimia

Tx-AMS and Glaucoma (Open) Dec. CSF and its pH; —-CNS Drowsiness; tolerance dev, K-stones, HyperCl-MA
NOT-COPD, Asthma, Cirrhosis, Nephro-neuro toxic w/rx

A

Carbonic Anhydrous Inhibitors

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31
Q

Carbonic Anhydrous Inhibitors

A

Acetazolomide and AZT SR

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32
Q

Freely filterable at Glomerulus; Osmotic gradient Not reabsorbed–>water to be retained in in PCT–> diureses

Use: Cerebral Edema and maintain urine flow in toxic ingestion of renal failure susbtances; worsens CHF

A

Osmotic Diuretic (Mannitol)

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33
Q

Sodium Channel Inhibitors retains K+ in Collecting Duct
Added to prevent hypokalemia w/ Loops and Thiazides

Tx-resistant HTN, CHF,Ascites, Polycistic Ovary syndro., ADV: Hyperkalemia, Ulcer, pregnancy, ARBS, ACEI

A

Potassium Sparing Diuretics

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34
Q

Potassium Sparing Diuretics

A
  • Amiloride

- Triamterene

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35
Q

Usage in HF in mild fluid overload/regular management for HTN after Max ceiling of Loops met

A

(Thazide or Thiazide Like)

  • Metalozone
  • Indapamide
  • Chlorthalidone
  • Chlorothiazide
  • Hydrochlorothiazide (HCTZ)
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36
Q

used w/ Loop diuretics in diuretic resistance. Used when GFR<20mls/min;; Dose= 20mg/day for edema

Reserved for add on-on therapy in Loop refractory patients; Caution w/ ARBS and ACEIs and K+–>K+ Inc.

A

Metazolone

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37
Q

Possibly does not affect lipid profile; improves CV outcomes in pts >80 y/o

A

Indapamide

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38
Q

Diuretic with most evidence for improved CV outcome; little benefit with dose > 25mg/day (24 hr BP control)

A

Chlorthalidone

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39
Q

Most commonly used Thiazide and Thiazide like; Higher doses up to 200mg used in edema

A

Hydrochlorothiazide (HCTZ)

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40
Q

Has additional benefits in CHF diuretic unrelated. Slows ventricle hypertrophy, Inhibit cardiac remodeling

Dec. mortality and morbidity LVeF<40% S/S HF and DM
Add to ACEIs or ARBs; K+ accumulation;CrCl>30ml/min

A

Eplerenone and Spironolactone

(Aldosterone Antagonist)

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41
Q

Best when fluid overload is excessive, edema required to reduce quickly, or when kidney impaired

Avoid Nephrotoxic Rx; Abx Aminoglycosides; Hypovolemia; tinnitus; hyperurecimia;hypomagnesaemia

A

[Loop Diuretics]

  • Bumetanide;
  • Torsemide;
  • Furosimide;
  • Ethacrynic Acid;
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42
Q

Loop Diuretic much more potent than Furosimide

A

Bumetadine

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43
Q

Loop diuretic Generally given BID for HTN due short 1/2 life; causes hyperurecemia

A

Furosimide

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44
Q

Loop Diuretic much more potent than Furosimide

A

Torsemide

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45
Q

Loop diuretic Not a sulfa, Alternate for sulfa allergy pts; causes hyperurecemia

A

Ethacrynic Acid

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46
Q

Tx for AMS 24-48 hrs prior to ascent and continue 48
Tx for Open Angle glaucoma pre-Sx IOP lowering Rx

Tx; Absence seizures secondary acidosis
CI; Cirrhosis Caution; COPD,Asthma, Resp. Acidosis

A

Acetazolomide (Carboni Anhydrous Inhibitors)

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47
Q

Product crystalizes and requries warming (dry heat oven or hot water bath and cool) 20-200mg/24 hrs

CI: Intracranial bleeding, pulmonary or chronic edema
AE; Dehydration,Kidney fx and ICP monitoring

A

Mannitol

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48
Q

DOC for lithium induced nephrogenic diabetes insipidus; primarily used in combinations

A

Traimterene

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49
Q

Aldosterone Antagonist reduces morbidity asso. w/HF avoid in Scr<20/mg/dL HF-25mg and HTN-50mg

A

Eplerenone or Spironolactone

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50
Q

Inhibitor that blocks Angiotensin II at receptor and Inc. natriuretic peptide causes vessel dialation.

Reduce risk of CV death/hospital. Class II IV HF, in place of ARB or ACEI.

