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PH 113 - Pharmacology 1 > MIDTERM 02 - Drugs for IHD and HF > Flashcards

MIDTERM 02 - Drugs for IHD and HF Flashcards

1
Q

Refers to circulation within the myocardium

A

Coronary circulation

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2
Q

Arteries that branch from the ascending aorta

A

Coronary arteries

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3
Q

Veins that drain into the coronary sinus

A

Cardiac veins

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4
Q

Condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium

A

Ischemic heart disease (IHD)

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5
Q

Heart rate is a determinant of oxygen __________

A

Demand

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6
Q

Myocardial contractility is a determinant of oxygen __________

A

Demand

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7
Q

Myocardial wall tension/stress is a determinant of oxygen __________

A

Demand

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8
Q

Inspired level of oxygen is a determinant of oxygen __________

A

Supply

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9
Q

Pulmonary function is a determinant of oxygen __________

A

Supply

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10
Q

Hemoglobin concentration and function is a determinant of oxygen __________

A

Supply

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11
Q

Level of coronary blood flow is a determinant of oxygen __________

A

Supply

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12
Q

Condition that results to reduced blood flow to the myocardium due to the partial obstruction of coronary arteries

A

Myocardial ischemia

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13
Q

Refers to chest pain that usually accompanies myocardial ischemia

A

Angina pectoris

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14
Q

Condition that results to death of myocardial tissue due to complete obstruction of blood flow of coronary arteries

A

Myocardial infarction (Heart attack)

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15
Q

Treatment for myocardial infarction

A

Fibrinolytic

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16
Q

An effort-induced/classic angina; caused by transient myocardial ischemia; relieved by rest or NTG (Types of angina)

A

Stable angina pectoris

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17
Q

Patients have cardiac disease but without the resulting limitations of physical activity (New York Heart Association functional classification)

A

Class I

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18
Q

Patients have cardiac disease resulting in slight limitation of physical activity (New York Heart Association functional classification)

A

Class II

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19
Q

Patients have cardiac disease resulting in marked limitation of physical activity (New York Heart Association functional classification)

A

Class III

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20
Q

Patients have cardiac disease resulting in inability to carry on any physical activity without discomfort (New York Heart Association functional classification)

A

Class IV

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21
Q

Chest discomfort is severe; not relieved by rest or NTG (Types of angina)

A

Unstable angina

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22
Q

Variant angina; due to vasospasm; relieved by NTG and CCBs (Types of angina)

A

Prinzmetal’s angina

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23
Q

Causes vasodilation and decreased platelet aggregation; used for stable, unstable, and variant angina (Types of anti-anginal drugs)

A

Nitrates

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24
Q

A nicotinamide nitrate ester; its MOA is preconditioning by activation of cardiac Katp channels (Examples of nitrates)

A

Nicorandil

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25
Q

Relaxes blood vessel smooth muscle and cardiac muscle; used for stable and variant angina (Types of anti-anginal drugs)

A

Calcium channel blockers (CCBs)

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25
Q

Leads to decreased HR and contractility; used for stable and unstable angina (Types of anti-anginal drugs)

A

β-blockers

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26
Q

Used for stable angina when unresponsive to other treatment (Examples of new anti-anginal drugs)

A

Ranolazine

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27
Q

Reduces cardiac rate by inhibiting the hyperpolarization-activated sodium channel in the sinoatrial node (Examples of new anti-anginal drugs)

A

Ivabradine

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28
Q

Is a pFOX inhibitor that partially inhibits the fatty acid oxidation pathway in myocardium (Examples of new anti-anginal drugs)

A

Trimetazidine

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29
Q

Trimetazidine is an example of __________ inhibitor

A

pFOX

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30
Q

The mainstay in management of symptomatic heart failure, especially in edema is present; done through dietary salt restriction and a diuretic

A

Sodium removal

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31
Q

Involves the use of ACEIs, ARBs, Beta blockers, MRAs/Aldosterone antagonists, and ARNI (Treatment principles for heart failure)

A

Treatment principle I (Neurohumoral modulation)

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32
Q

Involves the use of diuretics (Treatment principles for heart failure)

A

Treatment principle II (Preload reduction)

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33
Q

Involves the use of hydralazine-isosorbide dinitrate (Treatment principles for heart failure)

A

Treatment principle III (Afterload reduction)

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34
Q

Involves the use of cardiac glycosides (Treatment principles for heart failure)

A

Treatment principle IV (Increasing cardiac contractility)

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35
Q

Involves the use of Ivabradine (Treatment principles for heart failure)

A

Treatment principle V (Heart rate reduction)

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36
Q

The cornerstone of heart failure therapy (Treatment principles for heart failure)

A

Treatment principle I (Neurohumoral modulation)

