Pharmacology for Cardiology

Question 1

What conditions are b-blockers contraindicated for?

Answer 1

CHF, cardiogenic shock

Question 2

What is the antihypertensive therapy of choice for DM?

Answer 2

ACE inhibitors/ ARBs

Question 3

What is the mechanism of Ca channel blockers?

Answer 3

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

Question 4

Amlodipine

Answer 4

Ca Channel blocker (dihydropyridine; mostly vascular smooth muscle)

Question 5

Nimodipine

Answer 5

Ca Channel blocker (dihydropyridine)

Question 6

Nifedipine

Answer 6

Ca channel blocker (dihydropyridine)

Mostly vascular smooth muscle

Question 7

diltiazem

Answer 7

Ca channel blocker (non-dihydropyridine)

Mostly heart

Question 8

Verapamil

Answer 8

Ca channel blocker (non-dihydropyridine)

Question 9

Toxicities of Ca channel blockers

Answer 9

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

Question 10

What is the mechanism and use of hydralazine?

Answer 10

Muscle relaxation (incr cGMP)
arterioles>veins

Question 11

What is the first line therapy for hypertension in pregnancy?

Answer 11

Hydralazine

Question 12

Nitroprusside

Answer 12

short acting antihypertensive

incr cGMP via NO release

Question 13

Fenoldopam

Answer 13

for hypertensive emergency

dopamine D1 receptor agonist

Question 14

What is the toxicity of nitroprusside?

Answer 14

Cyanide toxicity

Question 15

Nitroglycerin

Answer 15

Vasodilate by incr NO

veins»arteries

Question 16

How does nitroglycerin act on cardiac load?

Answer 16

Decr preload

Question 17

Isosorbide dinitrate

Answer 17

Vasodilate by incr NO

veins»arteries

Question 18

What b blockers are contraindicated in angina?

Answer 18

Pindolol, acebutolol

partial b agonists

Question 19

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

Answer 19

Decr O2 consumption

Nitrate and b block

Question 20

What are the toxicities of statins?

Answer 20

hepatotoxicity rhabdomyolysis

Question 21

What step is inhibited by statins?

Answer 21

HMG-CoA to mevalonate

Question 22

What is the mechansim of Niacin?

Answer 22

inhibits lipoylsis in adipose tissue

reduces hepatic VLDL synthesis

Question 23

What are the side effects of niacin?

Answer 23

red, flush face
hyperglycemia
hyeruricemia

Question 24

Cholestyramine

Answer 24

Bile acid resin

Question 25

Colestipol

Answer 25

bile acid resin

Question 26

colesevelam

Answer 26

bile acid resin

Question 27

Which lipid lowering agent has greatest affect on HDL?

Answer 27

Niacin

Question 28

Ezetimibe

Answer 28

cholesterol absorption blocker

Question 29

gemfibrozil

Answer 29

fibrate

Question 30

Mechanism of fibrates?

Answer 30

upregulate LPL incr TG clearance | activates PPARa to induce HDL synthesis

Question 31

What lipid lowering agent has greatest effect on triglycerides

Answer 31

Fibrates

Question 32

What is the mechanism of digoxin?

Answer 32

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

Question 33

What are the clinical uses of digoxin?

Answer 33

CHF, a fib

Question 34

How does digoxin help to resolve a fib

Answer 34

decr conduction of AV node, depression of SA node

Question 35

When is digoxin contraindicated?

Answer 35

renal failure, hypokalemia

Question 36

What are the toxicities of digoxin?

Answer 36

cholinergic (nvd, blurry vision) | hyperkalemia

Question 37

``` What are the different antiarrhythmics? Class I Class II Class III Class IV ```

Answer 37

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

Question 38

Quinide

Answer 38

Class 1A antiarrythmic

Question 39

Procainamide

Answer 39

Class 1A antiarrythmic

Question 40

Disopyramide

Answer 40

Class 1A antiarrythmic

Question 41

What are the uses of class 1A antiarrythmics

Answer 41

atrial and ventricular arrythmias | esp SVT, VT

Question 42

What are the general toxicities of class 1A antiarrythmics?

Answer 42

thrombocytopenia | torsades des pointes

Question 43

Describe the action of Class I antiarrythmics

Answer 43

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

Question 44

What metabolic abnormality increases toxcities for Class 1 antiarrythmics?

Answer 44

hyperkalemia

Question 45

What is an important side effect of procainamide

Answer 45

SLE-like syndrome

Question 46

Lidocaine

Answer 46

class 1B antiarrythmics

Question 47

Mexiletine

Answer 47

class 1B antiarrythmics

Question 48

What is the use for class 1B antiarrythmics?

Answer 48

Acute ventricular arrythmias

Question 49

Flecainide

Answer 49

class 1C antiarrythmics

Question 50

Propafenone

Answer 50

class 1C antiarrythmics

Question 51

Use of class 1C antiarrythmics

Answer 51

SVTs, including Afib

Question 52

what is the mechanism of class 1C antiarrythmics

Answer 52

prolongs refractory period of AV node

Question 53

What are the contraindications for class 1C antiarrythmics

Answer 53

structural and ischemic heart disease

Question 54

What is the mechanism of class II antiarythmics?

Answer 54

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

Question 55

What is the use of Class II antiarrythmics

Answer 55

SVT

Question 56

What is used to treat bblock overdose

Answer 56

glucagon

Question 57

Amiodarone

Answer 57

Class III antiarrythmic (with actions of all classes)

Question 58

Ibutilide

Answer 58

Class III antiarrythmic

Question 59

Dofetilide

Answer 59

Class III antiarrythmic

Question 60

Sotalol

Answer 60

Class III antiarrythmic

Question 61

What are the toxicities of amiodarone

Answer 61

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

Question 62

What is the use of Class III antiarrythmic

Answer 62

atrial fibrillation, atrial flutter

Question 63

What is the use of Class IV antiarrythmic

Answer 63

prevention of nodal arrythmias

Question 64

What are the antiarrythmic uses of Mg

Answer 64

torsades de pointes, digoxin toxicity