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USMLE Step 1 > Pharmacology-- Cardiology > Flashcards

Pharmacology-- Cardiology Flashcards

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USMLE® Step 1 flashcards
1
Q

Digoxin

A

Dec. AV nodal conduction. Inhibits Na/K ATPase= inc. Ca concentration in heart cells = inc. contraction force
Tx: CHF and atrial flutter. Negative inotropic
Decreased K+ levels cause digoxin toxicity (tx w Digoxin immune Fab

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2
Q

Diltiazem

A

Non-DHP Calcium channel blocker
Tx: black men
Tx: AV nodal re-entrance

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3
Q

Quinidine

A

Blockfast inward Na current (INa). – use dep block
Dec. AV nodal conduciton. Cinchonism (quinine OD, bc quinine stereoisomer). Anticholinergic= aggravates MG. Hypotension= alpha block

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4
Q

Verapamil

A

L-type Ca channel blocker
Dec AV nodal conduction, Dec BP. Negative inotrope= no CHF use
Inc O2 supply via dec. vasospasm. Tx: Prinzmetal’s angina

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5
Q

Propranolol

A

Nonselective beta blocker
Dec AV nodal conduction, dec BP Negative inotrope (B block). Aggravates asthma and DM via B2 block.
Blocks reflex tachy but causes excess bray= Inc diastole time= Inc EDV

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6
Q

Diazoxide

A

Balanced vasodilator– K-channel activator, leads to muscle relaxation

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7
Q

Nitroprusside

A

Balanced vasodilator. Unloads heart. Inc. cyanide= pre-tx w/ thiosulfate.
Tx: acute HTN crisis, dyspnea

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8
Q

Reserpine

A

Tx: severe and resistant HTN
Depletes Ca, See suffy nose. Not for pt.s w peptic ulcers
Mech: irreversibly blocks the vesicular monoamine transporter (VMAT).[4] This normally transports free Ne, 5HT, DA from the cytoplasm of the presynaptic nerve terminal into storage vesicles for subsequent release

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9
Q

Dobutamine

A

Primary mech: direct B1 stim. At high doses Beta2 offsets alpha1= beta1. Inc CO w/o systemic vascular resistance

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10
Q

Dopamine

A

At low doses: tx of shock = dilates renal and mesenteric arteries= maintain urine output

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11
Q

Esmolol

A

short acting beta antagonist

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12
Q

Captopril

A

ACE inhibitor. Balanced vasodilator. Tx: outpatient CHF. Dry cough (bradykinen excess induced)

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13
Q

Quinidine - mech

A

Class Ia anti-arrhythmic. Moderate Na channel block

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14
Q

Digoxin toxicity

A

Fatal ventricular arrhythmias w/ severe AV block

Tx w digoxin immune Fab (Digibind)

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15
Q

Lidocaine

A

ClassIB anti-arrhythmic. Normalizes conduction. Tx: inital MI to control arrhythmias

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16
Q

Flecanide

A

Class IC anti-arrhythmic (Na). Marked conduction slowing

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17
Q

Amiodarone

A

Long t1/2. Need potent doses to obtain desired level for action. Side effeects: blue skin, ocular deposits, pulm. fibrosis

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18
Q

NE

A

Inc AV nodal conduction via B1.

Metoprolol is B1 blocker

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19
Q

ACh

A

Dec. AV nodal conduction via M receptor.

Atropine is a muscarinic antagonist

20
Q

Atenolol

A

selective beta1 receptor antagonist

Controls catecholamine induced arrhythmias

21
Q

Bretylium

A

Class III anti-arrhythmic, blocks K channels

Tx: Malignant ventricular arrhythmias but cause catecholamine release that can aggravate arrhythmias briefly

22
Q

Nimodipine

A

DHP-Ca channel blocker, selective for cerebral vasculature

Tx: acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm

23
Q

Atropine

A

Competitive Ach Musc receptor antagonist (thus blocks PS action)
Dec excess vagal tone as seen in sinus bradycardia

24
Q

Nitrates

A

Decrease preload= Venous pooling, Dec MVO2=reflex tachy, Inc ventricular work= dec O2 demand

25
Q

Aspirin

A

Prevents arterial platelet adhesion (NOT DVT thrombi) . Irreversibly inactivates COX= Dec. platelet production of Txa 2, a potent vasoconstrictor

26
Q

Warfarin

A

Decreases vit-K dep. gamma-carboxylation of clotting factors= anticoagulation state

27
Q

Heparin

A

Activates Antithrombin III

–Only IV

28
Q

tPA

A

Binds to fibrin clots and activates plasminogen on the spot. Short t1/2, given IV. Dose not discriminate between fibrin-ased clots= bleeding/stroke risk

29
Q

Streptokinase

A

Binds and activates plasminogen (fibrinolytic). Used for some MI and PE
Bacteria derived so allergy risk high. Can see excess bleeding in pt.s post-op

30
Q

Urokinase

A

aka uPA. Plasminogen activator (fibrinolytic) Human source. Can see excess bleeding in pt.s post-op bc of inc plasmin

31
Q

Colestipol

A

Bile acid sequestrant. Interrupt bile acid reabsorption= Big inc in LDL uptake. Cholestyramine has same MOA

32
Q

Lovastatin

A

(a statin) HMG-coA reducatase inhibitor.Leads to inc. LDL-receptor synth. Provastatin/mevastatin have same MOA

33
Q

Losartan

A

Angiotensin II receptor antagonist. Decresease aldosterone, inc renin 2-3x.
Similar effects to ACE inhibition but no cough side effects

34
Q

Diazoxide

A

Tx insulinomas. Only dilates arterial smooth muscle, not venous

35
Q

Clonidine

A

Central alpha2 adrenergic agonist. Dec TPR via dec. sympathetic effects

36
Q

Methyldopa

A

Central alpha2 receptor iagonist.

??? Positive Coombs–> hemolytic anemia

37
Q

Quinidine Pre-tx

A

Atrial arrhythmia pretx w a drug that will dec ventricular response such as: digozxin, beta blocker, Ca channel blocker

38
Q

Class II–??

A

Beta blocker dec. risk for reinfarction & sudden death following MI

39
Q

“Gray man”

A

Amiodarone side effect— class III antiarrhythmic— skin discolors w extended use, see it in fair skinned ppl more

40
Q

Beperidil

A

Ca channel blocker. Limited clinical use due to Torsades de Pointes

41
Q

ACEIs

A

Vasodilate renal efferents > renal afferents. Dec. GFR and filtration pressure. Thus dec. Diabetic renal failure progression

42
Q

Adenosine

A

Adenosine receptor blocked by methylxanthines (e.g. theophyline). Favored for tx of reentrant supra ventricular tachy

43
Q

Enoxaparin

A

Low molec weight heparin (LMWH)= oral anticoagulant

44
Q

Isoproterenol

A

Inc HR and Dec MAP

45
Q

Variant angina

A

Prinzmetal…use Ca Channel receptor blocker like Nifedipine to dec. spasm

46
Q

Contraindicated in CHF

A

Beta receptor antagonists. Don’t want to dec. heart’s contractility.

USMLE Step 1 (9 decks)

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