Block 11 Flashcards
(159 cards)
1
Q
Classes of drugs for CHF (7)
A
Diuretics B blockers ACEI/ARBs CCB Neprilysin I If Na blocker Inotropic drugs
2
Q
Primary therapy for CHF
A
Diuretics
B blocker
ACEI/ARBs
3
Q
Class of drug: sacubitril
A
Neprilysin I
4
Q
Class of drug: metoprolol
A
B blocker
5
Q
Class of drug: ivabradine
A
If Na blocker
6
Q
Class of drug: amlodipine
A
CCB
7
Q
Class of drug: verapamil
A
CCB
8
Q
Class of drug: diltiazem
A
CCB
9
Q
3 types of inotropic drugs
A
Digitalis
B agonist
PDE I
10
Q
Class of drug: digoxin
A
Digitalis —>inotropic
11
Q
Class of drug: dobutamine
A
B agonist —> inotropic
12
Q
Class of drug: inamrinone
A
PDE I
13
Q
What does a PDE3 I do
A
Stops hydrolysis of cAMP —> prolonged activation of PK-A
14
Q
What does a B agonist do
A
Activated adenylyl cyclase —> inc Ca flow which increases force of contraction
15
Q
What 2 drugs are used acutely in CHF
A
Dobutamine and inamrinone
16
Q
2 things that can cause cardiac remodeling
A
High aldosterone and NE/Epi
17
Q
How to treat remodeling: high aldosterone
A
Tx with ACEI/ARBs
18
Q
How to treat remodeling: NE/Epi
A
Tx with B blocker
19
Q
For which primary therapy drug of CHF is dose critical
A
B blocker (metoprolol)
20
Q
Which diuretic affect remodeling
A
Spironolactone and eplerenone
21
Q
Which diuretics dont affect remodeling
A
Loops and TZ’s
22
Q
Class of drug: ivabradine
A
If Na blocker
23
Q
Class of drug: sacubitirl
A
neprilysin I
24
Q
With which inotropic drug should you monitor K
A
Digitalis (digoxin)
25
The P wave represents
Atrial depol
26
The QRS wave represents
Ventricular depol
27
The T wave represents
Ventricular repol
28
The PR interval represents
SA to AV node —> atrial conduction
29
The QT interval represents
Entire ventricle conduction
30
Which classes of drugs treat SVT
Class 2 and 4
Digoxin
Adenosine
31
Which classes of drugs treat VT
Class 1 and 3
32
Which classes of drugs cause torsades
1a and 3 - anything with K
33
Most common arrhythmia
A fib
34
Most dangerous arrhythmia
V fib
35
Antiarrhythmia drugs: class 1
Na blocker
36
Antiarrhythmia drugs: class 2
B blocker
37
Antiarrhythmia drugs: class 3
K blockers
38
Antiarrhythmia drugs: class 4
CCB
39
Drugs in class 2 for SVT Tx
Atenolol and metoprolol
40
Drugs in class 4 for SVT Tx
Verapamil and diltiazem
41
Drugs in class 1 for VT: 1a
Quinidine
42
What channels does quinidine block
Na and K
43
Drugs in class 1 for VT: 1b
Lidocaine
44
Drugs in class 1 for VT: 1c
Flecainaide
45
Drugs in class 3 for VT
Sotalol
| Amiodarone and dronedarone
46
Which anti arrhythmia drug is given IV to avoid first pass
Ib - lidocaine
47
Drug of choice for SVT
Adenosine - temporary flatline - only acutely
48
3 drug classes to treat stable angina
Nitrates
B blockers
CCB
49
2 drug classes to treat variant angina
Nitrates
| CCB
50
2 treatment methods for unstable angina
- aspirin or IV heparin
| - nitroglycerin, B block, CCB
51
Exercise induced angina
Stable
52
Angina not relieved by rest; O2 delivery dec bc of coronary vasospasm
Variant
53
Goal in treatment of stable angina
To slow HR
54
Goal in treatment of variant angina
Vasodilate
55
Most common drug to prevent stable angina
B blocker (-olols)
56
CCBs used in stable angina
Verapamil and diltiazem
57
CCBs used in variant angina
-dipines
58
Drug class used in Raynaud’s phenomenon
CCBs - -dipines
59
2 types of nitrates
Nitroglycerin
| Isosorbide mono/dinitrate
60
How does nitroglycerin affect vessels
Vasodilate by NO
61
How is nitroglycerin given
