Cardiovascular Drugs Flashcards

1
Q

[Anti-hypertensive drugs]

What is the formula for blood pressure?

A

BP = COxSVR

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2
Q

[Anti-hypertensive drugs]

What is the expanded formula for your blood pressure?

A

BP = HR x SV x SVR

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3
Q

[Anti-hypertensive drugs]
hypertension with comorbid CHF/DM
SE: cough, angioedema, contraindicated in bilateral RAS

A

Captopril (ACE inhibitors)
-increase bradykinin

ACE inhibitors: “-pril”
captopril, enalapril, benazepril, fosinopril, lisinopril, quinapril, ramipril, trandolapril, moexipril, perindopril, imidapril

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4
Q

[Anti-hypertensive drugs]

used in ACE-inhibitor intolerance

A

Losartan (ARBs)

ARBs: “-sartan”
losartan, candesartan, valsartan, irbesartan, eprosartan, telmisartan, azilsartan, valsartan

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5
Q

[Anti-hypertensive drugs]

hypertension with comorbid BPH

A

prazosin (alpha 1 selective adrenergic blockers)
“-osin”
prazosin, doxazosin, terazosin, tamsulosin, silodosin, alfazosin

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6
Q

[Anti-hypertensive drugs]
pre-eclampsia (maintenance medication)
SE: hemolytic anemia (positive coombs test)

A

methyldopa

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7
Q

[Anti-hypertensive drugs]
pre-eclampsia (acute BP lowering)
SE: reflex tachycardia, drug-induced lupus

A

hydralazine

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8
Q

[Anti-hypertensive drugs]
hypertensive emergency
SE: hypertrichosis

A

minoxidil (acts at K channels)

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9
Q

[Anti-hypertensive drugs]
hypertensive emergency
SE: cyanide poisoning

A

nitroprusside (both arterioles and venous site)

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10
Q

[Anti-hypertensive drugs]

treatment of cyanide poisoning

A

amyl nitrite

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11
Q

why do patients taking angiotensin antagonists (ACE-Is/ARBs) develop hyperkalemia?

A

ACE-Is/ARBs reduce aldosterone levels and cause potassium retention

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12
Q

which portion of the electron chain is affected by cyanide?

A

complex IV (cytochrome oxidase) of the ETC

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13
Q

what is the antidote for cyanide poisoning?

A

inhaled amyl nitrite + IV sodium nitrite + IV sodium thiosulfate

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14
Q

[Anti-anginal drugs]
used for relief of acute anginal attacks
SE: headache, tolerance

A

nitroglycerin, ISDN

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15
Q

[Anti-anginal drugs]
used for angina maintenance, VASCULAR> cardiac effect

SE: flushing, edema, gingival hyperplasia

A

nifedipine

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16
Q

[Anti-anginal drugs]
used for angina maintenance, CARDIAC> vascular effect, vasospastic angina, Raynaud’s phenomenon
*does not cause gingival hyperplasia

A

diltiazem

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17
Q

[Anti-anginal drugs]
used for supraventricular tachycardia, CARDIAC> vascular effect
SE: gingival hyperplasia

A

verapamil

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18
Q

drugs that cause gingival hyperplasia

A
"Nganga Pa Cagat Vampira"
nifedipine
phenytoin
cyclosporine
verapamil
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19
Q

why do patients taking nitrates usually experience throbbing headaches?

A

due to meningeal blood vessel vasodilation

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20
Q

why is calcium-dependent neurotransmission or hormone release not affected by CCBs?

A

CCBs block L-type calcium channels

other functions use N-, P- and R- types

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21
Q

[drugs for heart failure]
used as positive inotrope for heart failure
SE: arrhythmias (PVC, AVB), yellow visual halos

A

digoxin (Na-K pump)

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22
Q

[drugs for heart failure]

used as treatment for pulmonary edema in CHF

A

furosemide

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23
Q

[drugs for heart failure]

used as first line drug for chronic CHF, cardioprotective, renoprotective

A

ACE inhibitors, ARBs

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24
Q

[drugs for heart failure]

improved survival in CHF (decreases mortality)

A

ACE inhibitors/ARBs, beta blockers, spironolactone

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25
Q

[drugs for heart failure]

decreases hospitalizations in CHF

A

digoxin

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26
Q

[drugs for heart failure]

improves survival in CHF patients of African-American descent

A

hydralazine + ISDN

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27
Q

what drugs have been shown to imrpove survival in cases of heart failure?