A

Neprylisin Inhibitor/ARB (Sacubritil/Valsartan)

51
Q

Inhibits RAAS AT-I –>AT-II by Renin. Reduce, HR, ADH, Aldosterone, Na+ re-Abs., Sympathetic NS. DEC. HTN

No inc. HR, Output, contractility; Inc. of Bradykinin.
TX: DM, Post MI, CHF, Hx stroke, coronary disease
CI: Pregnancy, AE; Angioedema dry cough R-Trifecta

A

Antiotensin Converting Enzyme Inhibitors (ACEIs)

-Prils

52
Q

Tx: HTN Start= 6.25mg TID Target Dose= 50 mg TID

CI: Renal Trifecta; No ARB ACEI combo; Prego Cat-D Renal Artery Stenosis; Start 50% w/ diuretic*Inc age

A

Captopril

53
Q

Tx: HTN Start=2.5 BID Target Dose= 10mg BID

CI: Renal Trifecta; No ARB ACEI combo; Prego Cat-D Renal Artery Stenosis; Start 50% w/ diuretic*Inc. age

A

Enalapril

54
Q

Tx HTN Start= 2.5-5mg/day Target Dose= 20mg/day

CI: Renal Trifecta; No ARB ACEI combo; Prego Cat-D Renal Artery Stenosis; Start 50% w/ diuretic Inc age

A

Lisinopril

55
Q

Directly Inhibits Angiotensin converting enzyme. Reduces AT-I. “Sulfa” Avoid NSAIDS

TX: HTN 150mg/day :Cough,Angioedema, hyper-k
CI: Pregnancy; No ACEI or ARB combow/

A

Aliskerin (Direct Renin Inhibitor)

56
Q

Antagonize AT-II at AT1 Receptor. Blocks Aldosterone. Reserved for Non tolerance ACEI Pts. No Combo ACEI

TX: HTN (CHF) AE: Lower Angioedema, Dry cough; Hyper-k, Renal CI; Pregnancy Cat-D, R-Trifecta,

A

Angiotensin II Receptor Blockers (ARBs)

(-artan)

57
Q

TX: HF (HTN) Start: 4-8mg/day Target Dose=32mg/day

Start:Reduce 50% dose if w/ diuretic or elderly; Preg-D
Kidney failure in Renals Stenosis (ARB)

A

Candesartan

58
Q

TX: HF (HTN) Start: 20-40mg/Day
Target Dose= 160mg/day

Start:Reduce 50% dose if w/ diuretic or elderly; Preg-D
Kidney failure in Renals Stenosis (ARB)

A

Valsartan

59
Q

TX: HF (HTN) Start: 20-50mg/Day
Target Dose= 150mg/day

Start:Reduce 50% dose if w/ diuretic or elderly; Preg-D
Kidney failure in Renals Stenosis (ARB)

A

Losartan

60
Q

Selectively block Recep. at vessel, prevent vaso constriction. Rarely used as 1st step; Not-monotherapy

Tx: BPH and HTN; Resitant HTN w/ ACEor B-Blocker.AE: Reflex Tachycardia, Edema, CNS, Erectile D.

A

A1 Adrenergic Blcoking Agents (-sin)

61
Q

A1 Adrenergic Blocking Agents include

A
  • Terazosin
  • Doxazosin
  • Prazosin (PTSD)
  • Tamsulosin (BPH) Only
  • Silodosin (BPH Only)
62
Q

Tx: of Hypertension selectively blocks A1 Receptors in vessels. Erectile Dysfunction.

1st Dose should be given at bedtime; Educate to prevent hypotension syncope episode

A
  • Terazosin

- Doxazosin

63
Q

Tx: PTSD A1 Receptors in vessels. Erectile Dysfunction.

NOT for BPH 1st Dose should be given at bedtime; Educate to prevent hypotension syncope episode;

A

Prazosin

64
Q

TX: Benign Prostate Hyperplasia

1st Dose should be given at bedtime; Educate to prevent hypotension syncope episode;

A
  • Tamsulosin

- Silodosin

65
Q

Stimulates presynaptic receptor in the CNS inhibits negative feedback causing peripheral vasodilation

Best w/combo agents diuretics/ACEI; AE=Drowsiness, rebound hypertension, Edema/fluid retention,drymouth

A

Central A2 Agonist

66
Q

Tx: Hypertension, ADHD and Tourettes ; Combine w/ difficult control HTN; Patch change 1/week

