Pharmacology Flashcards
Antiarrhythmics (AA) causing increased QT interval
quinidine and procainamide (IA) AND AND disopyramide, amiodarone, sotalol, dofetilide
Antibiotics causing increased QT interval
azithromycin, clarithromycin, erythromycin (macrolides) AND trimethoprim-sulfamethoxazole, ketoconazole AND pentamidine, some flouroquinolones, mefloquine
Amiodarone (Cordarone), bretylium, ibutilide and sotalol (Betapace®) are class… antiarrhythmic drugs.
class III antiarrhythmic
Cough headache, ice-pick headache syndrome, chronic paroxysmal hemicrania and other syndromes such as effort migraine, coital headache, and hemicrania continua respond to …
indomethacin
Macrolides are…
ACE: azithromycin, clarithromycin, erythromycin
… and … are diuretics that competitively inhibit the mineralocorticoid (aldosterone) receptor.
Spironolactone / eplerenone
Pleuresy is often the presenting symptom in … induced by procainamide, hydralazine, minocycline, diltiazem and other Rx.
SLE
Lidocaine, tocainide are class… antiarrhythmic drugs.
IB
The … drugs act by modulating or closing the sodium channels, thereby inhibiting phase 0 depolarization.
class I antiarrhythmic
Drugs causing metabolic coma are …, … and ….
benzodiazepines AND barbiturates AND opioids
Flecainide (Tambocor™), propafenone (Rythmol) are class… antiarrhythmic drugs.
IC
… block the potassium channels, thereby prolonging repolarization and the duration of the action potential and the refractory period, manifested on the surface ECG by prolongation of the QT interval.
Class III antiarrhythmics
As a general rule, any herbs starting with the letter “G” should raise concern about possible …
Bleeding disorders
… root or extract taken in high doses may interact with antihypertensives and cause hypertension by allowing endogenous cortisol to act as a mineralocorticoid.
Licorice
Intravenous … is the single most effective intervention for the management of TCA cardiovascular toxicity, because it can reverse QRS prolongation, ventricular arrhythmias, and hypotension.
sodium bicarbonate
There are multiple, mostly nonspecific manifestations of …: fatigue, blurred vision, disturbed color perception, anorexia, nausea, vomiting, diarrhea, abdominal pain, headache, dizziness, confusion, delirium, and occasionally hallucinations
digitalis toxicity
Concomitant ingestion of … (food) and certain dihydropyridine calcium channel blockers may elevate the plasma concentration of the latter, possibly leading to hypotension
grapefruit juice
… used as a sedative, it can lead to dermatitis, hallucinations, SOB, liver toxicity.
Kava-kava
… may be the most frequent adverse reaction to herbal remedies (Jin Bu Huan, Ma-Huang, germander, valerian, mistletoe, skullcap, chaparral leaf, comfrey), and herbal teas containing toxic alkaloids, pennyroyal oil, and kava.
Hepatotoxicity
Hypertension, hypotension, tachycardia, ventricular arrhythmias, cardiac arrest are all side effects of this antidote …
Naloxone
The presenting signs of a … overdose include cardiac arrhythmias, hypotension, and anticholinergic signs (hyperthermia, flushing, dilated pupils, intestinal ileus, urinary retention, and sinus tachycardia)
TCA
Toxic levels of… (eg, tricyclic antidepressants, antipsychotic medication, benzodiazepines) can result in CNS excitation, which may lead to confusion, delirium, hallucinations, and seizures. Some patients develop hyperpyrexia, cardiac arrhythmias, coma, a
anticholinergic agents
Diuretics, especially HCTZ, are notorius for inducing or precipitating… (GI condition).
constipation
… has shown some efficacy in patients with nonorganic erectile dysfunction, but not in one with organic causes.
Yohimbine
… (antimalarial drug) is contraindicated in patients with cardiac conduction disease.