- Sublingual when attack is happening
| - patch worn 12 hours a day
62
6 drug classes that treat hyperlipidemia
- HMG CoA reductase I
- fenofibrate
- niacin
- BAS
- ezetemibe
- PCSK9 I
63
Class of drug: -statins
HMG CoA reductase I
64
Class of drug: cholestyramine
BAS
65
Class of drug: alirocumab
PCSK9 I
66
Which hyperlipidemia drug blocks rate limiting step in cholesterol synthesis
Statins
67
Which hyperlipidemia drug will affect all levels (dec LDL, dec TC and inc HDL)
Statins
68
Which hyperlipidemia drug binds PPAR-alpha
Fenofibrate
69
Which hyperlipidemia drug will only inc clearance of TG
Fenofibrate
70
Which hyperlipidemia drug will lower LDL and inc HDL
Niacin
71
Which hyperlipidemia drug will bind to bile salts to lower LDL and inc TG
BAS - cholestyramine
72
Which hyperlipidemia drug dec GI uptake of cholesterol and dec LDL
Ezetemibe
73
Which hyperlipidemia drug is expensive and dec LDL
PCSK9 I - alirocumab
74
Normal levels for cholesterol: total
< 200
75
Normal levels for cholesterol: LDL
< 100
76
Normal levels for cholesterol: TG
<150
77
Normal levels for cholesterol: HDL
>40
78
Leading cause of disability
Stroke
79
5th leading cause of death
Stroke
80
Clinical presentation of stroke
1 side weakness, inability to speak, vision loss, vertigo
81
4 drug classes used to prevent strokes (antiplatelets)
- aspirin
- ADP receptor blocker
- GP 2b/3a I
- PDE3 I
82
Class of drug: clopidogrel
ADP receptor blocker
83
Class of drug: abciximab
GP 2B/3A I
84
Class of drug: dipyridamole
PDE3 I
85
Which stroke prevention drug irreversibly prevents synthesis of TXA2
Aspirin
86
Which stroke prevention drug irreversibly inhibits ADP
ADP receptor blocker - clopidogrel
87
Which stroke prevention drug blocks binding of fibrinogen and prevents cross linking
GP 2b/3a I - abciximab
88
Which stroke prevention drug blocks breakdown of cAMP = less aggregating
PDE3 I - dipyridamole
89
Drug used in immediate stroke Tx
Alteplase (clot buster)
90
Clinical presentation of DVT
Leg welling, pain, warmth
91
Clinical presentation of PE
Cough, chest pain, shortness of breath
92
VTE drug class
- Heparin
- enoxaparin
- warfarin
- dabigatran
- rivaroxaban
93
Which VTE drug catalyze binding of antithrombin 3 to factors 2a 9a 10a 11a and 12a
Heparin
94
Does heparin acts fast or slow
Fast
| - given IV
95
Antidote for heparin
Protamine sulfate
96
Which VTE drug is low weigh heparin; against 10a
Enoxaparin
97
Which VTE drug dec liver synthesis of vit K dependent factors
Warfarin
98
Which VTE drug is given orally for long tern prevention
Warfarin
99
Antidote to warfarin
```
Slow = vit K
Fast = fresh, frozen plasma
```
100
Which VTE drug is a direct thrombin I
Dabigatran
101
Antidote of dabigatran
Idarucizumab
102
Which VTE drug is a direct factor 10a I
Revaroxaban
103
How quickly do dabigatran and revaroxaban take action
Fast
104
Where is the Na/H pump located in the nephron
PCT
105
Where is the Na, K, Cl pump in the nephron
Asc loop
106
Where is the Na/Cl pump in the nephron
DCT
107
Where are the principal cells with Na channels and intercalated cells located in the nephron
CD
108
Where in the nephron do CAIs work
PCT
109
Since bicarb is lost when pt is on CAIs, what can occur
Metabolic acidosis
110
Drug class: acetazolamide
CAI
111
CAIs often used to treat
- Closed angle glaucoma to dec AH formation in CB
| - acute mountain sickness
112
Where in the nephron do loop diuretics work
Ascending loop
113
As K is pumped into the ascending loop in the Na/K/Cl pump, what happens