Unlabeled tx: Alcohol/smoke withdrawal, mania, restless leg syndrome ; Abrupt stop= Reflex HTN

CI: Depression, TCAs and geriatrics

A

Clonidine (Patch available)

67
Q

TX: HTN (1st Line for Pregnancy) Requires TID or QID

AE: Mental deppresion, Dec. concentration, nightmares, constipation, sedation

A

Methyldopa

68
Q

TX: HTN, TICs, ADHD ; Do not offer advantage over clonidine rarely used

Older agent used in HTN

A

Guanabenz

Guanfacine (TIC/ADHD)

69
Q

TX;HTN=Dec. HR and contraction; CHF=Dec. vaso constriction. Blocks Receptors. Abrupt=Rebound HTN

AE: Bradycardia, caution-diabetics, Asthma hytension.
DI: Antagonizes after binding receptor.

A

Mixed A1 and B

  • Carvedilol
  • Labetalol
70
Q

TX: HTN and CHF “Mainly” w/food=Dec. Hypotension
Beta-nonselective caution: Asthma and Diabetes

Abrupt rebound HTN if abruptly discontinued

A

Carvedilol

71
Q

TX: HTN and CHF 2nd Line for Pregnancy
Beta-nonselective caution: Asthma and Diabetes

Abrupt rebound HTN if abruptly discontinued

A

Labetalol

72
Q

Antogonist for cardio recep. Inhibits Renin SNS; Reduces water retention Rate and Force; African Amer.

TX: HTN, Angina, CHF, Arrythmias (A-Fib), Post-MI, migraine headache, Hyperthyroidism, Pheo, Glaucoma

A

Beta Adrenergic Blocking Agent (-lol) (Beta-blockers)

73
Q

Inhibition @ low doses. In HTN dec. rate/ contraction
do not Restrict bronchioles or reduce glycogenolysis

Greater affinity for cardio and has less effect on asthma and diabetes

A

Cardio Selective B-Blockers

74
Q

Cardio Selective B-Blockers include

Which has immediate release? which has transition warning?

A
  • Atenolol
  • Betaxolol
  • Bisprolol
  • Metoprolol (Succinate/Tartrate)
  • Esmolol (Transition Warning)
75
Q

Non-Selective B-Blockers

A
  • Nadalol
  • Propranolol
  • Timolol
76
Q

Partial Beta agonist for pts that require Beta Blocker, but do not tolerate bradycardia w/ common B-blocker

AVOID; Post Myocardial Infarct (MI)

A

Intrinsic Sympathomimetic Activity (ISA)

  • Acebutolol
  • Penbutolol
  • Pindolol
77
Q

Block L-Type Ca++ channels of smooth m. coronary and systemic. Minim. direct cardio effect->compensative HR

TX;HTN in pts w/ Asthma, Diabetes, Angina,Arrythmia, PVD, African Americans; AE: Edema,flushing; 4th line tx
short acting= Inc. risk of MI/reflex tachycardia;combo BB

A

Dihydropyridine CCBs (-ines)

78
Q

Dihydropyridine CCBs (-ines) includes

A
  • Amlodipine
  • Felodipine
  • Israpidine
  • Nicardipine
  • Nifedipine (Only Long Acting)
  • Nimodipine (Subarachnoid hemorrhage only)
  • Nisoldipine
  • Clevidipine
79
Q

Preferred in patients w/ tachycardia and rate control w/ atrial fibrillation who do not tolerate BBs

A

Non-Dihydropyridines CCBs

  • Verapamil
  • Diltiazem
80
Q

Least selective of CCB (Nondihy) w/significant effects in Cardio and vascular smooth muscle.

Tx: Angina, SVT-Arrythmia, migraine and cluster HAs

A

Verapimil

81
Q

Less pronounced Negative Inotropic effects on Heart

Tx PSVT-arrythmia Aflutter/Fib

A

Diltiazem

82
Q

Blocks the transport of Epi/Norepi/serotonin; used as adjunct therapy for severe hypertension

AE: CNS S/S. Anxiety, depression or psychosis
Caution: Parkinson’s and Asthma

A

Peripheral Mononamine Antagonist

-Reserpine

83
Q

Inhibits PDE3 (breaksdown AMP/CAMP)–>Vasodilation and Dec. SVR; Inc.CO w/o HR change. 1/2 life 2-3 hrs

TX for ADHF “BBs” 1. Cold/Dry 2. Alt. Cold/Wet AE: Arrythmia,HoTN,thrombocytopenia

