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Pharmacology > PLE: Pharma Cardio > Flashcards

PLE: Pharma Cardio Flashcards

1
Q

Class of Digoxin

A

Cardiac glycoside - positive intoropic drug

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2
Q

MOA of Digoxin

A

Na/K/ATPase inhibition to increase intracellular calcium

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3
Q

Side effect of digoxin

A

Blurry, yellow visual changes

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4
Q

Drugs which reduce digoxin clearance (5)

A 
Quinidine
Amiodarone
Cyclosporine
DIltiazem
Verapamil
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5
Q

Drugs with Narrow Therapeutic Index mnemonics

A

WALA na Cyang Papa! VasTeD na!

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6
Q

Drugs with narrow therapeutic index

A 
warfarin
aminoglycoside
lithium
amphotericin B
carbamazepine
phenobarbital
phenytoin
vancomycin
theophylline
digoxin
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7
Q

Drug of choice for digitalis toxicity

A

lidocaine

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8
Q

1st line therapy for systolic and diastolic failure

A

diuretics

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9
Q

1st line drugs for chronic heart failure

A

angiotensin antagonists

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10
Q

MOA of phosphodiesterase inhibitors (inamrinone, milrinone)

A

increase in cAMP

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11
Q

Drugs that have shown improvement in survival of HF

A

ACE inhibitors
Beta blockers
Aldosterone antagonists

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12
Q

a drug that inhibits the enzyme neprilysin, which is responsible for degrading ANP and BNP

A

sacubitril

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13
Q

Singh-Vaughan Williams classification of anti-arrhythmics

A

Class 1: sodium channel blockers
Class 2: beta adreneceptor blockers
Class 3: potassium channel blockers
Class 4: calcium channel blockers

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14
Q

Class 1 sodium channel blockers block which phase of AP?

A

Phase 0

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15
Q

Group 1A anti arrhythmics effect on AP

A

PROLONG the AP

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16
Q

Group 1B anti arrhythmics effect on AP

A

SHORTEN the AP

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17
Q

Group 1C anti arrhthmics effect on AP

A

none

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18
Q

Group 1A antiarrhythmics

A

Disopyramide, procainamide, quinidine

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19
Q

side effect of procainamide

A

lupus-like syndrome

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20
Q

side effect of disopyramide

A

marked anti-muscarinic effects

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21
Q

sides effect of quinidine

A

cinchonism, autoimmune reactions

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22
Q

symptoms of cinchonism

A

headache
dizziness
tinnitus

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23
Q

antidote for cinchonism and other 1A antiarrhythmics

A

sodium lactate

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24
Q

Class 1B antiarrhythmics (4)

A

LIDOCAINE, mexiletine, phenytoin, tocainide

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25
Q

Why are Class 1B best for post MI?

A

selectively affect ischemic or depolarized Purkinje and ventricular tissue

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26
Q

Drugs that can cause AGRANULOCYTOSIS mnemonics

A

CCCAPPIT Me

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27
Q

Drugs that can cause AGRANULOCYTOSIS

A 
Clozapine
Co trimoxazole
Colchicine
Aminopyrine
Phenylbutazine
PTU
Indomethacin
Tocainide
Methimazole
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28
Q

MOA of Class 1C antiarrhythmics

A

Depress sodium current, seen in ECG as increased QRS duration

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29
Q

Class 1C antiarrhythmics (3)

A

FLECAINIDE, propafenone, encainide, moricizine

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30
Q

Use of Class 1C antiarrhythmics

A

refractory arrhythmias

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31
Q

Class 2 antiarrhythmics MOA

A

reduction in cAMP - reduction in sodium and calcium currents

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32
Q

Effect of class 2 antiarrhythmics

A

Prolonged PR interval, AV node sensitive

Act on phase 4

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33
Q

only beta blocker classified under class III

A

sotalol

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34
Q

MOA of class 3 antiarrhythmics

A

Act on phase 3
Blockade of Ik potassium channels responsible for the repolarization
Result to increase in ERP - reduced ability of heart to respond to rapid tachycardias

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35
Q

ECG morphology of class 3 aniarrhthymics

A

increased QT interval

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36
Q

Class 3 antiarrhythmics

A

dofetilide, ibutilide, AMIODARONE< dronedarone, VERNAKALANT

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37
Q

Side effects / amiodarone toxicity (6)

A 
corneal and skin deposits
paresthesia
pulmonary fibrosis
thyroid dysfunction
tremors
38
Q

Class 4 antiarrhythmics

A

verapamil

diltiazem

39
Q

MOA of class 4 antiarrhythmics

A

Block voltage-gated L-type calcium channels

40
Q

SE of verapamil

A

gingival hyperplasia

41
Q

SE of diltiazem

A

Raynauds phenomenon

42
Q

When should you not use class 4 antiarrhythmics

43
Q

ECG change of class 1A (procainamide)

A

Prolonged AP
Prolonged PR and QT interval
Prolonged QRS duration

44
Q

ECG change of class 1B (lidocaine)

