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Step One > Reverse Pharm-CV > Flashcards

Reverse Pharm-CV Flashcards

1
Q

Dihydropridine Calcium channel blocker (4)

Block voltage gated L type calcium channels of smooth muscle (decr. muscle contractility)

On vascular smooth muscle

Hypertension, angina (including prinzmetal), raynaud phenomenon

cardiac depression, peripheral edema, flushing, dizziness, constipation, gingival hyperplasia

A

amlodipine, clevidipine, nicardipine, nifedipine

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2
Q

Dihydropridine Calcium channel blocker

Not used to treat what the others are used to treat
Treats subarachnoid hemorrhage (prevents cerebral vasospasm)

A

Nimodipine

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3
Q

Non Dihydropridine Calcium channel blocker (2)

Blocks voltage gated l type calcium channels of cardiac muscle leading to decr. muscle contractility

Hypertension, angina, A-fib/flutter

AV block, hyperprolactinemia (verapamil), cardiac depression, peripheral edema, flushing, dizziness, constipation, gingival hyperplasia

A

diltiazem, verapamil

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4
Q

Dihydropridine Calcium channel blocker

Treats hypertensive urgency or emergency in addition to its other functions

A

clevidipine

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5
Q

Incr. cGMP via NO release

Short acting

Hypertensive emergency

Cyanide toxicity

A

nitroprusside

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6
Q

Dopamine D1 receptor agonist

Coronary, periph, renal, and splanchnic vasodilation

Decr. BP and Incr. natriuresis

Hypertensive emergency

A

fenoldopam

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7
Q

Nitrates

Vasodilate by incr. NO in vasc. smooth muscle leading to an incr. in cGMP and SM relaxation.

Veins > arteries
Decr preload

Angina, acute coronary syndrome, pulm. edema

Reflex tachy, hypotension, flushing, headache
Monday disease (industrial exposure): tolerance throughout the week, lose it over the weekend, symptoms back on monday.
A

nitroglycerin, isosorbide dinitrate, isosorbide mononitrate

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8
Q

HMG-CoA reductase inhibitors (5 or suffix)

LDL: 3x decr.
HDL: 1x incr.
TGs: 1x decr.

Inhibit conversion of HMG-CoA to mevalonate, a cholesterol precursor

decr. mortality in CAD patients

Hepatotoxicity (incr. LFTs)
Myopathy (w/ fibrates or niacin)

A

lovastatin, pravastatin, simvastatin, atorvastatin, rosuvastatin

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9
Q

Bile acid resins (3 or prefix)

LDL: 2x decr.
HDL: slight incr.
TGs: slight incr.

Prevent intestinal absorp f bile acids; liver must use cholesterol to make more

GI upset
DEcr. absorption of other drugs and fat soluble vitamins

A

cholestyramine, colestipol, and colesevelam

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10
Q

Fibrates (4 or suffix)

LDL: 1x decr.
HDL: 1x incr.
TGs: 3x decr.

upregulate LPL which leads to incr. TG clearance
Activates PPAR-alpha t induce HDL synth

Myopathy (incr. risk with statins)
cholesterol gallstones

A

gemfibrozil, clofibrate bezafibrate, fenofibrate

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11
Q

LDL: 2x decr.
HDL: none
TGs: none

Prevent cholesterol absorption at small intestine brush border

Rare incr. LFTs
Diarrhea

A

ezetimibe

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12
Q

LDL: 2x decr.
HDL: 2x incr.
TGs: 1x decr.

Inhibits lipolysis (hormone sensitive lipase) in adipose tissue
Reduces hepatic VLDL synth

Red, flushed face which is decr. by NSAID use
Hyperglycemia
Hyperuricemia

A

Niacin

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13
Q

Cardiac glycoside

Direct inhib. of Na/K ATPase leading to inhib. of Na/Ca exchanger leading to incr. intracellular calcium leading to positive inotropy.
Stimulates the vagus nerve leading to decr. HR

HF (incr. contractility)
A fib (Decr. conduction at AV node and depression of AV node=vagal nerve stim.)

TOXICITIES
Cholinergic: nausea, vomiting, diarrhea, blurry yellow vision (van gogh), arrhythmias, AV block
Hyperkalemia (poor prognosis)

PREDISP TO TOXIC.
Renal failure, hypokalemia (allows digoxin to bind), verapamil, amiodarone, quinidine

ANTIDOTE
slowly normalize K+, cardiac pacer, anti-digoxin Fab fragments, Mg2+

A

digoxin

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14
Q

Incr. K+ out of cells leads to hyperpolarizing of cell and thus decr. calcium current into cell.

Drug of choice in diagnosing/abolishing SVTs

Very short acting (15 sec)

Blunted by theophylline and caffeine

Flushing, hypotension, chest pain, sense of impending doom, bronchospasm

A

adenosine

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15
Q

Class IA antiarrhythmics (3)

Incr. AP duration
Incr. ERP
Incr. QT interval

Atrial and ventricular arrhythmias, especially re-entrant and ectopic SVT and VT

1=Cinchonism (headache, tinnitus)
2=reversible SLE like syndrome
3=HF

thrombocytopenia
Torsades de pointes due to incr. QT
nosine

A

Quinidine (1), procainamide (2), disopyramide (3)

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16
Q

Uses: Torsades de Pointes and Digoxin toxicity

A

Mg2+

17
Q

Class IV antiarrythmics (2)

Decr. conduction velocity
Incr. ERP
Incr. PR interval

Prevention of nodal arrhythmias (SVT)
Rate control in a fib

Constipation flushing, edema, CV effects

A

Verapamil, Diltiazem

18
Q

Class IC (2)

Prolongs ERP in AV node and accessory bypass tracts.
No effect on ERP in purkinje and ventricular tissue
Minimal effect on AP duration

SVTs, including a fib.
Last resort in refractory VT

Proarrhythmic, especially post MI (contraindicated)

A

flecainide, propafenone

19
Q

Class II antiarr (beta blockers) (6)

decr. SA and AV nodal activity by decr. cAMP and Ca currents.
Suppress abnormal pacemakers by decr. slope of phase 4.
AV node sensitive=Incr. PR interval

SVT, ventricular rate control for a fib and a flutter

Toxicity: Impotence, exacerbation of asthma and COPD, CV effects, CNS effects, mask signs of hypoglycemia

1=dyslipidemia
2=exacerbate vasospasm in prinzmetal angina

Toxicity treatment: Saline, atropine, and glucagon

A

metoprolol (1), propranolol (2), esmolol, atenolol, timolol, and carvedilol

20
Q

Class IB (sodium channel) (2)

Decr. AP duration
Ischemic or depol. purkinje and ventricular tissue

Acute ventricular arrhythmias (especially post MI)
Digitalis induced arrhythmias

CNS stim/depressin, CV depression

A

lidocaine, mexiletine

21
Q

Antiarr=potassium channel blockers (class III) (3)

Incr. AP duration, incr. ERP, incr. QT interval

Afib
A flutter
ventricular tachy (1,3)

1=torsades de pointes, excessive beta blockade

2=torsades de pointes

3=pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroid, acts as hapten (corneal deposits, blue/grey skin deposits), neuro effects, constipation, CV effects (bradycardia, heart block, HF)

3=check PFTs, LFTs, TFTs

3=lipophillic, all class effects.

A

sotalol (1) Ibutilide (2) Amiodarone (3)

Step One (49 decks)

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