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USMLE Rapid Reviews > Pharmacology - FA Section, Cardiology > Flashcards

Pharmacology - FA Section, Cardiology Flashcards

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USMLE® Step 1 flashcards
1
Q

Methacholine

A

Direct Cholinergic agonist:
dx of asthma
produces bronchoconstriction via muscarinic receptors in airway

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2
Q

Neostigmine

A

Anti-cholinesterase:
Reversal of NMJ blockade (ie succinylcholine or “-curaniums”)
Treats Myasthina Gravis
Increases endogenous Ach

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3
Q

Pyridostigmine

A

Anti-Cholinesterase:
Tr Myasthenia Gravis (long term)
Inc Ach

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4
Q

Edrophonium

A

Anti-cholinesterase:
Dx of myasthina gravis (short acting)
increases endogenous Ach

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5
Q

Physostigmine

A

Anti-cholinesterase:
Glaucoma (crosses BBB)
Atropine Overdose Antidote

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6
Q

Rivastigmine

A

Anti-cholinesterase:

Increase Ach in Alzheimer’s pt

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7
Q

Organophophates

A

Irreversible inhibitor of AchE:
==>Dumbells
Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscles, Lacrimation, sweeting, salivation.

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8
Q

Antidote for organophosphates

A

Atropine (treats symptoms)

Pralidoxime - dephosphorlates AchE (which was inactivated when phosphorylated by organophosphates) activating AchE

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9
Q

Benztropine

A

Muscarinic Antagonist:

Tr of Parkinson’s disease

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10
Q

Scopolamine

A

Muscarinic Antagonist:

Patch for motion sickness

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11
Q

Ipratropium

A

Muscarinic Antagonist:

Tr asthma and COPD

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12
Q

Atropine

A

Muscarinic Antagonist:

SE = Hot, dry mouth, flushed skin, cycloplegia, constipation, delerium

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13
Q

Epinephrine

A

a1, a2, B1, B2 - - stimulates symp.

DOC: Anaphylactic Shock

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14
Q

NE

A

a1, a2 > B1 - -Doesn’t affect heart or lungs

DOC: Septic Shock

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15
Q

Isoproterenol

A

B1=B2

Use for AV block

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16
Q

Dopamine

A

D1=D2 >B>a - - inotropic and chronotropic

May increase renal perfusion

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17
Q

Dobutamine

A

B1>B2

DOC: Heart Failure/ Cardiogenic shock

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18
Q

Metaproterenol

A

Selective B2 agonist

used for acute asthma

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19
Q

Albuterol

A

Selective B2 agonist

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20
Q

Salmeterol

A

Selective B2 agonist

Used in long term asthma treatment

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21
Q

Terbutaline

A

Selective B2 agonist

Reduces premature uterine contractions

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22
Q

Phenylephrine

A

a1>a2

Pupillary dilation, vasoconstriction, nasal decongestion (stops nose bleeds)

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23
Q

Ritodrine

A

B2 agonist

Reduces Premature Uterine Contractions

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24
Q

Amphetamine

A

Indirect Sympatheomimetic - - releases catecholamine stores

Narcolepsy, obesity, ADD

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25
Q

Ephedrine

A

Indirect Sympatheomimetic - - releases catecholamine stores

Nasal decongestion, urinary incontinence, hypotension

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26
Q

Cocaine

A

Indirect general agonist - - re-uptake inhibitor

Causes vasoconstriction and local anesthesia (vasoconstric prevents drug from diffusing away).

