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PCOL 2 > Lesson 2 > Flashcards

Lesson 2 Flashcards

1
Q

Diuretics used for hypertension

A

Hydrochlorothiazide
Chlorthalidone
Indapamide
Metolazone
Microside

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2
Q

Thiazides SE

A

Hypokalemia
Hypomagnesemia
Hypercalcemia
Hyperuricemia
Hyperglycemia
Hyperlipidemia

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3
Q

Beta Blockers MOA

A

negative inotropic, chronotropic action

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4
Q

Beta Blocker (Cardio Selective at Low Dose) Examples

A

Atenolol
Betaxolol
Bisoprolol
Metoprolol

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5
Q

Beta Blocker (Intrinsic Sympathomimetic Activity

A

Acebutolol
Carteolol
Penbutolol
Pindolol

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6
Q

Beta blockers with extensive first pass metabolism

A

Propranolol
Metoprolol

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7
Q

Beta Blocker with long half-life, renal excretion

A

Atenolol
Nadolol

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8
Q

SE Beta Blocker

A

Hypotension
Bradycardia
Heart failure
Heart block
Bronchospasm
Peripheral vasoconstriction and Intermittent claudication

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9
Q

ACE inhibitors examples

A

Captopril
Ramipril
Enalapril
Imidapril

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10
Q

It blocks conversion of angiotensin I to angiotensin II

It blocks the degradation of bradykinin—angioedema

It is given once daily except captopril (2-3x a day)

A

Angiotensin Converting Enzyme (ACE) Inhibitors

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11
Q

It blocks angiotensin type (AT 1) receptor.

It is contraindicated in pregnancy.

A

Angiotensin II Receptor Blockers

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12
Q

Examples of Angiotensin II Receptor Blockers

A

Losartan
Valsartan
Candesartan
Irbesartan
Valsartan

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13
Q

It blocks voltage sensitive calcium channels in cardiac and smooth muscles.

A

Calcium Channel Blockers

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14
Q

2 Classes of Calcium Channel Blockers

A

Non dihydropyridine

Dihydropyridine

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15
Q

Non dihydropyridine Examples

A

Diltiazem
Verapamil

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16
Q

Dihydropyridine Examples

A

Nifedipine
Felodipine
Amlodipine

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17
Q

Non dihydropyridine SE

A

Bradycardia
AV Block
Heart Failure
Constipation

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18
Q

Dihydropyridine SE

A

Dizziness
Headache

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19
Q

A1 Receptor Blockers

A

Prazosin
Terazosin
Doxazosin

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20
Q

It is reserved for patients with BPH

A

A1 Receptor Blockers

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21
Q

A1 Receptor Blockers SE

A

First-dose phenomenon - Orthostatic hypotension (dizziness, faintness,
syncope)

Sodium and water retention

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22
Q

Centrally acting/A2 agonist

A

Methyldopa
Clonidine
Guanabenz
Guanfacine

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23
Q

Presynaptic A2 agonist—-negative feedback—Dec. NE release

A

Centrally Acting A2 Agonist

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24
Q

The activity of methyldopa is due to stimulation of central alpha adrenoreceptors by methyldopamine and methylnorephinephrine

A
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25
Q

Centrally Acting A2 Agonists SE

A
  • Sedation, dry mouth, depression
  • Sodium and water retention (esp. methyldopa)
  • Rebound hypertension (esp. clonidine)
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26
Q

It depletes NE and blocks transport of NE into its storage vesicles.

A

Reserpine

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27
Q

Reserpine SE

A

Sodium and fluid retention

Parasympathetic effect (nasal congestion, diarrhea, bradycardia),

Depression

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28
Q

It increases HR and renin release ( should be given with beta blocker and a diuretic)

A

Vasodilators (Direct Arteriolar)

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29
Q

Examples of Vasodilators

A

Hydralazine - for eclampsia

Methyldopa - for chronic HTN in pregnant patients

Minoxidil

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30
Q

Side Effects of Hydralazine

A

Lupus-like reaction (rash, arthralgia; reversible)

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31
Q

Side effects of Minoxidil

A

Hypertrichosis (overgrowth of hair)

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32
Q

It depletes and inhibits the release of NE

A

Postganglionic Sympathetic Inhibitors

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33
Q

Postganglionic sympathetic inhibitors Examples

A

Guanethidine
Guanadrel

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34
Q

Postganglionic Sympathetic Inhibitors SE

A

Orthostatic Hypotension

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35
Q

Primary Agents:

A

Diuretics
Beta Blockers
ACE Inhibitors
Angiotensin II Receptor Blockers
Calcium Channel Blockers

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36
Q

Alternatives for HTN Treatment:

A

A-Blockers
A2 Agonists
Adrenergic Inhibitors

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37
Q

Drugs for Hypertensive Urgency

A

Oral: Captopril, Clonidine, Labetalol

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38
Q

Drugs for Hypertensive Emergency

A

IV Nitroprusside
Nitroglycerin
Nicardipine
Felodopam
Labetalol or Hydralazine

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39
Q

It is a chest pain due to decreased blood flow to the heart or due to an inadequate supply of oxygen to the heart muscle.