Cells separate and allow Mg and Ca to leak into the blood
114
What diuretics lose Ca
Loops
115
Drug class: -semides
Loops
116
What side affects can loops cause
Hypokalemic alkalosis
| Ototoxicity
117
Where in the nephron do the TZs act
DCT
118
TZs block the activity of the Na/Cl pump, so the Na/K ATPase activity increases and what happens
Inc in Na moving in = inc in Ca moving in
119
What diuretics save Ca
TZs
120
Which diuretic is often used in hypercalciuria, neph diabetes insipidus
TZ
121
Where in the nephron do K sparing drugs work
CD
122
What channels are in the principal cells in the CD
Na/K channel
Aldosterone
Androgen receptors
123
Normally, as Na moves into the principal cells what happens
K secreted from principal cells, causing H to be secreted from the intercalated cells
124
Drug class: amiloride
K sparing = block Na channels
125
Drug class: eplerenone
K sparing = block aldosterone
126
Drug class: spironolactone
K sparing = block aldosterone and androgen receptors
127
K sparing drugs can cause what
Hyperkalemia
128
Normally, as the CD loses K and H, what can occur
Hypokalemic alkalosis
129
First line Tx of HTN
ACEI/ARBs, CCB, diuretics (TZ)
130
Typical combo therapy in HTN
ACEI/ARBs + CCB
131
Typical treatment of HTN in black pts
Diuretics
CCBs
Bc their plasma renin is lower
132
Main sites of BP regulation
Arterioles
Postcapillary venules
Heart
Kidneys
133
Is most HTN primary or secondary
90% primary (unknown cause)
134
Adverse effects of diuretics in treatment of HTN
K depletion
135
2 classes of drugs used in HTN treatments in patients with diabetic nephropathy
ACEI and ARBs
136
Which 2 drug classes are not used in patients with bilateral renal artery stenosis and why
ACEI and ARBs
| - cause acute renal failure
137
Which drug classes can cause angioedema
ACEI and renin I
138
Which drug class do you not want to use in the Tx of HTN in asthmatics and diabetics
B blockers (A-M olols)
139
Which drug class can cause gingival hyperplasia in Tx of HTN
CCB - -dipines
140
HTN drug that also treats BPH
Alpha1 blockers (-zosin)
141
Which drug class can cause hemolytic anemia
Central alpha2 agonist (methyldopa)
142
Which HTN drug is safe for preggo
Methyldopa
143
Drug used in hypertensive emergencies
Labetalol
144
Which HTN drug blocks Beta 1 and vasodilate via NO
Nebivolol
145
Diuretic used to relieve the symptoms of acute pulmonary edema
-semides (loops)
146
Which hyperlipidemia drug blocks chol reuptake
Ezetemibe
147
Which hyperlipidemia drug dec VLDL synthesis
Niacin
148
Which hyperlipidemia drug binds to bile salts
BAS - choestyramine
149
Which hyperlipidemia drug blocks the rate limiting step in cholesterol synthesis
- statin
150
Which hyperlipidemia drug prevents breakdown of LDL receptors
PCSK9 I - alirocumab
151
Only B blocker you dont take all the time - not compatible with Cronin oral therapy for arrhythmia
Esmolol
152
Which 2 HTN drugs are harmful to fetus
ACEI and ARBs
153
Amiodarone can cause what side effects
Problems with lungs, liver, eyes and thyroid
Also blue skin
154
What drugs with CHF patients always get
ACEI and metoprolol
155
If CHF patient also has edema and HTN, what drugs will you give them
ACEI + metoprolol + HCTZ
156
Drug class that prolongs the QRS complex
Class 1 - Na blocker
157
Drug class that prolongs the entire QT interval
Class 1A and 3 - K blockers
158
SVT drugs prolong what part of the ECG
PR interval
159
DOC for acute SVT
Adenosine