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27
Q

Clonidine

A

Centrlly acting a2 agonist, decreases adronergic outflow
*Rebound Hypertension if miss dose
Treatment: Hypertension - especially in kidney disease b/c no dec in renal blood flow)

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28
Q

a-methyldopa

A

Central acting a2-agonist

DOC for prego with hypertension

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29
Q

Phnoxybenzamine

A

a-blocker
Tr: pheochromocytoma
Tox: Orthostatic hypotension / reflex tachycardia

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30
Q

Prazosin

A 
a1 selective ("-zosin")
Tr: Hypertension, urinary retention in BPH
Tox: first dose orthostatic hypotension
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31
Q

mirtaxapine

A

a2 selective
Tr: Depression
Tox: sedation, inc serum cholesterol, inc appetite

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32
Q

Selective b1 blocker

A

“-olol” A to M

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33
Q

Antidote for:

Acetaminophen

A

N-acetylcysteine

34
Q

Antidote for: Salicylates

A

NaHCO3 - - alkalinize urine

35
Q

Antidote for: Amphetamine

A

NH4Cl (acidify urine)

36
Q

Antidote for: Acetylcholinesterase inhibitors

A

atropine and pralidoxime (dephosphorylates AchE)

37
Q

Antidote for: Antimuscarinic, anticholinergic agents

A

physotigmine salicylate

38
Q

Antidote for: B-blockers / Verapamil

A

Glucagon or Calcium or Atropine

39
Q

Antidote for: Digitalis

A

Stop dig and normalize K+, atropine/lidocaine, anti-dig Fab fragments, Mg2+

40
Q

Antidote for: Iron

A

Deferoxamine

41
Q

Antidote for: Lead

A

CaEDTA, dimercaperal, succimer, penicillamine

42
Q

Antidote for: Mercury, arsenic, gold

A

Dimercaprol

43
Q

Antidote for: Copper, arsenic, gold

A

Penicillamine

44
Q

Antidote for: Cyanide

A

Nitrite, hydroocobolamine

45
Q

Antidote for: Methyhemoglobin

A

Methylene blue, vitamin C

46
Q

Antidote for: Carbon Monoxide

A

100% O2, hyperbaric O2

47
Q

Antidote for: methanol, ethylene glycol

A

Ethanol, dialysis, fomepizole

48
Q

Antidote for: ethenol overdose

A

fomepizole (inhibits alcohol dehydrogenase)

49
Q

Antidote for: Opioids

A

Naloxone / naltrexone

50
Q

Antidote for: Benzodiazepines

A

Flumazenil

51
Q

Antidote for: TCA’s

A

NaHCO3 (plasma alkalization)

52
Q

Antidote for: Heparin

A

Protamine

“H in heparin like at proton (H)”

53
Q

Antidote for: Warfarin

A

Vit K, Fresh Frozen Plasma (immediate treatment)

54
Q

Antidote for: tPA, streptokinase

A

Aminocaproic acid

55
Q

Antidote for: Theophylline

A

B-blocker

56
Q

P-450 Inducers

A

Quinidine, Barbiturates, St. John’s Wart, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, Chronic Alcohol use

57
Q

P-450 Inhibitors

A

HIV protease inhibitiors, Ketoconazole, Erythromycin, Grapefruit Juice, Acute alcohol use, Sulfonamides, Isoniazid, Cimetidine

58
Q

Antihypersensive therapy for essential hypertension

A

Diuretics (thiazides - retain calcium), ACEI, ARBs, CCB

59
Q

Antihypertensive Therapy for CHF

A

Diuretics (loops - loose Ca), ACE I / ARBs (reduce mortality), K+ sparing duretic (spironalactone)

60
Q

Antihypertensive Therapy for Diabetes Mellitus

A

ACEI/ARBs (renal protective), CCB, diuretics, a-blocker

61
Q

Hydralazine

A

MOA: inc cGMP = smooth muscle relaxation
dilate ARTERIOLES > VEINS = dec afterload.
DOC for hypertensive prego (with methyldopa)
Tox: Lupus like, reflexive tachycardia and fluid retention.

62
Q

Nifedipine

A

MOA: Dihydropyriden CCB - - smooth muscle

63
Q

Verapamil

A

MOA: non-dihydropyridine CCB - - Heart (“V for ventricles”. Slows down AV node and decreases contractility.
Use: hypertension and Prinzmetal’s angina (vasospasm), rayauds.
Tox: cardiac depression and AV block

64
Q

Diltiazem

A

MOA: non-dihydropyridine CCB.
Slows down AV node and decreases contractility.
Use: hypertension and Prinzmetal’s angina (vasospasm), rayauds.
Tox: cardiac depression and AV block

65
Q

Nitroglycerine

A

MOA: vasodilate by releasing NO in SM = inc cGMP. Dilates VEINS&raquo_space; ARTERIOLES = dec preload and O2 demand.
Use: angina and pulmonary edema.
Tox: Reflex tachy and “monday disease” in industrial work on re exposure.