The pain is typically severe and crushing, and it is characterized by a feeling of pressure and suffocation just behind the breastbone.

A

Angina Pectoris

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40
Q

Angina can accompany or be a precursor of a:

A

Heart Attack

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41
Q

2 Main Types of Angina

A

Exertional Angina
Vasospastic Angina

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42
Q

It is caused by increased physical exertion.

  • Most common type
  • Due to atherosclerosis of the coronary artery
A

Exertional Angina

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43
Q

Exertional Angina is also called:

A

Chronic Stable Angina
Classic Angina
Typical Angina
Effect-induced Angina

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44
Q

It is caused by vasospasm of the coronary artery.

A

Vasospastic Angina

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45
Q

Vasospastic Angina is also called:

A

Rest Angina
Variant
Prinzmetal

46
Q

Angina treatment to increase O2 delivery

A

Nitrates
Vasodilators
Ca blockers

47
Q

Angina treatment to decrease O2 demand

A

B-Blockers
Ca Blockers

48
Q

It is the most widely used drug of this class (Nitrates)

A

Nitroglycerin

49
Q

Nitroglycerin routes

A

Sublingual
Buccal
Spray
Patch

50
Q

Types of Nitrates

A

Nitroglycerin
ISDN
ISMN

51
Q

ISDN meaning and route

A

Isosorbide dinitrate
Oral / Sublingual

52
Q

ISMN meaning and route

A

Isosorbide Mononitrate
Oral

53
Q

It is converted to nitric oxide (NO)—this increase cGMP—–smooth muscle relaxation—-vasodilation—-venodilation and arterial dilation—decrease oxygen demand—therefore dilation of coronary artery.

A

Nitrates

54
Q

Drugs for Acute Attack (Angina)

A

Nitroglycerin - Sublingual, Buccal, Spray
ISDN - Sublingual

55
Q

Drugs for Prophylaxis (Angina)

A

Nitroglycerin - patch
ISDN - oral
ISMN - oral

56
Q

Note:
- The nitrates undergo extensive first pass metabolism

-Tolerance (have 8-12-hour nitrate free interval)

A
57
Q

Nitrates SE

A

Postural hypotension
Reflex tachycardia
Headache
Flushing

58
Q
  • Also known as coronary artery disease (CAD)
  • Lack of oxygen and decreased or no blood flow to the heart due to coronary artery narrowing or obstruction
A

Ischemic Heart Disease

59
Q

Ischemic Heart Disease may present as:

A

Acute MI
Unstable angina
Chronic stable angina
Variant angina

60
Q

It is the beta blocker most widely used in the treatment of angina.

A

Propranolol

61
Q

Antagonize or reverse the effects of sympathetic activation caused by exercise and other physical or mental exertions thereby decreasing HR, contractility and BP which reduces myocardial oxygen demand.

A

Beta Blockers

62
Q

Beta Blockers are effective as mono therapy and in combination with:

A

Nitrates
Calcium Channel Blockers

63
Q

Agents of choice for variant or Prinz metal angina

A

Calcium Channel Blockers

64
Q

It is a chronic progressive condition that affects the pumping power of your heart muscles.

It specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently.

A

Congestive Heart Failure

65
Q

It is the inability of the heart to pump sufficient blood to meet the metabolic needs of the body.

A

Heart Failure

66
Q

Common Causes of Heart Failure

A

Atherosclerosis
Arteriosclerosis
Myocardial ischemia and infarction, Hypertension
Valvular stenosis
Regurgitation

67
Q

First Line Therapies for Heart failure

A

Cardiac Glycosides (Digoxin, Digitoxin, Others (Deslanoside, Ouabain)

68
Q

The major side effect of cardiac glycosides

A

Hypokalemia

69
Q

It is the method of dosage with cardiac glycosides that rapidly produces effective drug level.

A

Digitalization

70
Q

Daily dosage of glycoside that maintains effective drug levels in the blood.

