pharma cardio U

Question 1

Calcium channel blockers

Answer 1

امل و نفين ركبو اليارة بالطريق عشان يشوفو سمكة نيمو
Amlodipine, clevidipine, nicardipine, nifedipine, nimodipine (dihydropyridines, act on vascular smooth muscle); diltiazem, verapamil (non-dihydropyridines, act on heart).

Question 2

Calcium channel blockers, CLINICAL USE

Answer 2

Block voltage-dependent L-type calcium channels of cardiac and smooth muscle􏰂􏰁muscle contractility.
Vascular smooth muscle—amlodipine = nifedipine > diltiazem > verapamil. Heart—verapamil > diltiazem > amlodipine = nifedipine (verapamil = ventricle).

Question 3

Calcium channel blockers, ADVERSE EFFECTS

Answer 3

Gingival hyperplasia.
Dihydropyridine: peripheral edema, flushing, dizziness.
Non-dihydropyridine: cardiac depression, AV block, hyperprolactinemia (verapamil), constipation.

Question 4

Nitrates names

Answer 4

Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate.

Question 5

MECHANISM of Nitrates

Answer 5

Vasodilate by inc NO in vascular smooth muscle inc in cGMP and smooth muscle relaxation.
Dilate veins&raquo_space; arteries. dec preload.

Question 6

ADVERSE EFFECTS of nitrates

Answer 6

Reflex tachycardia (treat with β-blockers), hypotension, flushing, headache,

“Monday disease” in industrial exposure: development of tolerance for the vasodilating action during the work week and loss of tolerance over the weekend => tachycardia, dizziness, headache upon reexposure.

Contraindicated:
right ventricular infarction,
hypertrophic cardiomyopathy,
and with concurrent PDE-5 inhibitor use. (as saldinafil , due to additive effect OF cGMP)

Question 7

use for Primary (essential) hypertension

Answer 7

Thiazide diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), dihydropyridine Ca2+ channel blockers.

Question 8

Hypertension with heart failure

Answer 8

Diuretics, ACE inhibitors/ARBs, β-blockers (compensated HF), aldosterone antagonists.

Question 9

Hypertension with diabetes mellitus

Answer 9

ACE inhibitors/ARBs, Ca2+ channel blockers, thiazide diuretics, β-blockers.

Question 10

Hypertension in asthma

Answer 10

ARBs, Ca2+ channel blockers, thiazide diuretics, cardioselective β-blockers.

Question 11

Hypertension in pregnancy

Answer 11

Hydralazine, labetalol, methyldopa, nifedipine.

“He likes my neonate”

Question 12

Ranolazine, MECHANISM

Answer 12

Inhibits the late phase of inward sodium current thereby reducing diastolic wall tension and oxygen consumption. Does not affect heart rate or blood pressure.

Question 13

CLINICAL USE Ranolazine

Answer 13

Angina refractory to other medical therapies.

Question 14

Sacubitril, MECHANISM

Answer 14

A neprilysin inhibitor; prevents degradation of natriuretic peptides, angiotensin II, and substance P inc vasodilation,dec ECF volume.

Question 15

CLINICAL USE of Sacubitril

Answer 15

Used in combination with valsartan (an ARB) to treat HFrEF.

Question 16

ADVERSE EFFECTS of Sacubitril

Answer 16

Hypotension, hyperkalemia, cough, dizziness; contraindicated with ACE inhibitors due to angioedema.