A

“ABA! Buhay ka pa”
ACE inhibitors
Beta blockers
Aldosterone Antagonists

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28
Q

[antiarrhythmic drugs]
treatment of all types of arrhythmias, WPW syndrome
SE: drug-induced lupus

A

procainamide

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29
Q

antidote of procainamide overdose

A

Na lactate

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30
Q

[antiarrhythmic drugs]
used for atrial and ventricular arrhythmia
SE: cinchonism (triad: headache, tinnitus, vertigo)

A

quinidine

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31
Q

[antiarrhythmic drugs]
used for post-MI arrhythmias, digitalis arrhythmias
SE: seizures

A

lidocaine

32
Q

[antiarrhythmic drugs]

contraindicated post-MI, refractory arrhythmias

A

flecainide

33
Q

[antiarrhythmic drugs]

used for perioperative and thyrotoxic arrhythmias, SVT

A

esmolol

34
Q

[antiarrhythmic drugs]
beta blocker, groups 3 activity
SE: dose-dependent torsades de pointes

A

sotalol

35
Q

[antiarrhythmic drugs]
most efficacious antiarrhythmic
SE: skin deposits, pulmonary fibrosis, hyper/hypothyroidism

A

amiodarone (1a activity) - can be used for Wolf Parkinson Wide syndrome

36
Q

[antiarrhythmic drugs]
used as outpatient managemene of SVT
SE: gingival hyperplasia

A

verapamil

37
Q

what are the effects of class 1 antiarrhythmics on action potential duration?

A

Class 1A: prolongs

Class 1B: shortens

Class 1C: no effect

38
Q

[antiarrhythmic drugs]

Class 1A drugs

A

[antiarrhythmic drugs]
Class 1A drugs - prolongs action potential

“QPD - Quezon Police District”
quinidine
procainamide
disopyramide

39
Q

[antiarrhythmic drugs]

Class 1B drugs

A

[antiarrhythmic drugs]
Class 1B drugs - shortens action potential

"PLM Tayo"
phenytoin
lidocaine
mexiletine
tocainide
40
Q

[antiarrhythmic drugs]

Class 1C drugs

A

[antiarrhythmic drugs]
Class 1C drugs - no effect on action potential; contraindicated for post-MI; powerful depressant of Na current

"Please Feed ME"
Propafenone
Flecainide
Moricizine
Encainide
41
Q
Anti-arrhythmics
Singh-Vaughan-William Classification
Class 1
Class 2
Class 3
Class 4
A

Anti-arrhythmics
Singh-Vaughan-William Classification
Class 1a, 1b, 1c - Sodium channel blockers (acts of phase 0)
Class 2 - beta blockers (acts on phase 4)
Class 3 - potassium channel blockers
Class 4 - calcium channel blockers

42
Q

what are the drugs that can cause agranulocytosis?

A
"CCCAPPIT Me!"
clozapine
co-trimoxazole
colchicine
aminopyrine
phenylbutazone
PTU
indomethacin
tocainide
methimazole
43
Q

Amiodarone toxicity symptoms

A
pulmonary fibrosis
paresthesias
tremors
thyroid dysfunction
corneal deposits
skin deposits
44
Q

why are dihydropyridine calcium channel blockers not useful as antiarrhythmics?

A

dihydropyridine CCBs evoke compensatory sympathetic discharge which facilitates arrhythmias rather than terminating them

45
Q

Anti-arrhythmics Class 1a effect on ECG

A

Anti-arrhythmics Class 1a effect on ECG:
prolongs PR interval
prolongs QRS duration
prolongs QT interval

46
Q

Anti-arrhythmics Class 1b effect on ECG

A

Anti-arrhythmics Class 1b effect on ECG:

no effect on normal cells

47
Q

Anti-arrhythmics Class 1c effect on ECG

A

Anti-arrhythmics Class 1c effect on ECG:

prolongs QRS duration

48
Q

Anti-arrhythmics Class 2 effect on ECG

A

Anti-arrhythmics Class 2 effect on ECG:

prolongs PR interval

49
Q

Anti-arrhythmics Class 3 effect on ECG

A

Anti-arrhythmics Class 3 effect on ECG:

prolongs QT interval

50
Q

Anti-arrhythmics Class 4 effect on ECG

A

Anti-arrhythmics Class 4 effect on ECG:

prolongs PR interval

51
Q

[Diuretics]

  • acts on PCT
  • used for treatment of glaucoma and mountain sickness
A
"-zolamide"
ACETAZOLAMIDE
dorzolamide
brinzolamide
dichlorphenamide
methazolamide
52
Q

[Diuretics]

adverse SE: NAGMA, hepatic encephalopathy

A
Carbonic anhydrase inhibitors:
"-zolamide"
ACETAZOLAMIDE
dorzolamide
brinzolamide
dichlorphenamide
methazolamide
53
Q

[Diuretics]

  • acts on TAL
  • treatment of pulmonary edema
  • most efficacious diuretics
A
loop diuretics:
"FB TE?"
FUROSEMIDE
bumetanide
tosemide
ethacrynic acid

