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Pharmacology > Antiarrhythmic - Diuretics - Hyperlipidemia > Flashcards

Antiarrhythmic - Diuretics - Hyperlipidemia Flashcards

(63 cards)

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0
Q

Polymorphic ventricular tachycardia, often displaying waxing and waning QRS amplitude in ECG

A

Torsades de Pointes

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1
Q

Two arrhythmogenic mechanisms

A
  1. Abnormal automaticity

2. Abnormal conduction

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2
Q

What are the different class of antiarrhythmic drugs based on Singh Vaughan Williams Classifications

A

Class 1: Sodium channel blockers
Class 2: Beta-adrenoceptor blockers
Class 3: Potassium channel blockers
Class 4: Calcium channel blockers

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3
Q

What portion of the cardiac action potential does the Class 1 antiarrhythmic drugs act on?

A

Phase 0

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4
Q

Class 1A antiarrhythmic drug that has a lupus like syndrome side effects

A

Procainamide - used for atrial and ventricular arrhythmias, especially after MI

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5
Q

A class 1A antiarrhythmic drug that has a marked antimuscarinic effects

A

Disopyramide

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6
Q

Antiarrhythmic drug that is also used in malaria with a side effect of having cinchonism and autoimmune reactions (ITP)

A

Quinidine - reduces clearance of digoxin

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7
Q

Treatment for class 1A overdose

A

Sodium lactate - reverse drug induced arrhythmias

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8
Q

Antiarrhythmic drugs that reduces AP duration, selectively affects ischemic or depolarized Purkinje and ventricular tissues. Have little effect on the ECG

A

Group 1B antiarrhythmic drugs

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9
Q

Drug of choice for ventricular arrhythmias post-myocardial infarction. It is also the least cardiotoxic among conventional anti-arrhythmic drugs

A

Lidocaine

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10
Q

Antiarrhythmic drug that has a powerful depressants of sodium current. Can markedly slow conduction velocity in atrial and ventricular cells

A

Group 1C antiarrhythmic drugs

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11
Q

Anti arrhythmic drug used for refractory arrhythmias, contraindicated for post MI arrhythmia

A

Flecainide

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12
Q

Class IA drugs used for WPW syndrome

A

Procainamide and Amiodarone

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13
Q

Class 2 antiarrhythmic drugs act on what phase of action potential?

A

Phase 4 - AV node is particularly sensitive to blockers

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14
Q

Class 2 antiarrhythmic drug used for post - MI prophylaxis against sudden death and thyrotoxicosis

A

Propranolol - slowed pacemaker activity

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15
Q

Beta-blocker lacking local anesthetic effect

A

Timolol

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16
Q

Beta-blocker with low lipid solubility

A

Atenolol

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17
Q

Antiarrhythmic drug that acts on phase 3, hallmark is prolongation of the AP duration, ECG: increAse in QT interval

A

Class 3 antiarryhythmic drugs - blockade of potassium that are responsible for the repolarization of the AP

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18
Q

Class 3 antiarrhythmic drug used for treatment and prophylaxis of atrial fibrillation

A

Dofetilide - side effects: Torsades de pointes

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19
Q

A beta-blocker that has class 3 properties, used for ventricular arrhythmia and atrial fibrillation

A

Sotalol

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20
Q

Class 3 antiarrhythmic drug used for refractory arrhythmias, most efficacious of all antiarrhythmic drugs.

A

Amiodarone - it has group 1, group 2 and 4 effects

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21
Q

Toxicity results to pulmonary fibrosis, paresthesias, tremors, thyroid dysfunctions, corneal deposits, and skin deposits

A

Amiodarone toxicity

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22
Q

Group of drugs effective in arrhythmias that must traverse calcium dependent cardiac tissues (AV node). ECG: PR interval is consistently increased

A

Class 4 antiarrhythmic drugs

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23
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

