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Cardiology > Pharm Cardio List > Flashcards

Pharm Cardio List Flashcards

1
Q

Atropine

Mechanism

A

Non-selective muscarinic blocker. Decrease HR, Contraction, and AV Node

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2
Q

Atropine Contraindicated

A

With use of Viagra (NO produces GMP and Viagra blocks its breakdown

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3
Q

Epinephrine
On Target Effects
Selectivity

A

Vasoconstrictor locally, increases HR, CO through B

ALL

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4
Q

Norepinephrine
On Target Effects
Selectivity

A

Increase BP through A

a1, a2, b1

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5
Q

Dobutamine
On Target Effects
Selectivity

A

Increase HR and CO

B1

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6
Q

Phenylephrine
On Target Effects
Selectivity

A

Increase BP through A

a1

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7
Q

Ephedrine

A

Mainly increase BP through A, but HR/ CO thorugh B

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8
Q

Centrally-acting alpha-2a agonists

A 
Clonidine
Methyldopa (pro)
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9
Q

Centrally-acting alpha-2a agonists

Mechanism

A

Agonist of postsynaptic A2a in Rostral Ventrolateral Medulla

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10
Q

Centrally-acting alpha-2a agonists

On Target Effects

A

Decreases sympathetic outflow of CO and/or Vascular Resistance by stimulating CNS receptors Major Compensatory responses is Na Retention Decrease Insulin Secretion

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11
Q

Methyldopa (pro)

Unusual Facts

A

Use in pregnancy
Positive Coombe’s Test
Treat HTN in preclampsia
Sedation

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12
Q

Reserpine

Mechanism

A

Prevents Dopamine Transfer to Vesicle through VMAT by destroying adrenergic synaptic receptor

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13
Q

Reserpine

On Target Effects

A

Depletes NE; reduces TPR, CO, and BP. Major Compensatory response is Na Retention

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14
Q

Reserpine

Side Effects

A

Depression, sedation, dry mouth,

night terrors

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15
Q

Alpha-Blockers

Mechanism

A

Reduce Vascular Resistance and Venous Return. Block Glucose Production. Not as good for essesntial HTN

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16
Q

Phenoxybenzamine

Mechanism

A

Binds to A receptor covalently; irreversible and non-competitive

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17
Q

Phenoxybenzamine
Indication
Selectivity
Side Effect

A

Pheocromocytoma
A1, A2
Raynaud’s phenomenon

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18
Q

Prazosin
Selectivity
Side Effect

A 
A1
Orthostatic HTN (Prazosin), Syncope
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19
Q

Alpha-Blockers

Name

A

Phenoxybenzamine
Phentolamine
Prazosin

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20
Q

Phentolamine
Prazosin
Mechanism

A

Block receptors on arterioles and venules. Competitive antagonists.
(Decrease Phase 4)

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21
Q

Beta-Blockers

Mechanism

A

Block Beta Receptor, decreases sympathetic outflow,

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22
Q

Beta-Blockers

On Target Effects

A

Reduce CO, then start to reduce Vascular Resistance as well. Reduce Renin release from the kidney. Block Glucose production. Decrease Insulin secretion. Activate HSL; lowers HDL and increases TG’s Angina

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23
Q

Propanolol (MS)

Also blocks?

A

Bind and block fast Na channels responsible for rapid depolarzation of fast response cardiac AP’s

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24
Q

Labetalol

Also blocks?

A

Also blocks A1

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25
Q

Nebivolol
Special
Indication

A

Antioxidant; NO production

Metabolic Syndrome HTN

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26
Q

Betaxolol
Special
Selectivity

A

Ca entry blockade

B1

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27
Q

Beta-Blockers

Contraindicated

A

Asthmatics, COPDl, and HF patients and Diabetics (NS ones)

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28
Q

Direct Vasodilators (Selective arteriolar smooth muscle relaxer)

A

Nitroprusside (prodrug)

Minoxidil (Rogaine)

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29
Q

Nitroprusside (prodrug)