66
Q

Malignant Hypertension Treatment?

A

Nitroprusside:
short acting, increase cGMP via release of NO.
Tox: cyanide toxicity

67
Q

Nimodipine

A

CCB that goes into CNS.

Prevents spasm after subarachnoid hemorrhage (MC of death)

68
Q

Minoxidil

A

dilates arterioles > veins = fluid retention in order to try and comp for dec BP

69
Q

DOC to lower LDL

A

“-statins”
MOA: HMG-CoA reductase inhibitor. Inhibits cholesterol precursor, mevalonate. DECREASE LDL (bad cholesterol).
Tox: Hepatotox, *don’t use with fibrates b/c results in rhabdomyolysis or myositis (severe muscle pain)

70
Q

DOC to increase HDL

A

Niacin
MOA: inhibits LPL in adipose and reduces hepatic VLDL secretion into circulation.
Tox: Flushing (due to PGE - prevented w/ asprin), Hyperuicema - exacerbates gout

71
Q

Cholestyramine
Colestipol
Colesevelam

A

Bile acid resins.
MOA: prevent intestinal reabsorption of bile slats.
Can be used to bind C. diff toxins!
Tox: bad taste and GI discomfort. Can cause cholesterol gallstones

72
Q

DOC to lower Triglycerides

A

“-fibrates”
MOA: upregulates LPL = inc TG clearance
Tox: Don’t mix with statins! b/c of myositis or rhabdomyolisis.

73
Q

Digoxin

A

Cardiac Glycosides
MOA: inhibits Na/K ATPase, indirectly inhibits Na/Ca exchange = inc intracellular Ca = inc iontropy.
Use: CHF, ATRIAL FIBRILATION (b/c dec AV node conduction).
Tox: Cholinergic (DUMBLES) and blurry yellow vision. Hyperkalemia, bradycardia, dec QT

74
Q

Classes of Anti-arrhythmics

A 
"No BadBoys Keep Clean"
Class 1 = Na blocker
Class 2 = Beta-Blocker
Class 3 = K+ blocker
Class 4 = Ca2+ blocker
75
Q

Class 1 Anti-arrhythmias pneumonic

A

1A = “Police Department Questions”
1B= “The Little Man”
1C=”For Pushing Ecstacy”

76
Q

Class 1A antiarrhythmics

A

Procainamide, Disopyramide, Quinidine

77
Q

Procainamide

A 
1A anti-arrhythmic
MOA: Na channel blocker
Tr: Wolf-pakinson White
Tox: Drug SLE
increases QT interval = torsades de pointes
78
Q

Class 1B antiarrhytmics

A

Tocainide, Lidocaine, Mexiletine

79
Q

Lidocaine

A

1B antiarrhythmic
MOA: Na Channel Blocker - - decrease AP.
Tr: Acute Ventricular Tachycardia (especially post MI)

80
Q

Proranolol

A

Beta-blocker
MOA: dec cAMP = dec Ca2+ current
-Suppresses abnormal pace by dec slope of phase 4! (AV node particularly sensitive = inc PR interval)

81
Q

Amioderone

A

Potassium Channel blocker (phase 3)
MOA: increases AP and ERP. Increase QT
Used: when antiarythmics fail
Tox! pulmonary fibrosis, hepatotoxicity, hypo/hyper thyroid (b/c amioderone is 40% iodine), blue grey skin deposits, photosensitivity.
NO increased risk for torsades de points.

82
Q

Adenosine

A

MOA: increases K out of cell = hyper polarization and dec Ca.
DOC for dx/abolishing SVT!
Effects blocked by theophylline.

USMLE Rapid Reviews (6 decks)

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