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37
Q

The __________ of ACE leads to ↓ angiotensin II and ↑ bradykinin

A

Inhibition

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38
Q

A peptide that contributes to the therapeutic efficacy of ACE inhibitors

A

Bradykinin

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39
Q

ACE inhibitors functions as a __________ by ↓ peripheral resistance and afterload

A

Vasodilator

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40
Q

ACE inhibitors function as an __________ by ↓ water and salt retention and preload

A

Indirect diuretic

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41
Q

ACE inhibitors function as a __________ by ↓ sympathetic activity

A

Sympatholytic

42
Q

ACE inhibitors helps in __________ by ↓ long-term remodeling of the heart and blood vessels

A

Antiremodeling

43
Q

The first-line therapy for chronic HF (Drugs under treatment principle I)

A

ACE inhibitors

44
Q

Used for selective, competitive receptor antagonism at the AT1 receptor (Drugs under treatment principle I)

A

Angiotensin (AT1) receptor blockers (ARBs)

45
Q

Used as a second choice in HF in patients who do not tolerate ACE inhibitors (Drugs under treatment principle I)

A

Angiotensin (AT1) receptor blockers (ARBs)

46
Q

Used for competitive inhibition of β receptor (Drugs under treatment principle I)

A

Beta blockers

47
Q

__________ and __________ are examples of cardioselective β blockers (MB)

A

Metoprolol, Bisoprolol

48
Q

__________ is an example of nonselective β blocker and an α1 receptor antagonist

A

Carvedilol

49
Q

__________ is an example of cardioselective β blocker that is an NO-mediated vasodilator

50
Q

It leads to lower HR and contractility, as well as lower renin levels (Drugs under treatment principle I)

A

Beta blockers

51
Q

Used for all patients with symptomatic HF and all patients with left ventricular dysfunction after MI (Drugs under treatment principle I)

A

Beta blockers

52
Q

____________ heart failure can precipitate acute decompensation of cardiac function

A

New onset/Acutely decompensated

53
Q

Used for antagonism of nuclear receptors of aldosterone (Drugs under treatment principle I)

A

Mineralocorticoid receptor antagonists (MRAs)/Alodsterone antagonists

54
Q

A selective antagonist of the mineralocorticoid receptor (Examples of MRAs/Aldosterone antagonists)

A

Eplerenone

55
Q

A nonspecific steroid receptor antagonist w/ similar affinity for progesterone and androgen receptors (Examples of MRAs/Aldosterone antagonists)

A

Spironolactone

56
Q

Used for K+ sparing diuresis and complete inhibition of aldosterone (Drugs under treatment principle I)

A

Mineralocorticoid receptor antagonists (MRAs)/Aldosterone antagonists

57
Q

Used for chronic HFrEF; may become the first choice in HF (Drugs under treatment principle I)

A

Angiotensin receptor/Neprilysin inhibitor (ARNI)

58
Q

Works by increasing Na+ and water excretion; should not be given to patients without congestion (Drugs under treatment principle II)

59
Q

Used for inhibition of NKCC2 in the ascending limb of the Loops of Henle (Examples of diuretics)

A

Loop diuretics

60
Q

Diuretics of choice in HF (Examples of diuretics)

A

Loop diuretics

61
Q

Furosemide, Torasemide, and Bumetanide are all examples of __________

A

Loop diuretics

62
Q

Hydrochlorothiazide (HCTZ) and Chlorthalidone are all examples of __________

A

Thiazide diuretics

63
Q

Used for inhibition of NCC in the distal convoluted tubule (Examples of diuretics)

A

Thiazide diuretics

64
Q

Used for inhibition of Na+ entry in ENaC in the apical membrane of collecting tubule (Examples of diuretics)

A

Potassium-sparing diuretics

65
Q

Amiloride and Triamterene are all examples of __________

A

Potassium-sparing diuretics

66
Q

Dilates large blood vessels; a venous dilator (Drugs under treatment principle III)

A

Isosorbide dinitrate (ISDN)

67
Q

Its MOA is unknown; an arteriolar dilator (Drugs under treatment principle III)

A

Hydralazine

68
Q

Can reduce damaging remodeling of the heart; lowers mortality in African-Americans (Drugs under treatment principle III)

A

Hydralazine isosorbide dinitrate

69
Q

Known for thousands of years; were used erratically and with variable success until 1785 (Drugs under treatment principle IV)

A

Cardiac glycosides

70
Q

__________ is sourced from Digitalis lanata (White foxglove)

71
Q

__________ is sourced from Digitalis purpurea (Purple foxglove) and Digitalis lanata

72
Q

Works by increasing cardiac contractility; used for heart failure, atrial fibrillation, and atrial flutter (Drugs under treatment principle IV)