Mechanism

A

Release of NO from drug or endothelium

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30
Q

Nitroprusside (prodrug)
On Target Effects
Indication
Side Effect

A

Forms NO; Causes relaxation. Dilates both arteries and veins
Drug of choice for malignant HTN &
HTN emergency
Hypotension, palpitations, tachycardia, cyanide

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31
Q

Minoxidil (Rogaine)

Mechanism

A

Open K channels, causing hyperpolarization of vascular smooth muscle

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32
Q

Minoxidil (Rogaine)
On Target Effects
Side Effect

A

Relaxes arterial smooth muscles.
Hirsutism
Powerful activatator of Renin
(compensatory)

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33
Q

L-Type Calcium Channel Blockers

Name

A

Phenylalkylamine (Verapamil)

Benzothiazepine (Diltiazem)

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34
Q

L-Type Calcium Channel Blockers

Mechanism

A

Block L-type Calcium channels in Cardiac and Smooth Muscle

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35
Q

Phenylalkylamine (Verapamil)
On Target Effects
Selectivity

A

Rapid cycle; Require open channel; Decrease HR

Myocardium

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36
Q

Benzothiazepine (Diltiazem)

On Target Effects

A

Slow cycle; Require certain Voltage; Decrease HR

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37
Q

L-Type Calcium Channel Blockers
Contraindicated
Side Effect

A

Beta Blockers: Synergistic with SA Node Digoxin

Constipation, edema, headache, bradycardia, GI problems, dizziness, AV block, tachycardia

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38
Q

Dihydropyridines

Name

A

Amlodipine
Nifedipine
Nicardipine
Nimodipine

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39
Q

Amlodipine
Mechanism
On Target Effects

A

Block L-type Calcium channels in Cardiac and Smooth Muscle.
Decreases BP by relaxing arteriolar smooth muscle. Very mild changes
Angina

40
Q

Dihydropyridines

Side Effects

A

Edema, Reflex sympathetic response, Hypotension, Constipation
Gingival Hyperplasia

41
Q

ACE Inhibitors

Name

A

Captopril
Lisinopril
Enalapril (prodrug)
Ramipril

42
Q

ACE Inhibitors
Mechanism
On Target Effects

A

Blocks formation of Angiotensin II, decreasing Aldosterone

Lower TPR and BP, dilates vessels

43
Q

ACE Inhibitors
Indication
Contraindicated
Side Effects

A

Diabetes, Heart Failure, CKD, Stroke
Renal Disease Pregnancy
Cough, hyperkalemia, Hypotension,

44
Q

AR Blockers

A

Losartan (prodrug)

Candesartan

45
Q

AR Blockers
Mechanism
On Target Effects

A

Block Angiotensin II at AT receptor, decreasing aldosterone.

Vasodilation, high Na secretion, low TPR, CO, and BP.

46
Q

AR Blockers

Contraindicated

A

Renal Disease Pregnancy

47
Q

Renin Inhibitors

A

Aliskerin

48
Q

Aliskerin
Mechanism
On Target Effects
Side Effects

A

Inhibits Renin
Decrease Ang I and therefore Ang II and Aldosterone
Hyperkalemia

49
Q

Nitrates

Name

A

Nitroglycerin

50
Q 
Nitroglycerin
Mechanism	
On Target Effects
Indication	
Contraindicated
Side Effects
A 
NO activates cGMP 	
Venodilates (lowers Preload and afterload), coronary vasodilation  Angina	
Give with Beta Blockers	
Sildenafil (Viagra) (type V PDE)		
Hypotension, Headache, Racs
51
Q

ANTIARRHYTHMIC DRUGS

Classes

A 
Class I (Na Blockers)
Class II (Beta Adrenoceptor Blockers)
Class III (K Blockers)
Class IV (Ca Blockers)
Digitalis Glycosides (Vagotonic)
Adenosine Receptor Agonist
52
Q 
Class I (Na Blockers)
Drugs
A

Procaineamide
Lidocaine
Flecanide

53
Q 
Procaineamide
Mechanism	
On Target Effects
Notes	
Indication	
Side Effects
A

Suppresses ectopic pacemaker activity in partially depolarized cells slows conduction even at slow rates.
Prolongs AP (block K as well); slows conduction even at slow rates. > 1
Class I don’t effect SA Node
A or V Fib Torsades (3)
Drug induced LUPUS Torsades de Pointes

