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First Aid Cardiovascular > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Drugs for Primary (essential) HTN

A

Diuretics, ACE-Is, ARBs, CCB

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2
Q

HTN with CHF

A

Diuretics, ACE-Is, ARBs, beta-blockers (compensated CHF), aldosterone antagonists

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3
Q

Contraindicated in Cardiogenic Shock

A

Beta-blockers

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4
Q

HTN with diabetes

A

ACE-I/ARBs, CCB, diuretics, alpha and beta-blockers

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5
Q

Protective against diabetic nephropathy

A

ACE-I/ARBs

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6
Q

Dihydropyridines

A

Amlodipine, minodipine, nifedipine

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7
Q

MoA of CCB

A

Block voltage-dependent L-type calcium channels of cardiac and smooth muscle, thereby decreased muscle contractility

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8
Q

CCB toxicity

A

cardiac depression, AV block, peripheral edema, flushing, dizziness, hyperprolactinemia and constipation

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9
Q

Used for subarachnoid hemorrhage (prevents cerebral vasospasm)

A

Nimodipine

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10
Q

Calcium channel blockers with predominate effect on arteriole dilation

A

Nifedipine, amlodipine, nimodipine (dihydropyridines)

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11
Q

Calcium channel blockers with predominant effect on the heart

A

Verapamil, diltiazem (non-dihydropyridines)

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12
Q

HTN, angina, atrial fibrillation/flutter

A

Verapamil, diltiazem (non-dihydropyridines)

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13
Q

Used from HTN, angina, and Raynaud

A

Nifedipine, amlodipine (not nimodipine)

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14
Q

1st line therapy for HTN in pregnancy

A

Hydralazine with methyldopa

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15
Q

MoA of Hydralazine

A

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

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16
Q

S/E of Hydralazine

A

Lupus-like syndrome

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17
Q

Added to hydralazine to prevent reflex tachycardia

A

Beta-blocker

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18
Q

MoA of Nitroprusside

A

short acting, increase cGMP via direct release of NO

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19
Q

MOA and effect of nitric oxide

A

Stimulates cGMP, leads to vascular smooth muscle relaxation

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20
Q

IV nitrate used in hypertensive crisis

A

Nitroprusside

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21
Q

Nitroprusside vasodilates

A

Arteries and veins

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22
Q

Side effect of nitroprusside

A

Cyanide Poisoning

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23
Q

Fenoldopam

A

D1 receptor agonist, coronary, peripheral, renal and splanchnic vasodilation
decreases BP and increases natriuresis

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24
Q

Two drugs that may be used off-label for ischemia and gangrene caused by ergot alkaloids overdose

A

Nitroprusside, nitroglycerin

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25
Q

Primarily dilates veins, decreases preload

A

Nitroglycerin, isosorbide dinitrate

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26
Q

For angina, acute coronary syndrome and pulmonary edema

A

Nitroglycerin, isosorbide dinitrate

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27
Q

Monday disease

A

Toxicity of Nitroglycerin, isosorbide dinitrate, develop tolerance of vasodilating action during the work week and loss of tolerance on the weekend resulting in tachycardia, dizzy, and HA on re-exposure

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28
Q

Affect Preload

A

Nitrates

they decrease EDV, BP and MVO2

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29
Q

Affect Afterload

A

Beta-blockers

they increase EDV and ejection time but DECREASE contractility, HR, and MVO2

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30
Q

partial beta-agonists C/I in angina

A

Pindolol and Acebutolol

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31
Q

Selective beta 1 receptor blockers useful for treating cardiac conditions in patients with asthma

A

Acebutolol, betaxolol, esmolol, atenolol, metoprolol (A BEAM)

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32
Q

Blocks alpha 1 and beta receptors and indicated for the treatment of CHF

A

Labetalol and carvedilol

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33
Q

Beta blockers with partial agonist activity, can bronchodilate and may have an advantage treating patients with asthma

A

Pindolol and acebutolol

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34
Q

Non-selective beta blocker that lacks local anesthetic activity, indicated for glaucoma

A

Timolol

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35
Q

Short-acting beta blocker that can be given parenterally

A

Esmolol

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36
Q

Clinical uses of these agents include treatment of hypertension, angina, arrhythmias, and chronic congestive heart failure

A

Beta-blockers

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37
Q

Side effects of beta blockers

A

Bradycardia, AV block, impotence, dyslipidemia, exacerbation of COPD

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38
Q

Beta-blockers should be used cautiously in

A

Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease

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39
Q

Beta blockers’ effect on the heart in antianginal therapy

A

Reduce heart rate, blood pressure, contractility, and increase end-diastolic volume

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40
Q

Beta blockers are used for this type of angina attack

A

Classic (exertional) angina

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41
Q

A nonselective beta blocker with alpha 1 blocking effect indicated for congestive heart failure

