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Peds Cards Boards > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Mechanism of action and side effects of bosentan

A
  • Endothelin receptor antagonist leading to pulmonary vasodilation
  • Side effects: lower extremity edema
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2
Q

Mechanism of action of loop diuretics

A

Inhibit Na/2Cl/K transporter and blocks resorption of Na/Cl in ascending loop

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3
Q

Side effects with lasix

A

Ototoxicity
Drug fever/drug rash
Nephrocalcinosis with prolonged use in neonates

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4
Q

Mechanism of action of thiazide diuretics

A

Inhibits Na/Cl cotransporter and blocks Na resorption in distal tubule

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5
Q

Mechanism of action of K sparing diuretics

A

Competitive binding of aldosterone receptor for Na/K exchange in distal tubule

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6
Q

Mechanism of action of milrinone

A
  • Type III phosphodiesterase inhibitor
  • Inodilator - inotropy, lusitropy, vasodilation
  • Blocks breakdown of cAMP, increases intracellular calcium and improves contractility, allows for vascular smooth muscle relaxation
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7
Q

Risk with nipride

A

Cyanide toxicity

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8
Q

Mechanism of action of nipride

A

Direct vasodilation - decreases SVR, PVR and preload

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9
Q

Mechanism of action of ACEi

A
  • Inhibits ACE from converting AT1 to AT2
  • Decreases SVR, BP and increases venous capacitance
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10
Q

Side effects of ACEi

A
  • Cough d/t bradykinin
  • Renal insufficiency, hyperkalemia
  • NO in pregnancy
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11
Q

Mechanism of action of ARB

A
  • Blocks binding of ATII to AT receptor
  • Decreases SVR, BP and increases venous capacitance
  • NO in pregnancy
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12
Q

Mechanism of action of calcium channel blockers

A
  • Blocks Ca entry via slow channels or select voltage sensitive areas of vascular smooth muscle and myocardium
  • Peripheral arterial and coronary vasodilation
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13
Q

Receptors and use of carvedilol

A
  • NON selective B anatagonist and some alpha blocking too
  • Improves NYHA class in adult HF - decreases afterload, LVEDp and increases LVEF
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14
Q

Receptors and use of propranolol

A
  • NON selective B antagonist
  • Half life 4-7 hours (increased with hepatic dysfunction)
  • Can cause bronchospasm or hypoglycemia
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15
Q

Mechanism of action of digoxin

A
  • Blocks membrane Na/K/ATPase leading to increased intracellular calcium
  • Inotropy, vasodilation, decreased speed of AV conduction
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16
Q

Symptoms and treatment for dig toxicity

A
  • Nausea, vomiting, vision changes, PVCs, change in ST/T segments, PR prolongation
  • Tx; treat hypokalemia, atropine for bradycardia, esmolol for VT, digibind (monoclonal antibody)
17
Q

Side effects of PGE

A

Platelet inhibition
Fever
Vasodilation
Apnea
Gastric outlet obstruction with prolonged use
Cortical hyperostosis

18
Q

Cardiac receptors and effect

A
  • B1: sinus node (increases HR), AV node (increases conduction velocity), myocardium (increases contractility)
  • A1: coronary vasoconstrction
  • DA1 - coronary vasodilation
19
Q

Peripheral artery receptors and effect

A
  • A1 - skin and pulm vasoconstrction
  • B2 - mesenteric, splanchnic, skeletal muscle vasodilation
  • DA1 - renal vasodilation

DA2 - mesenteric and splanchnic vasodilation

20
Q

Effects of epinephrine

A
  • B1 (HR and contractility), B2 (decreased SVR/vasodilation)
  • Increased doses will get more A1 vasoconstriction
21
Q

Effects of dopamine

A
  • DA1 and DA2 (increased renal, mesenteric and coronary perfusion), B1 (increased HR and contractility)
  • Medium dose mostly B1
  • High dose transition to A1 vasoconstriction
22
Q

Effects of norepinephrine

A
  • A1 increase SVR and vasoconstriction
  • Minimal B1 contractility
23
Q

Effects of dobutamine

A
  • B1 increase HR and contractility
  • B2 vasodilation
24
Q

Effects of isoproterenol

A
  • B1 increase HR and contractility
  • B2 vasodilation
25
Q

Effects of vasopressin

A
  • V1 vascular smooth muscle constriction

-V2 renal collecting ducts lead to increase water reuptake

26
Q

Hi Kamel

A

<3 :)

27
Q

Symptoms of flecainide toxicity

A

Flecainide is a Na channel blocker
Can cause PR prolongation and possible heart failure
Flec levels increase with less breastmilk or formula

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