A

Shortened AP

NO effect on normal cells

45
Q

ECG change of class 1C (flecainide)

A

NO effect on AP

Prolonged QRS duration

46
Q

ECG change of class 2 (propanolol)

A

no effect on AP

prolonged PR interval

47
Q

ECG change of class 3 (dofetilide)

A

prolonged AP

prolonged QT interval

48
Q

ECG change of class 4 (verapamil)

A

no effect on AP

prolonged PR interval

49
Q

DOC for paroxysmal SVT

50
Q

MOA of adenosine

A

Activation of the inward rectifier K + current (hyperpolarization)
Inhibition of Ca 2+ current (suppression of calcium dependent AP)

51
Q

Drugs that modify salt excretion

A 
Carbonic anhydrase inhibitors (PCT)
Loop diuretics (TAL)
Thiazides (DCT)
Potassium sparing diuretics (CCT)
Osmotic diuretics
52
Q

Drugs that modify water excretion

A

Osmotic diuretics
ADH agonists
ADH antagonists

53
Q

Site of uric acid transport

54
Q

3 MOA of acetazolamide

A

in PCT
reduced aqueous humor
metabolic acidosis to increase respiration

55
Q

uses of acetazolamide

A

glaucoma, mountain sickness, edema with alkalosis

56
Q

SE of acetazolamide in cirrhotics

A

hepatic encephalopathy

57
Q

Causes of HAGMA

A 
MUDPILES
Methanol
Uremia
DKA
Paraldehyde
Isoniazid, iron
Lactic acid
Ethanol, ethylene glycol
Salicylates
58
Q

Causes of NAGMA

A 
HARDUP
Hyperalimentation
Acetazolamide
RTA
Diarrhea
Ureteral diversion
Pancreatic fistula
59
Q

Site of calcium and magnesium reabsorption

60
Q

Decreases the efficacy of loop diuretics

61
Q

Drug class of dichlorphenamide

A

carbonic anhydrase inhibitor

62
Q

drug class of bumetanide

A

loop diuretic

63
Q

drug class of ethacrynic acid

A

loop diuretic - has no sulfa group

64
Q

MOA of loop diuretics

A

inhibition if Na/K/2Cl transporter in TAL

causes increased Ca excretion

65
Q

Synergistic ototoxicity with furosemide

A

aminoglycosides

66
Q

Adverse effects of loop diuretics mnemonic

67
Q

adverse effects of loop diuretics

A 
ototoxicity
hypokalemia
dehydration
allergy to sulfa
nephritis
gout
68
Q

MOA of thiazides

A

inhibition of Na/Cl transporter in DCT

reduced Ca excretion

69
Q

unusual thiazide diuretics

A

chlorthalidone
indapamide
quinethazone

70
Q

side effects of thiazide diuretics

A

hyperGlycemia
hyperLipidemia
hyperUricemia
hyperCalcemia

71
Q

primary site of urine acidification

A

cortical collecting duct

72
Q

potassium sparing diuretics

A

spironolactone
triamterene
amiloride
eplerenone

73
Q

MOA of spironolactone

A

inhibits aldosterone receptor in CCD

74
Q

SE of aldosterone

A

gynecomastia
BPH
hyperchloremic metabolic acidosis

75
Q

MOA of amiloride/triamterene

A

inhibits ENaC

do not give with potassium supplements

76
Q

drugs that cause gynecomastia

A 
spironolactone
digoxin
cimetidine
alcohol
ketoconazole
77
Q

osmotic diuretics

A

mannitol
glycerin
isosorbide
urea

78
Q

ADH agonists

A

vasopressin

79
Q

MOA of ADH agonists

A

V1 and V2 receptors

activate insertion of aquaporin in collecting tubule

80
Q

factor increased by vasopressin

A

factor VIII

81
Q

ADH agonist contrainidicated in pregnancy as it can cause contractions

A

terlipressin

82
Q

ADH antagonists

A

tolvaptan
lixivaptan
demeclocycline
lithium

83
Q

uses of ADH antagonists

A

SIADH

hyponatremia

84
Q

AE of rapid correction of hyponatremia

A

central pontine myelinolysis

85
Q

diuretics that increase urine calcium, causing hypocalcemia

A

loop diuretics

86
Q

diuretics that decrease urine calcium, causing hypercalcemia

A

thiazide diuretics

87
Q

diuretics that decrease blood pH (acidemia)

A

carbonic anhydrase inhibitors (cause HCO3 reabsorption)

K sparing diuretics (aldosterone blockade prevents K and H secretion)

88
Q

diuretics that increase blood pH

A

loop diuretics

thiazides

89
Q

dual endothelin receptor antagonist used in PAH, teratogenic

90
Q

a sympatholytic anti HPN acting on A1 (antagonist) and 5HT1A (agonist); does not elicit reflex tachycardia

91
Q

B2 agonist that causes direct relaxation of uterine smooth muscle used for premature labor

A

isoxuprine

Pharmacology (8 decks)

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