A

Carvedilol

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42
Q

This class of drugs inhibit angiotensin-converting enzyme

A

ACE inhibitors

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43
Q

Captopril and enalapril (-PRIL ending) are

A

ACE inhibitors

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44
Q

Side effects of angiotensin converting enzyme inhibitors

A

Dry cough, hyperkalemia, angioedema

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45
Q

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

A

Bradykinin

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46
Q

Angiotensin converting enzyme inhibitors are contraindicated in

A

Pregnancy, hyperkalemia

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47
Q

Mechanism of action of losartan and valsartan

A

Block AT1 receptors

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48
Q

Side effect associated with angiotensin converting enzyme inhibitors but not angiotensin receptor blockers

A

Dry cough

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49
Q

Alpha 2 agonist used in pregnant women with hypertension

A

methyldopa

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50
Q

Side effects of methyldopa

A

Positive Comb’s hemolytic anemia, SLE-like syndrome, CNS depression

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51
Q

Methyldopa is contraindicated in

A

Geriatrics due to its CNS (depression) effects

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52
Q

Side effect of clonidine

A

Rebound hypertension, sedation, dry mouth

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53
Q

Arterial vasodilator that works by opening K+ channels

A

Minoxidil

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54
Q

Side effect of minoxidil

A

Hypertrichosis

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55
Q

MOA and effect of nitric oxide

A

Stimulates cGMP, leads to vascular smooth muscle relaxation

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56
Q

Mechanism of action of sildenafil

A

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

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57
Q

Drugs used in the management of exertional (classic) angina

A

Nitrates, calcium channel blockers, beta blockers

58
Q

Aspirin reduces mortality in unstable angina by

A

Inhibiting platelet aggregation

59
Q

Mechanism of action of organic nitrates

A

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

60
Q

Nitrate free intervals are needed due to

A

Tolerance

61
Q

Side effects of nitrates

A

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

62
Q

Mechanism of action of cardiac glycosides (eg. digoxin)

A

Inhibit Na+/K+ ATPase and indirectly increase intracellular calcium and cardiac contractility

63
Q

Indication of digoxin

A

Atrial fibrillation and congestive heart failure

64
Q

Digoxin toxicity can be precipitated by

A

Hypokalemia

65
Q

Phosphodiesterase (PDE3) inhibitors indicated for acute congestive heart failure; long term use is associated with increased mortality

A

Amrinone and milrinone

66
Q

Side effect of amrinone and milrinone

A

Thrombocytopenia

67
Q

Agent used in acutely decompensated congestive heart failure resembling natriuretic peptide

A

Nesiritide

68
Q

Mechanism of action of class I antiarrhythmics

A

Sodium channel blockers

69
Q

Mechanism of action of class II antiarrhythmics

A

Beta -blockers

70
Q

Mechanism of action of class III antiarrhythmics

A

Potassium channel blockers

amiodarone, Ibutilide, dofetilide, sotalol

71
Q

Mechanism of action of class IV antiarrhythmics

A

Calcium channel blockers

72
Q

Limiting side effect of class Ia and III antiarrhythmics

A

Prolongs QT interval

73
Q

Most common side effects of quinidine that limits its use

A

Cinchonism

74
Q

Major drug interaction with quinidine

A

Increases concentration of digoxin

75
Q

Side effect of procainamide

A

Systemic lupus-like syndrome

76
Q

Contraindication of disopyramide use

A

heart Failure

77
Q

Used as last line antiarrhythmic agents due to proarrhythmic property; strongest sodium channel blocker

A

Class IC (flecainide, propafenone)

78
Q

Anti-arrhythmic agents that decrease mortality

A

Beta-blocker

79
Q

Used intravenously for acute tachycardia during and post- surgery

A

Esmolol

80
Q

Drug of choice for management of acute ventricular tachycardia

A

Amiodarone

81
Q

Antiarrhythmic effective in most types of arrhythmia

A

Amiodarone

82
Q

Class III antiarrhythmic that exhibits properties of all 4 classes

A

Amiodarone

83
Q

Side effects of Amiodarone

A

Thyroid dysfunction, corneal deposits, liver damage and pulmonary fibrosis

84
Q

Antiarrhythmic that exhibits Class II and III properties

A

Sotalol

85
Q

Side effect of sotalol

A

prolongs QT interval

86
Q

Life threatening cardiac event that prolong QT leads to

A

Torsades de pointes

87
Q

Drug of choice for narrow complex paroxysmal supraventricular tachycardia (PSVT)

A

Adenosine

88
Q

Mechanism of action of adenosine

A

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

89
Q

Anti-arrhythmic with <10 second duration of action

A

Adenosine

90
Q

Drug of choice for early after depolarizations (Torsade)

A

Magnesium sulfate

91
Q

Mechanism of action of statins

A

inhibits HMG COA reductase

92
Q

HMG CoA reductase inhibitors are contraindicated in

A

Pregnancy

93
Q

Two side effects of HMG COA reductase inhibitors

A

Rhabdomyolysis and Hepatotoxicity

94
Q

Two parameters to obtain before initiation of statins

A

LFT’s, creatine kinase

95
Q

How grapefruit juice increases statin effect

A

Inhibit CYP450 3A4

96
Q

Concurrent use of fibrates and statins increases risk of

A

Rhabdomyolysis

97
Q

Class of agents for cholestyramine, colestipol, colesevalem

A

Bile acid-binding resins

98
Q

Major nutritional side effect of bile acid-binding resins

A

Impair absorption of fat soluble vitamins (A,D,E,K)

