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BOARDS specific notecards > Pharm 1 Liner- Cardiovascular > Flashcards

Pharm 1 Liner- Cardiovascular Flashcards

1
Q

3 side effects of ACE inhibitors

A

Dry cough, hyperkalemia, angioedema

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2
Q

Inactivated by angiotensin converting enzyme, contributes to dry cough and angioedema

A

Bradykinin

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3
Q

ACE inhibitor is drug of choice for

A

Hypertension with diabetic nephropathy because it can decrease the intraglomerular pressure and slow GBM thickening

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4
Q

Ace inhibitors are contraindicated in

A

Pregnancy, hyperkalemia, bilateral renal artery stenosis

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5
Q

Mechanism of action of losartan and valsartan

A

Block angiotensin II type 1 receptor

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6
Q

Side effect associated with ACE inhibitors but not angiotensin receptor blockers

A

Dry cough

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7
Q

Calcium channel blockers with predominant effect on arteriole dilation

A

Nifedipine, amlodipine, nimodipine (dihydropyridines)

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8
Q

Calcium channel blockers with predominant effect on heart

A

Verapamil and diltiazem

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9
Q

Side effects of calcium channel blockers

A

Constipation, peripheral edema, cardiac depression, AV block, gingival hyperplasia

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10
Q

Alpha 2 agonist used in pregnant women with hypertension

A

Methyldopa

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11
Q

Side effects of methyldopa

A

Positive Coombs hemolytic anemia, SLE-like syndrome, CNS depression

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12
Q

Methyldopa is contraindicated in

A

Geriatrics due to its CNS (depression) effects

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13
Q

Side effect of clonidine

A

Rebound hypertension, bradycardia, sedation, dry mouth

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14
Q

Direct vasodilator of arteriolar smooth muscle by increasing cGMP and inhibit IP3-induced calcium release from the SR

A

Hydralazine

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15
Q

Side effect of hydralazine

A

Lupus-like syndrome

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16
Q

Arterial vasodilator that works by opening K channels

A

Minoxidil

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17
Q

Side effect of minoxidil

A

Hyertrichosis

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18
Q

MAO and effect of nitric oxide

A

Increase NO leads to increased cGMP which leads to vascular smooth muscle relaxation

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19
Q

IV nitrate used in hypertensive crisis

A

Nitroprusside

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20
Q

What does nitroprusside dilate

A

Veins and arteries

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21
Q

Side effect of nitroprusside

A

Cyanide poisoning

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22
Q

Mechanism of action of sildenafil

A

Inhibits phosphodiesterase 5, enhancing effects of nitric oxide, activated increase in cGMP

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23
Q

Drugs used in management of exertional angina

A

Nitrates, calcium channel blockers, beta blockers

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24
Q

Aspirin reduces mortality in unstable angina by

A

Inhibiting platelet aggregation

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25
Q

Mechanism of action of organic nitrates

A

Requires enzymatic release of NO, relaxes vascular smooth muscle of veins

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26
Q

Nitrate free intervals are needed due to

A

Pharmacological tolerance

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27
Q

Side effects of nitrates

A

Reflex tachycardia, hypotension, flushing, throbbing headache due to meningeal artery dilation

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28
Q

Indication for digoxin

A

Atrial fibrillation and CHF

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29
Q

Digoxin toxicity can be precipitated by

A

Hypokalemia

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30
Q

PDE3 inhibitors indicated for acute CHF; long term use is associated with increased mortality

A

Amrinone and milrinone

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31
Q

Side effect of amrinone and milrinone

A

Thrombocytopenia

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32
Q

Agent used in acutely decompensated CHF resembling natriuretic peptide

A

Nesiritide

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33
Q

Mechanism of action of class 1 antiarrythmics

A

Sodium channel blockers

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34
Q

Mechanism of action of class 2 antiarrythmics

A

Beta blockers

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35
Q

Mechanism of action of class 3 antiarrthmics

A

Potassium channel blockers

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36
Q

Mechanism of action of class 4 antiarrythmics

A

Calcium channel blockers

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37
Q

Limiting side effect of class 1a and III antiarrythmics

A

Prolongs QT interval

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38
Q

Most common side effects of quinidine that limits its use

A

Cinchonism

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39
Q

Major drug interaction with quinidine

A

Increased concentration of digoxin

40
Q

Side effect of procainamide

A

Systemic lupus like syndrome

41
Q

Disopyramide is contraindicated for

A

Obstructive uropathy, glaucoma, heart failure

42
Q

Class of drug is selective for ischemic heart tissue

A

Class 1B (lidocaine, mexiletine)

43
Q

Used as last line antiarrythmics agents due to pro arrhythmic property; strongest sodium channel blocker

A

Class 1C (flecainide, propafenone)