A

Inotrope

-Milrinone

84
Q

Inhibits late phase inward Na+ channel in ischemic myocytes. Reduces Na= concentrations reduces Ca++

Tx: Monotherapy if initial tx w/ BBs adverse effects or CI
3rd line agent adjunct to CCBs, BBs, Nitrates; when traditonal meds not effective

A

Ranolazine

85
Q

Selective B1 Recetor agonist with min.A1 and B2. Inc. CO, Slight peripheral Vasodilation, Pos. Inotropic effect

Tx: ADHF “HoTN” 1; Cold/Wet; in lie of Dopamine if not effective; Declines in efficacy in 48-72hrs; 1/2 lie 2 min

A

Dobutamine (Inotrope)

86
Q

Agonist agent that is dose dependent on effects of A1, B1, B2, and D1; Avoided in ADHF unless;

Patient is hemodynamically unstable or cardiogenic shock in elevated bventricular pressures

A

Dopamine

87
Q

Direct Vasodilator; severe HTN who fail triple therapy or other agents precluded from use; Cause Lupus S/S

Tx; HTN ER, HTN control in pregnancy HTN, HF and HTN African American AE:Angina, arrythmia, headache

A

Hydralizine (PO/IV)

88
Q

Direct vasodilator; when hydralizine maxed, renal failure and severe HTN; Baldness Rogaine.

AE: Tachycardia,palpitations, angina edema, headache
hypertrichosis

A

Minoxidil

89
Q

coronary dialators relaxes vascular m. veins-dec. preload; N+O+ dependent dec. O2 demand

Tx:Stable Angina;in conjunct w/NonDHP/CCB;Prophylax for exercise;PRN use,immediate onset 1- 3 min ; Tolerance Dev; CI: ICP Reflex tachy, PDE5 viagra or Cialis

A

Nitrates

90
Q

Tx Prevention of Angina; Better clearence than NTG combo w/ Hydraziline. Add to ACEI and BBs dec mortal

Tabs onset 30min. 8-2hrs duration Sublingual available. TID/QID dosing

A

Isoborbide Dinitraite (ISDN)

91
Q

Tx: MGNT of chronic stable angina w/ BBs; Better clearence than NTG. Bioavailability 100% no 1st pass

not FDA approved for HF 1/day tablet. 30min. onset 8-12 hrs duration

A

Isoborbide Monotritrate

92
Q

Tx: Acute Angina .3,.4,.6 mg tabs c 1-5 min Max dose 3 in 15min.

Air and light sensitive CI; Viagra and Sialis, ICP (6 month old=no use) Tolerance dev w/i 24-48 hrs

A

Nitroglycerin (PO) (Spray)

93
Q

Tx: Chronic Stable Angina 12hrs on 12 hrs off mg release rate.

Air and light sensitive CI; Viagra and Sialis, ICP (6 month old=no use) Tolerance dev w/i 24-48 hrs short1/2

A

Nitroglycerin (Patch) (Ointment=15mg=1” TID)

94
Q

TX: ADHF 1. Warm and wet 2. Alt.Cold/Wet Hypertensive ER; ischemic HD, MI, HTN post bypass, Acute pulmonary edema; preferred preload redux

PVC tubing/bags absorb med, Severe headache, ICP short half life

A

Nitroglycerin (I.V)

95
Q

Tx: Severely elevated BP>180/120; not organ damage. Hospital not required. 24-48 BP redux Sympt or Asympt

Redux MAP no > 15%

A

Hypertensive Urgency

96
Q

Hypertensive Urgency Meds; Specialty of each?

A
  • Clonidine
  • Captopril (If pt has HF not pregnant)
  • Labetalol (Methyldopa not tolerated or pregnant)
97
Q

Elevated BP life threatening; Dec. BP in min-hrs180/120
W/ evidence of progressive organ damage S/S stroke, crushing chest pain, HA, eye kidney damage, disection

Goal BP;160/100 >in dissection;

A

Hypertensive emergency

98
Q

Hypertensive ER Vsodilators

A
  • Nitroglycerin I.V *
  • Soidum Nitroprusside *
  • Hydralazine *
  • Fenoldopam
99
Q

Emergency Hyepertensive ACEI (Only one IV) Longer lasting 12-24 hrs onset 15min only

Avoid in decompensated HF or Acute MI

A

Enalaprit

100
Q

Emergency Hypertensive CCB- Alternative to NTG.