Mefloquine
A rise in INR at 48 hours after the first dose implies … (condition), due to either other drugs or a problem with the cytochrome P-450 system.
high sensitivity to warfarin
Regular … Rx is an absolute contraindication to sildenafil use because of hypotensive effect potentiation.
nitrate
… complications are significantly increased in patients who are receiving activated protein C (dotrecogin alfa).
Bleeding
ACEI and ARBs should be discontinued in the … trimesters because of fetal complications.
2nd and 3rd
… are the most potent anti-retroviral drugs and most commonly studied for long-term follow-up when taken together with two NRTI.
Protease inhibitors (PI)
ABx … (side effect) should not be used in patients receiving class IA or III antiarrhythmic agents.
prolonging the QTc interval (fluoroqui, macro)
The 8 mg dexamethasone suppression test differentiates between pituitary and ectopic ACTH production, in the latter cortisol is…
not suppressed.
After large dose steroids, patients should receive stress doses steroids for… (duration)
one year.
… (2 oral hypoglycemic drugs) may cause fluid retention and weight gain and are contraindicated in severe CHF patients.
Pioglitazone (Actos) and Rosiglitazone (Avandia)
Insulin can not be combined with Pioglitazone (Actos) and Rosiglitazone (Avandia) due to…
increased risk for fluid retention with CHF.
Beta-blockers selectivity (or cardioselectivity) refers to the ability of a drug to preferentially block the…
beta-1 receptors.
BP that contraindicates for t-PA use is…
SBP>185 or DBP>110.
Advanced age is… in t-PA administration for ischemic stroke.
not a contraindication
The relatively cardioselective agents are:
atenolol or metoprolol.
Nonselective beta blockers can cause worsening of symptoms of severe peripheral vascular disease or Raynaud’s phenomenon but usually not in milder disease, with mild to moderate intermittent claudication. … are probably preferable in such patients.
Cardioselective beta blockers
The prototype nonselective beta-blocker is…
Propranolol
Toxic myopathy can be caused by… (class drugs).
statins
ABx known to cause… are: Bactrim, rifampicin, vancomycin, cephalotin and linezolid.
thrombocytopenia
Heparin, quinidine, quinine and valproic acid can all cause… (blood dyscrasia).
thrombocytopenia.
Adding warfarin to ASA and clopidogrel combination increases the risk of bleeding … times.
5
In cardiogenic shock from anaphilactoid reaction to contrast agent, epinephrine should be administered in doses of …micrograms.
10
In cardiogenic shock from anaphilactoid reaction to contrast agent, epinephrine should be administered every …
minute.
In cardiogenic shock from anaphilactoid reaction to contrast agent, epinephrine should be administered in a concentration of …
1:10,000.
These drugs can modestly lower Lp(a) levels: …
niacin and fibric acids.
Platelet transfusion cannot be used for 2b3a reversal in drugs with high drug : receptor ratio such as …
eptifibatide (Integrilin) and tirofiban (Aggrastat). (100:1)
Platelet transfusion can be used for 2b3a reversal in drugs with low drug : receptor ratio such as …
abciximab. (1.5:1), despite being irreversible.
Metformin-induced lactic acidosis is fatal in … % of the cases.
50
Among paclitaxel and sirolimus, only … has an anti-inflammatory effect.
sirolimus
… high affinity for the beta-2 adrenergic receptor causes vasodilation and a decrease in MAP, therefore its utility in hypotensive patients is limited to situations in which hypotension results from bradycardia.
Isoproterenol’s
… is primarily an inotropic and chronotropic agent rather than a vasopressor. It acts upon beta-1 adrenergic receptors and, unlike dobutamine, has a prominent chronotropic effect.
Isoproterenol (Isuprel®)
In patients during the initial management of AMI who have a contraindication to…, coronary angiography is class IIa indication when performed in a timely fashion by individuals skilled in the procedure and supported by experienced personnel in an appropri
fibrinolytic therapy