MOA: inhibit Na-K-2Cl transporter

54
Q

[Diuretics]

adverse SE: ototoxicity, HYPOcalcemia, HYPOkalemia

A
loop diuretics:
"FB TE?"
FUROSEMIDE
bumetanide
tosemide
ethacrynic acid

MOA: inhibit Na-K-2Cl transporter

55
Q

[Diuretics]
major site for NaCl & NaHCO3 reabsorption (60-70%);
site of uric acid transport

A

PCT

56
Q

[Diuretics]
responsible for a significant % of NaCl reabsorption via Na-K-2Cl transporter
site of Ca and Mg reabsorption

A

TAL

57
Q

[Diuretics]
pumps Na and Cl out of the lumen of the nephron via Na-Cl transporter
responsible for 5-8% of Na reabsorption

A

DCT

58
Q

[Diuretics]

acts on DCT

A
Thiazide diuretics:
HYDROCHLOROTHIAZIDE
chlorthalidone
indapamide
metolazone
bendroflumethiazide
hydroflumethiazide
methyclothiazide
polythiazide
quinethazone
trichlormethiazide

MOA: inhibit Na-Cl transporter

59
Q

[Diuretics]

adverse SE if thiazide diuretics

A
hyperGLUC:
hyperglycemia
hyperlipidemia
hyperuricemia
hypercalcemia
60
Q

[Diuretics]
used for renal Ca stines, nephrogenic DI;
efficacy decreased by NSAIDs

A
Thiazide diuretics:
HYDROCHLOROTHIAZIDE
chlorthalidone
indapamide
metolazone
bendroflumethiazide
hydroflumethiazide
methyclothiazide
polythiazide
quinethazone
trichlormethiazide

MOA: inhibit Na-Cl transporter

61
Q

[Diuretics]
acts on cortical collecting duct
used for hyperaldosteronism, HPN, HF, hypoK

A

K-sparing Aldosterone antagonists:
spironolactone
eplerenone

62
Q

[Diuretics]

adverse effect: gynecomastia, hyperkalemia

A

K-sparing Aldosterone antagonists:
spironolactone
eplerenone

63
Q

[Diuretics]

reduces progression of DM nephropathy and reduces mortality in post MI

A

eplerenone

64
Q

[Diuretics]
acts on PCT, DCT, and CCD
treatment if rhabdomyolysis and increased ICP, contraindicated in heart failure

adverse SE: transient volume expansion

A

mannitol

65
Q

What are the causes of HAGMA?

A
causes of HAGMA:
"MUDPILES"
methanol
uremia
DKA
paraldehyde
isoniazid, iron
lactic acid
ethanol, ethylene glycol
salicylates
66
Q

What are the causes of NAGMA?

A
causes of NAGMA:
"HARDUP"
hyperalimentation
acetazolamide
RTA
diarrhea
ureteral diversion
pancreatic fistula
67
Q

what are the adverse effects associated with loop diuretics?

A
adverse effects associated with loop diuretics:
"OH DANG!"
ototoxicity
HYPOkalemia
dehydration
allergy to sulfa
nephritis
gout
68
Q

what are the adverse effects of thiazide diuretics?

A
adverse effects of thiazide diuretics:
hyperGLUC:
glycemia
lipidemia
uricemia
calcemia
69
Q

which drugs can cause gynecomastia?

A
cause gynecomastia:
"Sa Dede Co Asset Ko"
Spironolactone
Digoxin
Cimetidine
Alcohol
Ketoconazole
70
Q

Anti-hypertensive drugs that can cause depression (usually centrally acting)

A
“RAMP”
Reserpine
A2 adrenergic antagonists (Guanabenz, Guanfacine, Clonidine)
Methyldopa
Propranolol
71
Q

Cardioselective beta blockers without intrinsic sympathomimetic activity

A
“MABB”
Metoprolol
Atenolol
Bisprolol
Betaxolol
72
Q

This vasodilator provides myocardial protection via preconditioning by activation of cardiac Katp channels

A

Nicorandil

73
Q

Drugs for Pheochromocytoma

A
“PaPa Loves Cars”
Phenoxybenzamine
Phentolamine
Labetalol
Carvedilol
74
Q

Antihypertensive drugs given during pregnancy

A
“My Love, Hold Na”
Methyldopa
Labetalol
Hydralazine
Nifedipine
75
Q

Drugs that decrease digitalis clearance

A
“VAD C Q”
Verapamil
Amiodarone
Diltiazem
Cyclosporine
Quinidine
76
Q

Drugs with narrow therapeutic index like digoxin

A
“Vhaklang To! WALA Cyang PaPa Dai”
Vancomycin
Theophylline
Warfarin
Aminoglycosides
Lithium
Amphotericin
Carbamazepine
Phenobarbital
Phenytoin
Digoxin
77
Q

Drugs that cause agranulocytosis

A
“Clozap Col Co PAPI To Me”
Clozapine
Colchicine
Cotrimoxazole
PTU
Aminopyrine
Phenybutazone
Indomethacine
Methinazole
Tocainidine