54
Q 
Lidocaine	
On Target Effects
Indication	
Contraindicated	
Side Effects
A 
Rapid dissociation; will fall off by normal HR. 
Slows conduction of fast HR	
Least likely to have negative effects
Ventricular Tachycardia Torsades (2)
NOT atrial or prophylactic
55
Q

Flecanide
Mechanism
On Target Effects
Contraindicated

A

Suppress automaticity, increases RefractoryDissociation is very slow
Organic or structural heart disease

56
Q 
Class II (Beta Adrenoceptor Blockers)
MP
A

Propranolol

Metoprolol

57
Q

Propranolol

Selectivity

A

B1, B2

58
Q

Metoprolol

Selectivity

A

B1

59
Q

Metoprolol

On Target Effects

A

Slow SA Node (agent of choice)

60
Q

Class III (K Blockers)

A

Class III (K Blockers)
Amiodarone
Sotolol
Ibutilide

61
Q 
Class III (K Blockers)	
Mechanism	
On Target Effects
A

Increase refractory period by prolonging repolarization

Prolongs phase 3, prolonging the ERP. Shows prolongation of QT Interval

62
Q

Amiodarone
Indication
Side Effects

A

A/V arrhythmias Torsades (1)

Pulmonary Fibrosis, Hyperthyroidism, Hepatitis

63
Q

Sotolol
Notes
Contraindicated
Side Effects

A

Beta blocking effect
Prolong QT Interval
Torsades

64
Q

Ibutilide
Indication
Side Effects

A

Rapid V Fib

IV only. Torsades

65
Q

Digitalis Glycosides (Vagotonic)

A

Digoxin

66
Q

Digoxin
Mechanism
On Target Effects

A

Increase vagal nerve acivity, inhibit Na/K pump (Ca overload)
Slows SA Node; Antiarrythmic and arrhthmogenic

67
Q

Digoxin
Notes
Contraindicated
Side Effects

A

Causes Ventricular Bigeminy.
Low Therapeutic Window
Wolff Parkinson White
Halo Lights

68
Q

Adenosine Receptor Agonist

A

Adenosine

69
Q

Adenosine
Mechanism
On Target Effects
Notes

A

Used to terminate acute PSVT by blocking AV node
Rapid half life; given IV
Fixes this or allows attrial flutter diagnosis

70
Q

HMG-CoA Reductase Inhibitors (Statins)

A

Lovastatin
Simvastatin
Pravastatin
Atorvastatin

71
Q

HMG-CoA Reductase Inhibitors (Statins)

Mechanism

A

Analogs of HMB-CoA that competitively inhibit the enzyme. Liver compensates by increasing number of LDL receptors.

72
Q

HMG-CoA Reductase Inhibitors (Statins)

On Target Effects

A

Direct anti-atherosclerotic effects.

73
Q

HMG-CoA Reductase Inhibitors (Statins)
Notes
Indication

A

Lowers TG’s

FHCH

74
Q

HMG-CoA Reductase Inhibitors (Statins)
Contraindicated
Selectivity
Side Effects

A

Gemfibrozil
CYP3A4; Cleared by liver on 1st pass
CNS, Teratogenic Potential, Rhabdomyolysis , GI

75
Q

Bile Acid Sequestrants (Resins)

Drugs

A

Colestipol
Cholestyramine
Colesevelam

76
Q 
Bile Acid Sequestrants (Resins)
Mechanism	
On Target Effects	
Contraindicated	
Side Effects
A

Bind bile acids in intestine and prevent reabsorption
Effects LDL only; Not TG or HDL
Elderly patients and hypertriglyceridema
Prevent absorption of other drugs

77
Q

Nicotinic Acid- Vitamin B3

Drug

A

Niacine

78
Q

Niacine
Mechanism
On Target Effects
Notes

A

Inhibits mobilization of FFA from adipocytes
Increases HDL by 35% and ApoA1
TG. Effects all
Flushing (aspirin helps) Myocitis