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24
Class 4 antiarrhythmic drug used for Reynaud's phenomenon
Diltiazem
25
Site of active sodium and chloride pump out of the lumen of the nephron via Na/Cl carrier
Distal convoluted tubule
27
It is a miscellaneous antiarrhythmic drug of choice for paroxysmal supraventricular tachycardia
Adenosine
28
Major site for sodium chloride and sodium bicarbonate reabsoption (60-70%)
Proximal convoluted tubule
29
Carbonic anhydrase inhibitor drug used for glaucoma,
Acetazolamide - SE: hyperchloremic metabolic acidosis (NAGMA)
30
Site for sodium chloride reabsoption via Na/K/2Cl transporter
Thick ascending loop of Henle
31
Site of calcium and magnesium reabsorption
Thick ascending loop of Henle
32
Important in maintaining glomerular filtration
Prostaglandins
33
Drugs that decreases the efficacy of loop diuretics
NSAIDs
35
Site for last tubular sodium reabsoption, reabsorbing (2-5%) of sodiu via channels
Cortical collecting ducts
36
Loop diuretic that has synergistic effect with aminoglycosides. Half life of 6 hours used for heart failure and pulmonary edema
Furosemide - SIMD: Ethacrynic acid
37
Primary site of acidification of urine, last site of potassium excretion
Cortical collecting duct
38
Site of reabsorption of water occurs under the control of antidiuretic hormones (ADH)
Medullary collecting duct
39
Calcium is also reabsorbed at this distal convoluted tubule under the control of what hormone?
PTH
40
Diuretic used for hyperaldosteronism, SE: gynecomastia, impotence
Spironolactone - SIMD: Eplerenone - reduces progression of DM nephropathy
42
Remains in the lumen and holds water by virtue of its osmotic effect. Used for rhabdomyolysis and increased intracranial pressure
Mannitol
45
Drugs effective in lowering LDL cholesterol except: | Statins, fibrates, resins, ezetimibe, niacin
Fibrates - has no or little effect on LDL concentrations
46
Potassium - sparing diuretic (Na blocker) used for hypokalemia. SE: hyperkalemia, acute renal failure and kidney stones
Amiloride
47
An ADH antagonist used for SIADH and hyponatremia
Conivaptan
48
Drug used for hypercholesterolemia (high LDL), pruritus in cholestasis. SE: steatorrhea, constipation and malabsorption
Cholestyramine - bile acid binding resin
49
Conditioned highly associated with acute pancreatitis
Hyperchylomicronemia
52
Drugs most effective in lowering triglycerides and VLDL, increasing HDL
Niacin and fibrates
53
It raises triglyceride and VLDL levels and should be avoided in patients with hyoertriglyceridemia
Alcohol
54
Has anti-atherosclerotic effects and prevent bone loss. However, had increased risk of myopathy and rhabdomyolysis when used with fibrates
Simvastatin - reversible competitive inhibitor of HMG-CoA reductase
55
Drug converted to glucuronide form in the liver, it inhibits NPC1L1 transporter and prevents absorptionof dietary cholesterol and cholesterol that is excreted in bile
Ezetimibe - with synergistic effect with Statins in lowering LDL
56
Most effective agent for increasing HDL levels, reduces LDL cholesterol, triglycerides and VLDL. Both vitamin and antihyperlipidemic drug
Niacin - aspirin pre-treatment reduces flushing, avoid in patients with peptic ulcer disease
57
90% of bile acids are reabsorbed and returned to the liver for reuse via?
Enterohepatic recirculation
58
Synergistic combination for Familial combined hypercholesterolemia?
Niacin + Resin or Statin + Fibrate
59
Disadvantage of Statin and Fibrate combination
Increased risk of myopathy and rhabdomyolysisw
60
A sterol absorption blocker used for hypercholesterolemia by acting as cholesterol analog
Sitosterol
61
Used as an antiarrhythmic drug by depressing ectopic pacemakers, including those caused by digitalis toxicity
Potassium ion
62
Drug that activates PPAR-a, increases expression of lipoprotein lipase and apolipoproteins apoA-I and apoA-II. Drug of choice for hyperetriglyceridemia but increased risk for cholesterol gallstones
Gemfibrozil - fibric acid derivative
63
Combination of hyperlipidemic drugs that may increase risk of cholithiasis
Fibrate + Resin
64
Synergistic combination for familial hypercholesterolemia?
Niacin + Statins or Statin + Ezetimibe
65
ADH agonist - act at V1 and V2 ADH receptors used in central diabetes insipidus
Desmopressin
67
What would be the blood pH if using both loop diuretics and thiazides?
Alkalemia
68
Thiazide diuretic that has synergistic effect with loop diuretics
Hydrochlorothiazide
69
Toxicity results to ototoxicity, hypokalemia, dehydration, allergy to sulfa drugs, nephritis and gout
Loop diuretic toxicity
74
Site of uric acid transport
Proximal convoluted tubules

Pharmacology (11 decks)

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