Cardiac

Question 1

Use for Primary HTN

Answer 1

thiazides
Ace inhibitors
Angiotensin receptor blockers

Question 2

HTN with HF

Answer 2

diuretic, ace inhibitor, and arb (only use beta blockers in compensated HF)

Question 3

HTN with DM

Answer 3

ace inhibitors and angiotensin receptor blockers

Question 4

HTN in pregnancy

Answer 4

hydrazine, nifedipine, methyldopa, labetalol

Question 5

Dihydropyridine calcium channel blockers work on?

Answer 5

vascular smooth muscle

Question 6

Amlodipine, clevidipine, nifedipine, nimodipine

Answer 6

dihydropyridine calcium channel blockers

Question 7

nondihydropyridine calcium channel blockers

Answer 7

work on the heart

Question 8

dilitazem, verapamil

Answer 8

nondihydropyridine calcium channel blockers

Question 9

-“dipine”=

Answer 9

Dihydropyridine calcium channel blockers

Question 10

MOA of calcium channel blockers

Answer 10

block voltage gated L type calcium channels of cardiac and smooth muscle

(Class 4 will decrease conduction velocity and increase EP and increase PR interval)

Question 11

Use all Dihydropyridines except nimodipine for:

Answer 11

HTN, angina, raynaud phenomenon

Question 12

nimodipine used for

Answer 12

subarachnoid hemorrhage

Question 13

nondihydropyridines used for

Answer 13

HTN, angina, a fib/flutter, and to prevent SVT

Question 14

SE of dihydropyridines

Answer 14

cardiac depolarization, av block, hyperprolactinemia, constipation

Question 15

SE of nondihydropyridines

Answer 15

peripheral edema, flushing, dizziness, gingival hyperplasia

Question 16

Hydralazine works by:

Answer 16

increased cGMP; which works to vasodilator arterioles > veins ; decreases afterload

Question 17

Hydralazine is used for HF when given with?

Answer 17

nitrate

Question 18

Hydralazine avoids reflex tachycardia with?

Answer 18

beta blockers

Question 19

SE: of hydralazine

Answer 19

SLE like symptoms, increase HR, and fluid retention

Question 20

1 drug for HTN emergency =

Answer 20

nitroprusside

Question 21

NItroprusside works by:

Answer 21

increase cGMP–> by releasing NO and can cause Cyanide toxicity

Question 22

Nitrates examples:

Answer 22

nitroglycerin, isosorbide dinitrate, isosorbide mononitrate

Question 23

MOA of nitrates:

Answer 23

dilate veins> arterioles; which decreases preload

**Will also see a decrease in EDV, BP, ejection time, and MVO2

Question 24

Nitrates work on EDV and BP by:

Answer 24

decreases MVO2

Question 25

Beta blockers work on contractility and BP by:

Answer 25

MVO2

Question 26

Inhibits late phase of sodium current --> decreases diastolic wall tension and oxygen consumption

Answer 26

ranolazine

Question 27

use for angina due to other therapies; that doesn't affect the HR or contractility?

Answer 27

ranolazine

Question 28

Inhibit NA/K ATPase; which indirectly inhibits the Na/Ca exchanger which increases calcium

Answer 28

digoxin

Question 29

increases calcium means increasing contractility; also + ionotrophy ; which stimulates vagus nerve and decreases the HR

Answer 29

digoxin

Question 30

digoxin SE:

Answer 30

blurry yellow vision

Question 31

HMG COA reductase inhibitors MOA:

Answer 31

prevent mevalonate synthesis

Question 32

Which lipid lowering agents decrease LDL?

Answer 32

HMG COA reductase inhibitors; bile acid resins, ezetimibe

Question 33

Which lipid lowering agents increase HDL?

Answer 33

niacin

Question 34

Which lipid lowering agents decrease triglycerides?

Answer 34

fibrates, omega 3 FA

Question 35

Which lipid lowering agent increases LFTs?

Answer 35

ezetimibe

Question 36

Statins cause increased or decreased mortality in CAD patients?