Used in intracerebral hemorrhage/stroke, preclampsia; Not used due to long 1/2 life

A

Nicardipine PO or IV

101
Q

Emergency Hypertensive Adrenergic Inhibitors B1 Select Short-acting; severe tachy and inc. CO post OP HTN

Caution : Airway disease onset 2 min duration 10-20mi

A

-Esmolol

102
Q

Emergency Hypertensive Adrenergic Inhibitors B1 Select Short-acting; No reflex tachycardia inc. O2 demand. caution asthma

Preffered in CAD, acute dissection, Intracerebral hemo/stroke or MI Max potency 2 hrs onset=2min 2+hrs

A

Labetalol

103
Q

ypertensive emergency agent Nitrate onset 2-3 min

AE: cyanide Toxic, inc. ICP, CI: Renal Hepatic failure caution in asthma, acute HF and Heart block

A

Sodium Nitroprusside

104
Q

Arrhythmia PR prolongation SA impulse slow but reaches AV

A

1st Degree Block

105
Q

Arrhythmia P wave dropped occasionally. P wave present at times , occasionally dropped

A

2nd degree HB

106
Q

Arrhythmia SA node never crosses and AV takes over

A

3rd Degree Block

107
Q

Electrical impulse originating from SA node travels slowly or not at all to AV

A

Re-entry phenomenon

108
Q

Caused by excessive prolongation of K+ inhibition
Most commonly drug induces . Hypokalemia/manesimia

TX: Mg++

A

Torsades De Pointes

109
Q

Drugs that induce Torsades

A 
Anti-arrhythmics -Amiodorone
Antibiotics- Macrolides, quinolones
Anti-nausea-Odansetron
Antuidepressants/psychotics
Antimigraine- sumatryptan
110
Q

Types of Atrial Arrhythmias

A 
Supraventricular
A-Fib: HF, Ischemic stroke (head)
A-flutter
PSVT
PACs Premature Atrial Contractions
111
Q

Types of Ventricle Arrhythmias

A

Arrythmias
Vtac-Vfib
Torsades de Pointes
PVCs

112
Q

Slow the efflux of K+ during repolarization–> length in refratory period–> Dec. velocity

Na Channel Blocker TX:A-fib and A-flutter
(Dec. use due to proarrhythmias)

A

Class IA

  • Disopyramide
  • Quinidine
  • Procainamide
113
Q

Weak sodium channel blocker Shortens repolirization decreases refractory period. Local anesthetics agents

Tx: Ventricular Tachy/arrhythmia CI;3rd degree HB

A

Class IB

  • LIdocaine
  • Mexiletene
114
Q

Potent NA channel blocker; slows conduction while not affecting refractory period;

TX: supra ventricular arrythmias (A-FIB /FLutter)
DI: Digoxin CI:HF,CAD

A

Class I C

  • Flecainide (Pill in pocket)
  • Propafenone (Pill in pocket)
115
Q

Block Catecholamines; caution Asthma, DM, lipid abn.

TX: DOC AFIB/Flutter following MI

A 
Class II
Atenolol
Propanolol
Esmolol
Metoprolol
116
Q

Prolong Phase III prolongs duration of action potential and refractory period; rythm rate control

TX: Atrial and ventricular arrhythmias
(potential induce arrhythmias)

A

Class III

  • Amiodorone (Iodine based and CI: 3rd deg. Block)
  • Sotolol (CI: 2nd 3r deg Block and HF)
  • Ubutilide (Excellent:Atrial FIb/Flutter)
  • Dofetilide (specialized training rqd)
117
Q

Block L time calcium

Tx More Atrial than Ventricular AE;induces AV blocks

A

Class IV

  • Verapimil
  • Diltiazem
118
Q

Cardiac Glycoside inhibits Na+K+ ATPase Increses force stimulates vagus nerve slows SA and AV node

High toxicity Dev. Not for Renal Dfx pts. very narrow therapeutic window DI;Many (K+) DOC= PSVT

A

Digoxin

119
Q

Tx : PSVT DI theophylline AE: Asystole, chest tightness burning or SOB IV Push w/ flush

A

Adenosine

120
Q

Beta Blockers used for heart failure

A
  • Carvediolol and Carvedilol CR
  • Metoprolol Succinate succinate
  • Bisoprolol
121
Q

Starting Dose= 1.25mg/day Target Dose= 10mg/day

A

Bisoprolol

122
Q

Starting Dose= 3.125mg BID Target Dose=25mg BID

A

Carveidolol (10-80 for CR)

123
Q

Starting Dose= 12.5-25mg/D Target Dose=200mg/D

A

Metoprolol

Pharmacology (5 decks)

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