Pharmacology Flashcards
Dihydropyridine used in subarachnoid hemorrhage to prevent cerebral vasospasm
Nimodipine
Calcium channel blocker that can cause hyperprolactinemia
Verapamil
Secondary messenger elevated by hydralazine
cGMP
Type of vessel that is predominantly dilated by hydralazine
Arterioles
Antihypertensive that can cause cyanide toxicity
Nitroprusside
Type of vessel that is predominantly dilated by nitroprusside
Both venous and arterial dilator
Mechanism through which nitroprusside increases cGMP
Direct release of nitric oxide
Type of vessel that is predominantly dilated by nitrates (eg, nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
Veins
Antihypertensives that develop tolerance
Nitrates
Nitrates are contraindicated in which type of infarction
Right ventricular infarction
Mechanism of action of ranolazine
Inhibits the late phase of sodium current (reducing calcium accumulation), thereby reducing diastolic wall tension (for coronary flow) and oxygen consumption
Drug used in drug resistant angina
Ranolazine
Mechanism of action of milrinone and inamrinone
Selective PDE-3 inhibitors
Mechanism of action of neprilysin inhibitors
Prevent degradation of ANP
Bile acid resins (eg, cholestyramine, colestipol, colesevelam) are contraindicated in patients with which type of hyperlipidemia
Hypertriglyceridemia
Hypolipidemic drug that inhibits NPC1L1, thereby preventing colesterol absorption
Ezetimibe
DOC for patients with hypertriglyceridemia
Fibrates (eg, gemfibrozil, bezafibrate, fenofibrate)
Mechanism of action of fibrates
- Upregulate LPL to increase TG clearance
* Activate PPAR alpha to induce HDL synthesis
Adverse effects of fibrates
- Myopathy (increased risk with statins)
* Cholesterol gallstones
Mechanism of action of niacin
- Inhibit hormone-sensitive lipase in adipose tissue
* Reduces hepatic VLDL synthesis
Mechanism of action of PCSK9 inhibitors (eg, alirocumab, evolocumab)
Inactivation of LDL receptor degradation, increasing amount of LDL removed from bloodstream
Hypolipidemic drugs that have neurocognitive effects
PCSK9 inhibitors
How does cardiac glycosides decrease heart rate
Stimulation of the vagus nerve
Clinical use of cardiac glycosides
- HF (increase contractility)
* Atrial fibrillation (decreased conduction at AV node and depression of SA node)
Factors that predispose to digoxin toxicity
- Renal failure (decrease excretion)
- Hypokalemia (permissive for digoxin binding at K binding site on Na/K ATPase)
- Drugs that displace digoxin from tissue binding sites
- Decreased clearance
Mechanism of action of nesiritide
Recombinant form of human B type natriuretic peptide
Type 1 antiarrhythmics depress which type of tissue
Tissue that is frequently depolarized
Type of antiarrhythmics that block fast sodium channels on an open or activated state
Type 1A antiarrhythmics
Effects of type 1 antiarrhythmics on action potential (AP) duration
- Type 1A: increase AP
- Type 1B: decrease AP
- Type 1C: no effect
Class of type 1 antiarrhythmics that preferntially affect ischemic or depolarized Purkinje and ventricular tissue
Type 1B
Class of type 1 antiarrhythmics with the weakest binding to the channels
Type 1B
Class of type 1 antiarrhythmic that prolongs effective refractory period (ERP) in AV node and accessory bypass tracts
Type 1C
Class of type 1 antiarrhythmics with the strongest bindings to the channels
Type 1C
Mechanism of action of beta blockers (as antiarrhythmics)
- Decrease SA and AV nodal activity by decreasing cAMP and calcium currents
- Suppress abnormal pacemakers by decreasing the slope of phase 4
- Increase PR Interval (AV node is very sensitive)
Mechanism of action of ivabradine
Selective inhibition of funny sodium channels
Main contraindication of class 1A antiarrhythmics
Patients with prolonged QT interval
Type of drugs used to diagnose Prinzmetal angina
Ergonovines
Specific combination of drugs that show a survival benefit in African American patients with systolic heart failure
Hydralazine + isosorbide nitrate
Mechanism through which fibrates exacerbate statin-associated myopathy
They impair statin clearance in the liver
Intracellular event responsible for nitrates’ effects
Myosin light chain dephosphorylation by cGMP
- Decreased intracellular calcium
- Activation of myosin light chain phosphatase
Vessels that are preferentially dilated by dihydropyridines
Precapillary vessels (arterioles)
vessels that are preferentially dilated by renin-angiotensin system blockers (ACE inhibitors and ARBs)
Postcapillary vessels (venules)
Class 1A antiarrhythmic that has antimuscarinic and alpha 1 blocking effects and thus, increases conduction through the AV node and shortens the PR interval
Quinidine
Why is hydralazine contraindicated in patients with angina
Because it can potentiate it through reflex tachycardia
Resistance to methicillin (in Staph) confers resistance to what other antibiotic
Cephalosporins, because the mechanism of methicillin resistance involves penicillin binding protein alterations (PBPs are also used by cephalosporins)
Only statin that is not metabolized by P450 enzyme system
Pravastatin
Sypmatholytic drug that is used for opiate withdrawal
Clonidine
