First Aid pg 306-310 Cardio Rx

Question 1

Which lipid lowering agent upregulates LPL?

Answer 1

Fibrates - gemfibrozil, clofibrate, bezafibrate

Question 2

Which lipid lowering agent exacerabates gout?

Answer 2

Niacin

Question 3

Which lipid lowering agent inhibits hormone sensitive lipase?

Answer 3

Niacin

Question 4

Bleeding is potential side effect of which lipid lowering agent?

Answer 4

Bile acid resins - due to dec absorption of other drugs and fat sol vitamins (uworld Q)

Question 5

Bonus Q - what Tx for Statin induced rhabdomyolysis?

Answer 5

mannitol

Question 6

What kidney pathology is associated with statins?

Answer 6

Acute tubular necrosis ( break down of musc –> Mgb can plug up kidney –> oxidative damage)

Question 7

Which lipid lowering agent decreases function of the ETC (electron transport chain)

Answer 7

Niacin –> Dec Mevalonate –> Dec FPP –> Dec coenzyme Q

Question 8

GI discomfort - which lipid lowering agent?

Answer 8

Bile acid resins

Question 9

What drug blocks chol absorption at SI brush border?

Answer 9

ezetimibe

Question 10

Which Drug is an antisense oligonucleotide vs apoB100 mRNA?

Answer 10

Mipomersen

Question 11

Digoxin has a secondary effect on heart rate, separate from contractility - what is it? Mech?

Answer 11

Dec HR by stimulating CN X

Question 12

Why does digoxin require a loading dose?

Answer 12

Bc has a long half life will take a long time to get to steady state.

Question 13

Lower dose of digoxin in patients with which comorbidities?

Answer 13

renal failure bc dec excretion - digoxin is renally cleared.

Question 14

Name 4 drugs that can increase Digoxin Tox - Why?

Answer 14

Verapamil, Amiodarone, Quinidine, Propafenone - bc they displace digoxin from tissue binding sites

Question 15

Digoxin tox antidote

Answer 15

anti digoxin Fab frangments, Mg2+, slowly normalize K+ (using insulin, kayexalate, hemodialysis)

Question 16

Class I anti-arr Rx overall affect which phase of the cardiac cycle?

Answer 16

phase 0

Question 17

What can increase the chances of toxicity of all class I drugs?

Answer 17

Hyperkalemia

Question 18

Which anti-arr Rx increase AP duration?

Answer 18

Class III (K ch blockers) and Class Ia (block open active Na channels)

Question 19

Adenosine affects which phase of cardiac cycle? Mech of action?

Answer 19

phase 4; Inc K+ efflux –> hyperpol and dec Ca current

Question 20

Which drugs will blunt the affect of Adenosine?

Answer 20

Theophylline, Caffeine

Question 21

Which Anti-arr Rx is associated with gingival hyperplasia ?

Answer 21

Verapamil

Question 22

Which Anti-arr Rx is associated with “sense of impending doom” as Tox?

Answer 22

Adenosine

Question 23

Which Anti-Arr Rx will increase PR interval?

Answer 23

BB, CCB

Question 24

Drug associated with headache, tinnitus?

Answer 24

Quinidine (Cinchonism)

Question 25

Anti Arr Rx that can lead to reversible SLE like syndrome?

Answer 25

Procainamide

Question 26

Best class for post MI?

Answer 26

Class Ib - block the inactivated Na channel, tissue post MI is hypoxic, closer to depol, and Na ch is in the inactivated state

Question 27

Which Anti arr rx is assoc with difficulty breathing, skin and eye issues?

Answer 27

Amiodarone - SE// pulm fibrosis, hyper/hypothyroidism, corneal deposits, blue/grey skin

Question 28

Which anti Arr rx affects both K channels and is a BB?

Answer 28

Sotalol

Question 29

Which anti Arr rx is CI post MI?

Answer 29

Any Class Ic - Flecainide, Proparenone - can be pro-arrythmic

Question 30

with which anti-Arr Rx will you have to do CBCs?

Answer 30

Class Ia (thrombocytopenia )

Question 31

Anti -Arr Rx that prolong QT?

Answer 31

Disopyramide, ibutilide, Dofetilide, Sotalol, Quinidine, Procainamide