99
Q

Fibrates increase activity of

A

Lipoprotein lipase

100
Q

Side effect of fenofibrate and gemfibrozil

A

Gallstone formation

101
Q

Mechanism of action involves indirect reduction of liver triglyceride synthesis

A

Niacin, fibrates

102
Q

Side effects of niacin

A

Cutaneous flush

103
Q

Cutaneous flush due to niacin can be reduced by pretreatment with

A

NSAIDs

104
Q

Inhibits intestinal cholesterol absorption by inhibiting Niemann Pick C1 Like 1 (NPC1L1) Protein

A

Ezetimibe

105
Q

Mechanism of action of aspirin

A

Irreversibly blocks COX1 and COX2

106
Q

Agent used to treat myocardial infarction (MI) and to reduce incidence of subsequent MI

A

Aspirin

107
Q

Side effect of aspirin

A

GI bleeding

108
Q

Antiplatelet drug reserved for patients allergic to aspirin

A

Ticlopidine

109
Q

Side effect for ticlopidine

A

Neutropenia and agranulocytosis

110
Q

Irreversible inhibitor of platelet P2Y12 receptors; effective in preventing transient ischemic attack

A

Clopidogrel and ticlopidine

111
Q

Phosphodiesterase inhibitor indicated for intermittent claudication

A

Dipyridamole, cilostazol

112
Q

Block glycoprotein IIb/IIIa involved in platelet cross-linking

A

Abciximab, tirofiban and eptifibatide

113
Q

Vitamin K dependent anticoagulant with zero-order kinetics of elimination

A

Warfarin

114
Q

Route of administration of warfarin

A

Oral

115
Q

Contraindication of warfarin

A

Pregnancy

116
Q

Anticoagulant of choice in pregnancy

A

Heparin

117
Q

Heparin (PTT) increases activity of

A

Antithrombin 3

118
Q

Routes of administration of heparin

A

IV and SC

119
Q

Side effect of both warfarin and heparin

A

Bleeding

120
Q

Specific side effect of heparin

A

Heparin induced thrombocytopenia (HIT)

121
Q

Two anticoagulant used for prophylaxis and treatment of thrombosis in patients with heparin-induced thrombocytopenia

A

Bivalirudin, argatroban

122
Q

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

A

Alteplase

123
Q

Mechanism of action of thrombolytics

A

Lyse thrombi by catalyzing the formation of plasmin which cleaves fibrin

124
Q

Side effect of tissue plasminogen activators

A

Cerebral Hemorrhage

125
Q

Indications for thrombolytics

A

Pulmonary embolism, severe deep vein thrombosis

126
Q

Thrombolytic that can cause allergic reaction and non-selective systemic fibrinolysis

A

Streptokinase

127
Q

Hyperglycemia (acanthosis nigricans) and Hyperurecemia (exacerbates gout)

A

Niacin

128
Q

Activates PPAR-alpha to induce HDL synthesis

A

Fibrates (gemfibrozil, clofibrate, bezafibrate, fenofibrate)

129
Q

Antidote for Digoxin

A

slowly normalize potassium, cardiac pacer, anti-digoxin Fab fragments, magnesium

130
Q

Class IA antiarrhythmics

A

Quinidine, Procainamide, Disopyramide

131
Q

Clinically used or both atrial and ventricular arrhythmias, esp re-entrant and ectopic SVT and VT

A

Class IA antiarrhythmics

132
Q

Increase AP duration, increases effective refractory period, increase QT interval

A

Class IA antiarrhythmics

133
Q

Class IB antiarrhythmics

A

Lidocaine, Mexiletine

134
Q

Used for post-MI acute ventricular arrhythmias

A

Class IB antiarrhythmics (Lidocaine and Mexiletine)

135
Q

Decreases AP duration

A

Class IB antiarrhythmics (Lidocaine and Mexiletine)

136
Q

Contraindicated in structural and ischemic heart disease

A

Class IC antiarrhythmics (Flecainide, Propafenone)

137
Q

Decrease slope of phase 4, increase PR interval

A

Beta blockers

138
Q

May mask hypoglycemia

A

Beta blockers

139
Q

May exacerbate vasospasm in Prinzmetal angina

A

Propranolol

140
Q

Tx of beta blocker overdose

A

Glucagon

141
Q

Toxicity of Amiodarone

A

pulmonary fibrosis, hepatotoxicity, corneal deposits, skin deposits (blue/gray) resulting in photodermatitis, neurologic effects, constipation, bradycardia, heart block, CHF)

142
Q

Who is always hungry?

A

JEN-NAY

First Aid Cardiovascular (4 decks)

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