Answer 36

decreased

Question 37

SE of statins:

Answer 37

statin induced myopathy ; esp with vibrates or niacin

Question 38

examples of bile acid resins:

Answer 38

cholestyramine, colestipol, colesevelam

Question 39

Bile acid resins MOA:

Answer 39

prevent intestinal reabsorption of bile acids

Question 40

SE of bile acid resins

Answer 40

decrease absorption of other drugs and fat soluble vitamins *** cholestyramine can bind C. difficle

Question 41

MOA: prevent cholesterol absorption at the small intestine brush border

Answer 41

ezetimibe

Question 42

can be used when a patient cannot handle statins?

Answer 42

ezetimibe

Question 43

MOA of fibrates:

Answer 43

upregulate LPL which increase TG clearance; use PPAR gamma to decrease hepatic LDL and increase LPL activity which will ultimately decrease TG and increase HDL

Question 44

Fibrates SE:

Answer 44

myopathy and cholesterol gallstones

Question 45

Inhibit lipolysis in adipose tissue:

Answer 45

Niacin

Question 46

SE of Niacin:

Answer 46

red flushed, face * can be decreased with NSAIDS

Question 47

Class 3 K+ channel blockers drugs:

Answer 47

amiodarone, ibutilide, dofetilide, sotalol (AIDS)

Question 48

Increase AP, increase ERP Increase QT interval

Answer 48

Class 3 K+ channel blockers drugs:

Question 49

Use for A-fib/flutter, V-tach

Answer 49

Class 3 K+ channel blockers drugs: For Vtach ( use amiodarone or sotalol)

Question 50

Sotalol has more risk of _________ and amiodarone has a less risk of _________.

Answer 50

Torsades

Question 51

You must check what with amiodarone?

Answer 51

PFTS, LFTS, TFTS

Question 52

Adenosine MOA:

Answer 52

increases K+ out of cells which hyper-polarizes and then decreases intercellular calcium

Question 53

Adenosine indications:

Answer 53

diagnose and terminate SVT ** effect is blunted by theophylline and caffeine

Question 54

Magnesium use:

Answer 54

torsades and digoxin toxicity

Question 55

Class 2 Anti arrhythmic: Beta blockers

Answer 55

metoprolol, propanolol, esmolou, atenolol, timolol, carvedilol

Question 56

decrease SA / AV node activity by decreases cAMP and decreasing calcium current which also decreases slope of phase 4

Answer 56

Class 2 Anti arrhythmic: Beta blockers

Question 57

SE of Class 2 Anti arrhythmic: Beta blockers

Answer 57

impotence, COPD exacerbation, can masks signs of hypoglycemia **** beta blockers can cause unopposed alpha 1 agonism if given alone for pheochromocytoma or cocaine toxicity

Question 58

Class 1 (Sodium channel blockers) action of what phase?

Answer 58

Phase 0; by decreasing slope

Question 59

Class 1A: drugs?

Answer 59

quinidine, procainamide, disopyramide

Question 60

Class 1B: drugs?

Answer 60

lidocaine and mexiletine

Question 61

Class 1C: drugs?

Answer 61

flecainide, propafenone

Question 62

Class 1A MOA:

Answer 62

prolong the AP, prolong the QT (causes torsades de pointes) , increases effective refractory period

Question 63

Class 1A SE:

Answer 63

reversible SLE like symptoms ( esp. procainamide) , cinchonism ( esp. quinidine) and heart failure (disopyramide)

Question 64

Class 1A used for?

Answer 64

atrial and ventricular arrhythmias

Question 65

Class 1B MOA

Answer 65

decerase AP duration

Question 66

Class 1B used for?

Answer 66

best for: ventricular arrhythmias that are post MI

Question 67

Class 1C MOA

Answer 67

prolong ERP in AV node and accessory bypass tracts

Question 68

Class 1C used for?

Answer 68

use for SVTS ; CONTRAINDICATED POST MI ;

Question 69

Mneumonic for Class 1 anti-arrhythmics (Sodium) channel blockers

Answer 69

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