79
Q

Fibric Acid Derivatives

Drugs

A

Fenofibrate

Gemifribozil

80
Q

Fibric Acid Derivatives
Mechanism
On Target Effects

A

Ligand for the ligand-activated PPAR receptor

Results in increased synthesis by adipose tissue of lipoprotein lipase

81
Q

Fenofibrate
Indication
Contraindicated
Side Effects

A

Metabolized by Liver
Gall stones RF
Increased creatinin, pregnancy

82
Q

Gemifribozil
Notes
Contraindicated

A

Reduce TG

Gall stones Statins

83
Q

N-3 Fatty Acids (Fish Oil)
Mechanism
On Target Effects

A

Reducing SREBP

Reduce TG up to 35%

84
Q

Penbutolol acts on?

A

The β1 adrenergic receptors in both the heart and the kidney.

85
Q

Penbutolol to act as a partial?

A

Partial agonist proves useful in the prevention of bradycardia.

86
Q

Penbutolol has also been found to be one of very few compounds that?

A

Are 5-HT1A antagonists. (Serotonin)

87
Q

Bisoprolol
Selectivity
Side Effects

A

B1
Bisoprolol has both lipid and water soluble properties making it a prime candidate over other β-blockers and even over other β1-blockers, being water soluble it will have decreased incidence of CNS side effects

88
Q 
Ezetimibe (prodrug)
Mechanism			
Indication	
Contraindicated
Selectivity
A

Inhibits transporter mediates GI uptake cholesterol itself (50%)
Lowers plasma cholesterol
Hepatic toxicity if given with a Statin
Bile sequestrants, Biliary excretion;

89
Q 
Ephedrine
On Target Effects	
Notes
Selectivity	
Side Effects
A

Mainly increase BP through Alpha, but HR/ CO through Beta
Sustaining BP
Mixed acting (D+ID)
Baseball Player; fatal arrhythmias

90
Q

Milrinone
On Target Effects
Mechanism

A

Milrinone is a phosphodiesterase 3 inhibitor that works to increase the heart’s contractility.
Phosphodiesterases are enzymes responsible for the breakdown of cAMP

91
Q

Nesiritide
Mechanism
On Target Effects

A

The recombinant form of the 32 amino acid human B-type natriuretic peptide.
Counterregulation RAAS

92
Q

Pindolol
Mechanism
Selectivity
Contraindicated

A

It possesses ISA (Intrinsic Sympathomimetic Activity). This means that pindolol, particularly in high doses, exerts effects like epinephrine or isoprenaline (increased pulse rate, increased blood pressure, bronchodilation).
Nonselective beta blocker with partial beta-adrenergic receptor agonist activity. Contraindication for hyperthyroidism

93
Q

Propafenone
Mechanism
Contraindicated

A

Slows the influx of sodium ions into the cardiac muscle cells, causing a decrease in excitability of the cells.
Hepatic dysfunction, asthma, CHF, or bradycardia.

94
Q

Ranolazine
Mechanism
Selectivity
Contraindicated

A

Believed to have its effects via altering the transcellular late sodium current.
Inhibits CYP2D6. Causes toxicity with drugs metabolized by CYP2D6
Contraindicated other medications that increase the QT interval

95
Q 
Furosemide
Mechanism
On Target Effects
Side Effects
Contraindicated
A

Inhibit Na-K-2Cl symporter in TALOH
Copious diuresis with NaCl loss, loss of K+, H+, Ca2+, Mg2+, increase PG’s, venous capacitance; Very protein bound.
Ototoxicity
Interactions with Li+, indomethacin, probenecid, warfarin

96
Q

Spironolactone
Mechanism
Side Effects

A

Binds to aldosterone receptor in cytoplasm and prevent its translocation to the nucleus; Reduce Enac channels involved in Na reabsorption.
Hyperkalemia (combine with thiazide); Gynecomastia, hirsutism, uterine bleeding.

97
Q

Hydrochlorothiazide

A

Inhibit NaCl reabsorption in the Na+, K+ aldosterone independent segment of D.T.
Low Na, K, Cl, Mg; Hyperuricemia, high Ca, Hyper secretion of renin and aldosterone.

Cardiology (10 decks)

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