Meds/Bloods

Question 1

How often should you change your blood filter?

Answer 1

Every 4 units

Question 2

What are the universal blood products to give if you don’t know type?

Answer 2

O- for women of childbearing years
O+ to dudes and young/old women

Question 3

Name a Class Ia antiarrhythmic, where it acts and it’s effect on the AP.

Answer 3

Procainamide
Blocks Na+ and K+ channels
Lengthens AP and effective refractory period

Question 4

Name a Class Ib antiarrhythmic, where it acts and it’s effect on the AP.

Answer 4

Lidocaine
Blocks Na+ NOT K+
Shortens AP
Greatest effect on depolarized/ischemic tissue
Least cardiotoxic but high CNS toxicity

Question 5

Name a Class Ic antiarrhythmic and it’s effect on the AP.

Answer 5

Flecainide or Propafenone
Slows AP
Prescribed for chronic afib

Question 6

Name the Class II antiarrhythmics, where they act and their effect

Answer 6

Class II: Beta Blockers

• Competitivelry blocks B1 on cardiac myocytes blocking epi/norepi from binding and opening Ca++ channels
• Reduces renin (B1 in juxtaglomerular cells) therefore HTN
• Can be cardiac selective, non-selective or mixed

Question 7

Describe Labetolol by class, MOA and effect

Answer 7

Class II antihypertensive (urgent)
Non-selective beta blocker
Blocks a1, B1, B2 decreasing sympathetic tone = vasodilation

Question 8

Describe Metoprolol by class, MOA and effect

Answer 8

Class II: Beta Blocker
Selective
Inhibits B1 decreasing ino/chronotropy

Question 9

Define Class III antihypertensives, list one and describe their action on the AP as well as a known side effect

Answer 9

• Class III: Potassium Channel Blockers
• Amiodarone
• Prolongs AP, decreases AV conduction & SA node function
• Can prolong QT = Torsades

Question 10

Define Class IV antihypertensives inc. subtypes, where they act and their effect

Answer 10

Class IV: Calcium Channel Blockers

IVa: Non-Dihidropyridines (Diltiazem) - Slows AP in SA & AV nodes (they’re Ca++ dependent) - Have antiarrhythmic properties

IVb: Non-Hidropyridines (Nifedipine) - Same, no antiarrhythmic properties - Relaxes vascular smooth muscle = decreased PVR

Question 11

Define Class V antihypertensives and list 4 drugs from this class

Answer 11

Class V: the unclassifiable…

Digoxin

Adenosine

Atropine

Isoproterenol

Question 12

List the antihypertensive class, classification, MOA and effect of Digoxin

Answer 12

Class V, cardiac glycoside

Inhibits Na+/K+ pump resulting in increased intracellular Na+, Na+/Ca++ pump activates = increased intracellular Ca++

Increased inotropy (via Ca++), decreased dromotropy

Question 13

List the antihypertensive class, classification, MOA and effect of Adenosine

Answer 13

Class V, antidisrhythmic

Modulates K+ currents to suppress AV node conduction

Blunts catacholamine response

Decreases automaticity (opens K+ channels hyperpolarizing cell)

Dilates coronary arteries

Question 14

List the antihypertensive class, classification, MOA and effect of Isoproterenol

Answer 14

Class V, antiarrhythmic, beta agonist, synthetic catacholamine

Increases chrono/inotropy through increased cAMP, increases Ca++ resulting in increased slope of phase 4 shortening AP

Question 15

ACE Inhibitors:

• List
• MOA
• Side effects

Answer 15

Ramipril, Captopril, Fosinopril

Inhibits conversion of Angiotensin I to Angiotensin II, inhibits degredation of bradykinin (a vasodilator)

Side effects include hypotension (esp in renin-deficient pts), hyperkalemia (decreased aldosterone), cough (inc bradykinin), angioedema (worst in 1st month)