Pharm 1 Flashcards
Nitrates (mechanism, use, toxicity)
Cause NO release -> vasodilation (veins»_space;> arteries); used in angina; fast tolerance, hypotension, flushing, headache
Niacin (mechanism, use, toxicity)
Inhibits lipolysis and reduces VLDL secretion, lowering LDL and raising HDL; hyperlipidemia; flushing and hyperuricemia
Cholestyramine, colestipol, colesevelam (mechanism, use, toxicity)
Inhibits reabsorption of bile acids -> lower LDL with slight increase in HDL; unpigmented gallbladder stones and malabsorption
Ezetimibe
Prevents cholesterol reabsorption -> lower LDL
Fibrates (gemfibrozil + -fibrates) (mechanism, use, toxicity)
Upregulates LPL (lipoprotein lipase), activates PPAR-alpha to induce HDL synthesis -> lower triglycerides, slightly inc. HDL and slightly dec. LDL; myositis (aka rhabdomyolysis) and hepatoxicity
Digoxin and digitoxin (mechanism, use, toxicity)
Inhibits Na/K ATPase -> indirectly inhibits Na/Ca exchanger -> inc. calcium levels -> inc. contractility, Stimulates the vagus; CHF, afib; causes cholinergic symptoms and hyperkalemia
Adverse effects of statins
Hepatoxicity and muscle breakdown
Class 1A antiarrhythmics
Quinidine, procainamide, and disopyramide; inc. AP duration and QT interval; can cause torsades de pointes, cinchonism (qunidine), procainamide (drug-induced lupus)
Class 1B antiarrhythmics
Lidocaine, mexiletine, and tocainide; dec. AP duration especially in depolarized/ischemia tissue; best following MI
Class 1C antiarrhythmics
Flecainide, propafenone; no effect on AP, used in ventricular tachycardias; do not use post-MI due to risk for arrhythmias
Class 1 antiarrhythmics (general mechanism and toxicity)
Blocks Na channels, decreasing the slope of phase 0 depolarization; toxicity exacerbated by hyperkalemia
Class 2 antiarrhythmics
Beta-blockers; reduces cAMP, slowing SA and AV node activity, increases PR interval; adverse effects include impotence, asthma exacerbation, sedation
Class 3 antiarrhythmics
Amiodarone, ibutilide, dofetilide, sotalol; K channel blockers; inc. AP duration and QT interval
Toxicity of amiodarone
Pulmonary fibrosis, hepatotoxicity, thyroid dysfunction
Class 4 antiarrhythmics
Ca channel blockers; verapamil and diltiazem; dec. conduction velocity and inc. PR interval; cause constipation, flushing, and edema