44
Q

Anti-arrhythmic agents that decrease mortality

A

Beta blockers

45
Q

Used intravenously for acute tachycardia during and post surgery

46
Q

Drug of choice for management of acute ventricular tachycardia

A

Amiodarone

47
Q

Antiarrythmics effect in most types of earth is

A

Amiodarone

48
Q

Class 3 antiarrythmics that exhibits properties of all 4 classes

A

Amiodarone

49
Q

New non-iodinated amiodarone analogue

A

Dronedarone

50
Q

Side effects of amiodarone

A

Thyroid dysfunction, corneal deposits, liver damage and pulmonary fibrosis

51
Q

Antiarrythmics that exhibits class 2 and 3 properties

52
Q

Side effect of sotalol

A

Prolongs QT interval

53
Q

Life threatening cardiac event that prolong QT leads to

A

Torsades de pointes

54
Q

Drug of choice for narrow complex PSVT

55
Q

Mechanism of action of adenosine

A

Activates G-protein coupled K+ channels in atrium, SA and AV node

56
Q

Anti arrhythmic with less than 10 second duration of action

57
Q

Drug of choice for early depolarizations

A

Magnesium sulfate

58
Q

Drug is 2nd line choice for chronic stable angina that modifies myocardial metabolism

A

Ranolazine

59
Q

Mechanism of action of ranolazine

A

Blocks the late inward sodium current in ventricular myocardial cells’ reduces diastolic wall tension and oxygen consumption

60
Q

Mechanism of action of statins

A

Inhibits HMG CoA reductase

61
Q

HMG CoA reductase inhibitors are contraindicated in

62
Q

2 side effects of HMG CoA reductase inhibitors

A

Rhabdomyolysis and hepatotoxicity

63
Q

2 parameters to obtain before initiation of statins

A

LFTs, creatine kinase

64
Q

How grapefruit Juice increases statin effect

A

Inhibit CYP450 3A4

65
Q

Concurrent use of fibrates and statins increases risk of

A

Rhabdomyolysis

66
Q

Class of agents for cholestyramine, colestipol, colesevalem

A

Bile acid binding resins

67
Q

Major nutritional side effect of bile acid binding resins

A

Impair absorption of fat soluble vitamins

68
Q

Fibrates increase activity of

A

Lipoprotein lipase

69
Q

Fibrates bind and activate a nuclear receptor to upregulate lipoprotein lipase, downregulate hepatic apolipoprotein CIII and increase hepatic fatty acid oxidation in hepatocytes

70
Q

Side effect of fenofibrate and gemfibrozil

A

Cholesterol-gallstone formation

71
Q

Mechanism of action involves indirect reduction of liver triglyceride synthesis

A

Niacin, fibrates

72
Q

Side effect of niacin

A

Cutaneous flushing

73
Q

Cutaneous flush due to niacin can be reduced by pretreatment with

74
Q

Inhibits intestinal cholesterol absorption by inhibitin NPC1L1protein

75
Q

Mechanism of action of aspirin

A

Irreversibly blocks COX1 and COX2 via acetylation

76
Q

Agent used to treat MI and to reduce incidence of subsequent MI

77
Q

Side effect of aspirin

A

GI bleeding

78
Q

Antiplatelet drug reserved for patients allergic to aspirin

A

Ticlopidine

79
Q

Side effect of ticlopidine

A

Neutropenia and agranulocytosis

80
Q

Inhibit platelet aggregation by irreversibly blocks ADP (P2Y12) receptor; effective in preventing TIA

A

Clopidogrel and ticlopidine

81
Q

Phosphodiesterase III inhibitor that increases cAMP and inihibits platelet aggregation indicated for intermittent claudication, coronary vasodilation and prevention of stroke

A

Dipyridamole, cilostazol

82
Q

Block glycoprotein IIb,IIIa involved in platelet cross linking

A

Abciximab, tirofiban, and eptifibatide

83
Q

Vitamin K dependent anticoagulant with zero order kinetics of elimination

A

Warfarin (PT)

84
Q

Route of admin of warfarin

85
Q

Contraindications of warfarin

86
Q

Anticoagulant of choice when pregnant

87
Q

Heparin (PTT) increases activity of

A

Antithrombin 3

88
Q

Routes of administration of heparin

89
Q

Side effect of both warfarin and heparin

90
Q

2 anticoagulant used for prophylaxis and treatment of thrombosis in patients with HIT

A

Bivalirudin, argatroban

91
Q

Mechanism of action of bivalirudin and argatroban

A

Bind to thrombin active site and inhibit thrombin directly

92
Q

Thrombolytic used for acute MI and ischemic (non-hemorrhagic) cerebral vascular accident (stroke

93
Q

Mechanism of action of thrombolytics

A

Lyse thrombi by catalyzing the formation of plasmin which cleaves fibrin

94
Q

Side defect of tissue plasminogen activators

A

Cerebral hemorrhage

95
Q

Indications for thrombolytics

A

pulmonary embolism, severe DVT

96
Q

Thrombolytic that can cause allergic reaction and non selective systemic fibrolysis

A

Streptokinase

97
Q

Oral agents that inhibit factor Xa

A

Apixaban, rivaroxaban

BOARDS specific notecards (42 decks)

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