IHD, Conduction Pharmacology

Question 1

Nitroglycerine MOA

Answer 1

Stimulates GMP production, resulting in vascular smooth muscle relaxation.
Metabolized by CYP450

Question 2

Nitro dosage/forms

Answer 2

.3 - .6 mg repeat Q5 mins until 3rd dose, then drip.

SL, Spray, IV

Question 3

Nitro SE

Answer 3

HA
Dizziness
Hypotension
Flushing

Question 4

Long-acting nitrates

Answer 4

Added to beta blockers or calcium channel blockers to control stable angina.
Limited by development of tolerance

Question 5

Types of long-acting nitrates

Answer 5

Isosorbide mononitrate (Imdur)
Isosorbide dinitrate (Isordil)
Transdermal patch (NItroDur)

Question 6

NItrate CI

Answer 6

HypOtension
Aortic stenosis
Severe volume depletion
Acute RV infarction
Hypertrophic cardiomyopathy
Recent ED meds

Question 7

Beta blocker MOA

Answer 7

Competitive antagonists for B1 and B2 receptors
Antagonize effects of catecholamines in heart
Decrease myocardial workload

Question 8

Metoprolol (Lopressor, Toprol)

Answer 8

Cardioselective
Tabs and IV
50 - 200 PO BID
Avoid abrupt cessation

Question 9

Bisoprolol (Zebeta)

Answer 9

Cardioselective
Oral form, 2.5 - 20 mg PO daily
Adjust for renal, hepatic

Question 10

Atenolol (Tenormin)

Answer 10

Cardioselective
50 - 100 mg PO daily
Adjust for renal, hepatic
Avoid abrupt cessation

Question 11

Beta-Blocker SE

Answer 11

B1: Bradycardia, heart block, heart failure
B2: Bronchospasm, PVD, Raynaud’s phenomenon
Fatigue, depression, nightmares, impotence

Question 12

Beta Blocker CI

Answer 12

Severe bronchospasm
Severe hypotension
Bradyarrhythmias
Decompensated heart failure
May worsen prinzmetals angina

Question 13

Calcium channel blocker MOA

Answer 13

Prevent opening of voltage gated calcium chanels
Bind to Alpha-1 subunit of cardiac muscle
Vasodilatory effect

Question 14

Dihydropyridine CCB’s

Answer 14

Amlodipine (Norvasc)

Nifedipine (Adalat, Procardia)

Question 15

Nondihydropyridine CCB’s

Answer 15

Diltiazem (Cardizem)

Verapamil

Question 16

CCB CE

Answer 16

HA
Flushing
Edema
Constipation
Hypotension
Dizziness
Bradycardia

Question 17

CCB CI

Answer 17

SYstolic CHF
AV block or bradycardia
Multiple drug interactions

Question 18

What do long acting nitrates end in again?

Answer 18

Dur …. DUR!

Question 19

Aspirin Dosage

Answer 19

81 - 325 mg once daily

Max of 4g/day

Question 20

Clopidogrel (Plavix) dosage

Answer 20

75 mg once daily for prevention

in ACS, 300 mg initial with another agent

Question 21

When should statins be taken?

Answer 21

Bedtime

Question 22

Statin SE

Answer 22

GI upset
HA
Hepatotoxicity
Myopathy
CYP450 interaction

Question 23

Digoxin Indications

Answer 23

SVT

Question 24

Adenosine Indications

Answer 24

SVT

Question 25

Class 1a Antiarrhythmics MOA

Answer 25

Sodium Channel Blockers

Prolong repolarization

Question 26

Class 1a Antiarrhythmics Types

Answer 26

Quinidine
Procainamide
Disopyramide

Question 27

Class 1b Antiarrhythmics MOA

Answer 27

Shorten Repolarization

Question 28

Class 1d Antiarrhythmics Types

Answer 28

Lidocaine

Mexiletine

Question 29

Class 1c Antiarrhythmics MOA

Answer 29

Slow conduction

Question 30

Class 1c Antiarrhythmics Types

Answer 30

Flecainide

Propafnone

Question 31

Class II Antiarrhythmics MOA

Answer 31

Beta Blockers

Slow AV conduction

Question 32

Class II Antiarrhythmics Types

Answer 32

Asmolol
Proplanolol
Metoprolol

Question 33

Class III Antiarrhythmics MOA

Answer 33

Prolong action potential

Question 34

Class III Antiarrhythmics Types

Answer 34

Amiodarone
Dronedarone
Sotalol

Question 35

Class IV Antiarrhythmics MOA

Answer 35

Slow calcium channel blockers

Used for SVT

Question 36

Class IV Antiarrhythmics Types

Answer 36

Verapamil

Diltiazem

Question 37

Adenosine Dose

Answer 37

6mg then 12mg 1-2 min after of not successful.