Heart Medchem

Question 1

how is verapamil administered?

Answer 1

orally or IV

Question 2

which CCB is used as a racemate?

Answer 2

verapamil

Question 3

DHPs must have what structural feature?

Answer 3

unsubstituted nitrogen on the DHP ring

Question 4

which substituent at C3 and C5 results in best activity?

Answer 4

Ester (COO-R)

Question 5

When R3 does not equal R5, the compound is?

Answer 5

chiral

Question 6

the 4 position of the DHP ring must have?

Answer 6

an aromatic sub (usually Nitrogen)

Question 7

ortho and meta groups that are ________ ________ increase activity

Answer 7

electron withdrawing

Question 8

which substitution significantly decreases activity?

Answer 8

para

Question 9

what are the two metabolic pathways of nifedipine?

Answer 9

condensation rxn and oxidation via Cyp3A4

Question 10

what can nimodipine specifically treat? why?

Answer 10

subarachnoid hemorrhage
greater lipophilicity = increased distribution to cerebral tissue

Question 11

what makes nicardipine’s structure unique?

Answer 11

tertiary amine group leading to phenyl ring on C3

Question 12

what makes nimodipine’s structure unique?

Answer 12

long chain with an ether on C3

Question 13

what makes amlodipine’s structure unique?

Answer 13

long chain into primary amine on C2

Question 14

what makes isradipine’s structure unique?

Answer 14

double ring off C4

Question 15

what makes nisoldipine’s structure unique?

Answer 15

long chain on C3

Question 16

what is the benefit of isradipine?

Answer 16

less reflex tachycardia

Question 17

what makes felodipine’s structure unique?

Answer 17

2 chlorines on C4 phenyl ring

Question 18

what are the requirements of benzothiazepines?

Answer 18

rings should be unsubstituted
aryl group at C2 needs a para sub
ring nitrogen must be alkylated

Question 19

what are the 3 ways diltiazem is metabolized?

Answer 19

O-demethylation via Cyp2D6
N-demethylation via Cyp3A4
deacetylation

Question 20

which plant is responsible as the source of digoxin?

Answer 20

digitalis lanata

Question 21

which plant is responsible as the source of digitoxin?

Answer 21

digitalis purpurea

Question 22

The digoxin structure is comprised of what structures?

Answer 22

digoxigenin with 3 D-digitoxose attached

Question 23

why can antibiotics such as erythromycin increase risk of digoxin toxicity?

Answer 23

they kill bacteria in gut which metabolize digoxin which increases its bioavailability making it more potent

Question 24

how can reducing extracellular potassium (such as furosemide use) increase digoxin potency?

Answer 24

less extracell. K increases phosphorylation which increases binding affinity of digoxin

Question 25

which drugs increase digoxin’s potency?
which drugs decrease?

Answer 25

quinidine, verapamil, and furosemide
rifampin and bile acid sequestrants

Question 26

which drug is the only oral inotropic agent?

Answer 26

digoxin