A

Maintenance

71
Q

It is a problem with the rate or rhythm of your heartbeat. It means that your heart beats too quickly, too slowly, or with an irregular pattern.

A

Arrhythmia

72
Q

Heart beats faster than normal

A

Tachycardia

73
Q

Heart beats too slowly

A

Bradycardia

74
Q

The most common type of arrhythmia, which causes an irregular and fast heartbeat.

A

Atrial fibrillation

75
Q

Tachycardia[ atrial or ventricular] beats/min

A

150 - 250

76
Q

Atrial flutter beats/min

A

200 - 350

77
Q

Atrial Fibrillation beats/min

A

greater than 350

78
Q

Ventricular Fibrillation characteristic rate

A

Uncoordinated Contraction

79
Q

Premature contraction of aorta characteristic rate

A

Variable

80
Q

Premature contractions of the ventricles characteristic rate

A

Variable

81
Q

Bradycardia beat/min

A

Less than 50

82
Q

It is the most serious arrythmia ; can result in cardiac arrest and death.

A

Ventricular fibrillation

83
Q

Signs and Symptoms of Arrhythmia

A

Palpitations
Irregular pulse
Dizziness
Syncope
Heart failure
Chest pain

84
Q

How is arrhythmia diagnosed?

A

Through Electrocardiogram (ECG)

85
Q

Class I of Antiarrhythmic drugs (Sodium Channel Blockers)

A

Class 1A:
- Procainamide
- Quinidine
- Disopyramide

86
Q

Class II Antiarrhythmic drugs (Beta blockers)

A

Propranolol
Esmolol

  • for patients with AF
87
Q

Class III Antiarrhythmic drugs (Potassium Channel Blockers)

A

Bretylium
Sotalol
Ibutilide and doletilide
Amiodarone

88
Q

Class IV Antiarrhythmic drugs (Calcium Channel Blockers)

A

Verapamil
Diltiazem

89
Q

Miscellaneous antiarrhythmics drugs:

A

Adenosine
Magnesium Sulfate

90
Q

Non-Pharmacologic treatment for Arrhythmia

A

Defibrillation
Pacemaker

91
Q

this is a specific type of abnormal heart rhythm that can lead to sudden cardiac death… a polymorphic ventricular tachycardia

A

torsades de pointes

92
Q

a good enzyme in the heart

A

cGMP - Cyclic Guanosine Monophosphatase

93
Q

S/Sx of Heart Failure

A

Dyspnea
Orthopnea
Fatigue
Cough

94
Q

Lipid Solubility of Digoxin

A

Medium

95
Q

Lipid Solubility of Digitoxin

A

High

96
Q

Half-Life of of Digoxin

A

Short

97
Q

Half-life of Digitoxin

A

Long

98
Q

Digoxin Excretion

A

Renal

99
Q

Digitoxin Excretion

A

Hepatic

100
Q

Cardiac Glycosides Interactions

A
  1. Diuretics
  2. ACE Inhibitors
  3. Beta Blockers
  4. Diuretics
101
Q

Types of Arrhythmia / Commonly Occurring Arrhythmia

A

Tachycardia
Atrial Flutter
Atrial Fibrillation
Ventricular Fibrillation
Premature Contraction of Aorta
Premature Contraction of Ventricles
Bradycardia

102
Q

Uses and SE of Procainamide

A
  • All types: AF, VT
  • Hypotension, Lupus
103
Q

SE of Quinidine

A

Cinchonism, GI Upset, Torsades de pointes

104
Q

SE of Disopyramide

A

Antimuscarinic (dry mouth, blurred vision, hot and flushed skin, dry skin, inc. intraocular pressure)

105
Q

Uses of Class II Beta Blockers (Propranolol, Esmolol)

A

For patients with AF

106
Q

Uses and SE of Bretyllium

A
  • Refractory Post-MI, VF
  • Arrhythmia, Hypotension
107
Q

Uses and SE of Sotalol

A
  • Oral
  • Torsades, Bradycardia, Asthma
108
Q

Uses and SE of Ibutilide and Doletilide

A
  • Atrial Fibrillation
  • Torsades
109
Q

Uses and SE of Amiodarone

A

Most effective
Blocks Na, Ca, K channels and B receptors
VT (1st line)

  • Corneal deposits, Hypothyroidism, Pulmonary Fibrosis
110
Q

Uses and SE of Verapamil

A

Atrial Fibrillation (1st line)
IV, Oral

  • Hypotension

PCOL 2 (8 decks)

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