A

Cardiac glycosides

73
Q

Most frequent and most serious adverse effect of cardiac glycosides

A

Cardiac arrhythmias

74
Q

__________ is a strong determinant of cardiac energy consumption

A

Heart rate (HR)

75
Q

Used for selective inhibition of If sodium channel (Drugs under treatment principle V)

A

Ivabradine

76
Q

Effective in both systolic and diastolic failure (Treatments for chronic diastolic heart failure)

77
Q

Used to increase ventricular filling time by decreasing HR (Treatments for chronic diastolic heart failure)

A

Ivabradine

78
Q

A heterogenous clinical syndrome most often resulting in need for hospitalization

A

Acute decompensated heart failure

79
Q

__________ treatment is the rule in drug therapy of acute HF

A

Intravenous (IV)

80
Q

Promptly initiated in dyspnea and signs of fluid overload/congestion (Treatments for acutely decompensated heart failure)

A

Loop diuretics (Ex: Furosemide IV)

81
Q

Can be added in small doses to loop diuretics to break a relative resistance to loop diuretics (Treatments for acutely decompensated heart failure)

A

Thiazide diuretics

82
Q

Lowers preload and afterload; no documented symptomatic benefit; best suited for patients with hypertension (Treatments for acutely decompensated heart failure) (NN)

A

Nitroglycerin, Nitroprusside

83
Q

Dilates arterial and venous blood vessels; approved for the treatment of acutely decompensated heart failure in the US (Treatments for acutely decompensated heart failure)

A

Nesiritide

84
Q

Agents that are associated with worse outcome; should be restricted to patients with critically low CO and perfusion of vital organs (Treatments for acutely decompensated heart failure)

A

Positive inotropic agents

85
Q

A selective β1 agonist; increases CO; provides the strongest stimulation of the heart; a catecholamine (Treatments for acutely decompensated heart failure)

A

Dobutamine

86
Q

β agonist of choice in acute HF with systolic dysfunction; a catecholamine (Treatments for acutely decompensated heart failure)

A

Dobutamine

87
Q

A balanced β1, β2, and α1 adrenergic agonist; is the second-choice inotrope in acutely decompensated heart failure; a catecholamine (Treatments for acutely decompensated heart failure)

A

Epinephrine

88
Q

Potent β1 and α1 agonist and weak β2 receptor agonist; has positive inotropism; a catecholamine (Treatments for acutely decompensated heart failure)

A

Norepinephrine

89
Q

Used for inhibition of PDE-3 and PDE-4; increases contractility, HR, and CO; a phosphodiesterase inhibitor (Treatments for acutely decompensated heart failure)

90
Q

A short term treatment of acute HF and advance/severe chronic HF; a phosphodiesterase inhibitor (Treatments for acutely decompensated heart failure)

91
Q

Withdrawn in the USA; its MOA is the same as milrinone; a phosphodiesterase inhibitor (Treatments for acutely decompensated heart failure)

A

Inamrinone

92
Q

Used for relative selection inhibition of PDE-3; a phosphodiesterase inhibitor (Treatments for acutely decompensated heart failure)

93
Q

Works by binding to and inducing conformational change in troponin C; causes vasodilation; a short-term treatment (Treatments for acutely decompensated heart failure)

A

Myofilament calcium sensitizers

94
Q

A recombinant human relaxin 2; a promising drug for ADHF (Novel approaches to HF)

95
Q

A direct, heme-dependent stimulator of sGC (Examples of sGC activators)

96
Q

A heme-dependent activator of sGC (Examples of sGC activators)

A

Cinaciguat

97
Q

The oxidative inactivation of __________ is believed to be a common pathology in cardiovascular disease

A

Soluble guanyl cyclase (sGC)

98
Q

Are sodium-glucose cotransporter-2 (SGLT2) inhibitors (Novel approaches to HF) (DE)

A

Dapagliflozin, Empagliflozin

99
Q

A PDE-5 inhibitor; improves filling pressures and right ventricular function in HFpEF (Novel approaches to HF)

A

Sildenafil

100
Q

No improvement in QOL or submaximal exercise capacity and decreased overall activity levels (Novel approaches to HF) (II)

A

Isosorbite mononitrate, Inorganic nitrates

102
Q

Drug that promotes inhibition of neprilysin (Examples of angiotensin receptor/neprilysin inhibitor)

A

Sacubitril

103
Q

A peptidase mediating the enzymatic degradation and inactivation of natriuretic peptides, bradykinin, and substance P

A

Neprilysin

104
Q

Levosimendan and pimobendan are examples of __________ (Treatments for acutely decompensated heart failure)

A

Myofilament calcium sensitizers

PH 113 - Pharmacology 1 (20 decks)

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