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Pharmacology for Cardiology Flashcards

1
Q

What conditions are b-blockers contraindicated for?

A

CHF, cardiogenic shock

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2
Q

What is the antihypertensive therapy of choice for DM?

A

ACE inhibitors/ ARBs

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3
Q

What is the mechanism of Ca channel blockers?

A

Blocks voltage-dependent L-type calcium channel in cardiac and smooth muscle; reduces muscle contractility

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4
Q

Amlodipine

A

Ca Channel blocker (dihydropyridine; mostly vascular smooth muscle)

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5
Q

Nimodipine

A

Ca Channel blocker (dihydropyridine)

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6
Q

Nifedipine

A

Ca channel blocker (dihydropyridine)

Mostly vascular smooth muscle

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7
Q

diltiazem

A

Ca channel blocker (non-dihydropyridine)

Mostly heart

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8
Q

Verapamil

A

Ca channel blocker (non-dihydropyridine)

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9
Q

Toxicities of Ca channel blockers

A

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

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10
Q

What is the mechanism and use of hydralazine?

A 
Muscle relaxation (incr cGMP)
arterioles>veins
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11
Q

What is the first line therapy for hypertension in pregnancy?

A

Hydralazine

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12
Q

Nitroprusside

A

short acting antihypertensive

incr cGMP via NO release

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13
Q

Fenoldopam

A

for hypertensive emergency

dopamine D1 receptor agonist

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14
Q

What is the toxicity of nitroprusside?

A

Cyanide toxicity

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15
Q

Nitroglycerin

A

Vasodilate by incr NO

veins»arteries

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16
Q

How does nitroglycerin act on cardiac load?

A

Decr preload

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17
Q

Isosorbide dinitrate

A

Vasodilate by incr NO

veins»arteries

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18
Q

What b blockers are contraindicated in angina?

A

Pindolol, acebutolol

partial b agonists

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19
Q

What is the goal of antianginal therapy? What two drugs work syngergistically to do this?

A

Decr O2 consumption

Nitrate and b block

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20
Q

What are the toxicities of statins?

A

hepatotoxicity rhabdomyolysis

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21
Q

What step is inhibited by statins?

A

HMG-CoA to mevalonate

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22
Q

What is the mechansim of Niacin?

A

inhibits lipoylsis in adipose tissue

reduces hepatic VLDL synthesis

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23
Q

What are the side effects of niacin?

A

red, flush face
hyperglycemia
hyeruricemia

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24
Q

Cholestyramine

A

Bile acid resin

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25
Q

Colestipol

A

bile acid resin

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26
Q

colesevelam

A

bile acid resin

27
Q

Which lipid lowering agent has greatest affect on HDL?

28
Q

Ezetimibe

A

cholesterol absorption blocker

29
Q

gemfibrozil

30
Q

Mechanism of fibrates?

A

upregulate LPL incr TG clearance

activates PPARa to induce HDL synthesis

31
Q

What lipid lowering agent has greatest effect on triglycerides

32
Q

What is the mechanism of digoxin?

A

inhibition of Na/K ATPase wich leads to inhibition of Na/ca exchanger

33
Q

What are the clinical uses of digoxin?

A

CHF, a fib

34
Q

How does digoxin help to resolve a fib

A

decr conduction of AV node, depression of SA node

35
Q

When is digoxin contraindicated?

A

renal failure, hypokalemia

36
Q

What are the toxicities of digoxin?

A

cholinergic (nvd, blurry vision)

hyperkalemia

37
Q 
What are the different antiarrhythmics?
Class I
Class II
Class III
Class IV
A

Class I- Na channel blocker
Class II- b blocker
Class III- K channel blocker
Class IV- Ca channel blocker

38
Q

Quinide

A

Class 1A antiarrythmic

39
Q

Procainamide

A

Class 1A antiarrythmic

40
Q

Disopyramide

A

Class 1A antiarrythmic

41
Q

What are the uses of class 1A antiarrythmics

A

atrial and ventricular arrythmias

esp SVT, VT

42
Q

What are the general toxicities of class 1A antiarrythmics?

A

thrombocytopenia

torsades des pointes

43
Q

Describe the action of Class I antiarrythmics

A

Decr slope of phase 0 depolarization, incr threshold for firing in abnormal
state dependent?

44
Q

What metabolic abnormality increases toxcities for Class 1 antiarrythmics?

A

hyperkalemia

45
Q

What is an important side effect of procainamide

A

SLE-like syndrome

46
Q

Lidocaine

A

class 1B antiarrythmics

47
Q

Mexiletine

A

class 1B antiarrythmics

48
Q

What is the use for class 1B antiarrythmics?

A

Acute ventricular arrythmias

49
Q

Flecainide

A

class 1C antiarrythmics

50
Q

Propafenone

A

class 1C antiarrythmics

51
Q

Use of class 1C antiarrythmics

A

SVTs, including Afib

52
Q

what is the mechanism of class 1C antiarrythmics

A

prolongs refractory period of AV node

53
Q

What are the contraindications for class 1C antiarrythmics

A

structural and ischemic heart disease

54
Q

What is the mechanism of class II antiarythmics?

A

decrease SA and AV nodal activity by decr cAMP, Ca2+ currents

55
Q

What is the use of Class II antiarrythmics

56
Q

What is used to treat bblock overdose

57
Q

Amiodarone

A

Class III antiarrythmic (with actions of all classes)

58
Q

Ibutilide

A

Class III antiarrythmic

59
Q

Dofetilide

A

Class III antiarrythmic

60
Q

Sotalol

A

Class III antiarrythmic

61
Q

What are the toxicities of amiodarone

A

pulm fibrosis, hepatotoxicit, thyroid, skin/corneal deposits, neuro

62
Q

What is the use of Class III antiarrythmic

A

atrial fibrillation, atrial flutter

63
Q

What is the use of Class IV antiarrythmic

A

prevention of nodal arrythmias

64
Q

What are the antiarrythmic uses of Mg

A

torsades de pointes, digoxin toxicity

Step 1 (34 decks)

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