Cardiac Drugs Flashcards Preview

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Flashcards in Cardiac Drugs Deck (102):
1

Hydralazine - mechanism?

Increases cGMP --> smooth muscle relaxation. Vasodilates arterioles > veins; afterload reduction

2

Hydralazine - use? 2+2

Acute severe HTN, HF, safe for pregnancy. Given with B-blocker to prevent reflex tachycardia.

3

Hydralazine - toxicity? (5)

Reflex tachycardia, fluid retention, headache, angina, lupus-like syndrome

4

Diltiazem/verapamil - mech? (4)

Block voltage-dependent L-type Ca channels of cardiac and smooth muscle --> decrease muscle contractility in heart
Decrease conduction velocity
Increase ERP
Increase PR interval

5

Nimodipine - mech?

Block voltage-dependent L-type Ca channels of cardiac and smooth muscle --> decrease muscle contractility in vascular smooth muscle

6

Nimodipine - use? (1)

Subarachnoid hemorrhage

7

Clevidipine - use? (1)

Hypertensive urgency or emergency

8

Diltiazem/verapamil - use? (4)

HTN
Angina
AFib/flutter rate control
Prevention of nodal arrhythmias

9

Clevidipine - mech?

Block voltage-dependent L-type Ca channels of cardiac and smooth muscle --> decrease muscle contractility in vascular smooth muscle

10

Nifedipine - mech?

Block voltage-dependent L-type Ca channels of cardiac and smooth muscle --> decrease muscle contractility in vascular smooth muscle

11

Diltiazem - side fx? (7)

Cardiac depression
AV block
Peripheral edema,
Flushing
Dizziness
Constipation
Gingival hyperplasia

12

Verapamil - side fx? (8)

HYPERPROLACTINEMIA
Cardiac depression
AV block
Peripheral edema,
Flushing
Dizziness
Constipation
Gingival hyperplasia

13

Nitroprusside - use? (1)

Hypertensive emergency

14

Nitroprusside - mechanism?

Short acting, increase cGMP via direct release of NO

15

Nitroprusside - side fx?

CN toxicity

16

Fenoldopam - use? (1)

Hypertensive emergency

17

Fenoldopam - mechanism?

Dopamine D1 receptor agonist - coronary, peripheral, renal, and splanchnic vasodilation. Decreases BP and increases natriuresis.

18

Nitroglycerin - use? (3)

Angina, acute coronary synddrome, pulmonary edema

19

Nitroglycerin - mech?

Vasodilate by increasing NO in vasc smooth muscle - increase cGMP and smooth muscle relaxation. Veins more than arteries to decrease preload.

20

Nitroglycerin - side fx? (4)

Reflex tachycardia (tx with B-blockers)
Flushing
Headache
"Monday disease"

21

Isosorbide dinitrate - use? (3)

Angina, acute coronary synddrome, pulmonary edema

22

Isosorbide dinitrate - mech?

Vasodilate by increasing NO in vasc smooth muscle - increase cGMP and smooth muscle relaxation. Veins more than arteries to decrease preload.

23

Isosorbide dinitrate - side fx (4)?

Reflex tachycardia (tx with B-blockers)
Flushing
Headache
"Monday disease"

24

Isosorbide mononitrate - use? (3)

Angina, acute coronary synddrome, pulmonary edema

25

Isosorbide mononitrate - mech?

Vasodilate by increasing NO in vasc smooth muscle - increase cGMP and smooth muscle relaxation. Veins more than arteries to decrease preload.

26

Isosorbide mononitrate - side fx? (4)

Reflex tachycardia (tx with B-blockers)
Flushing
Headache
"Monday disease"

27

Statins - use (3)

Decrease LDL greatly
Increase HDL
Decrease TG

28

Statins - mech?

Inhibit conversion of HMG-CoA to mevalonate, decrease mortality in CAD patients

29

Statins - side fx? (2)

Hepatotoxicity (LFTs)
Myopathy (esp w/ fibrates & niacin)

30

Cholestyramine - use (3)

Decrease LDL
Increase HDL slightly
Increase TG slightly

31

Colestipol - use (3)

Decrease LDL
Increase HDL slightly
Increase TG slightly

32

Colesevelam - use (3)

Decrease LDL
Increase HDL slightly
Increase TG slightly

33

Cholestyramine - mech

Prevent intestinal reabsorption of bile acids; liver uses cholesterol to make more

34

Colestipol - mech

Prevent intestinal reabsorption of bile acids; liver uses cholesterol to make more

35

Colesevelam - mech

Prevent intestinal reabsorption of bile acids; liver uses cholesterol to make more

36

Cholestyramine - side fx? (2)

GI upset
Decreased absorption of other drugs and fat soluble vitamins

37

Colestipol - side fx? (2)

GI upset
Decreased absorption of other drugs and fat soluble vitamins

38

Colesevelam - side fx? (2)

GI upset
Decreased absorption of other drugs and fat soluble vitamins

39

Ezetimibe - use

Decrease LDL

40

Ezetimibe - mech

Prevent cholesterol absorption at small intestine brush border

41

Ezetimibe - side fx? (2)

Rare increase in LFTs
Diarrhea

42

Gemfibrozil - use?

Decrease LDL
Increase HDL
Decrease TG greatly

43

Clofibrate - use?

Decrease LDL
Increase HDL
Decrease TG greatly

44

Bezafibrate - use?

Decrease LDL
Increase HDL
Decrease TG greatly

45

Fenofibrate - use?

Decrease LDL
Increase HDL
Decrease TG greatly

46

Gemfibrozil - mech? (2)

Upregulate LPL to increase TG clearance
Activates PPAR-a to induce HDL synthesis

47

Clofibrate - mech? (2)

Upregulate LPL to increase TG clearance
Activates PPAR-a to induce HDL synthesis

48

Bezafibrate - mech? (2)

Upregulate LPL to increase TG clearance
Activates PPAR-a to induce HDL synthesis

49

Fenofibrate - mech? (2)

Upregulate LPL to increase TG clearance
Activates PPAR-a to induce HDL synthesis

50

Gemfibrozil - side fx? (2)

Myopathy (increased risk with statins)
Cholesterol gallstones

51

Clofibrate - side fx? (2)

Myopathy (increased risk with statins)
Cholesterol gallstones

52

Bezafibrate - side fx? (2)

Myopathy (increased risk with statins)
Cholesterol gallstones

53

Fenofibrate - side fx? (2)

Myopathy (increased risk with statins)
Cholesterol gallstones

54

Niacin (Vit B3) - use?

Decrease LDL
Increase HDL (best)
Decrease TG

55

Niacin - mech? (2)

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

56

Niacin (Vit B3) - side fx?

Red flushed face (fix with NSAIDs/long term use)
Hyperglycemia
Hyperuricemia

57

Digoxin - use? (2)

HF (increase contractility)
AFib (decrease conduction at AV node and depression of SA node)

58

Digoxin - mech?

Direct inhibition of Na/K ATPase to indirectly inhibit the Na/Ca exchanger leading to increase in IC Ca = positive inotropy
Stimulates vagus nerve to decrease HR

59

Digoxin - side fx

Cholinergic - nausea, vomiting, diarrhea, blurry yellow vision, arrhythmias, AV block
Hyperkalemia

60

Digoxin - antidote (4)

Slowly normalize K+
Cardiac pacer
Anti-digoxin Fab fragments
Mg2+

61

Quinidine - mech? (4)

Class IA antiarrhythmic (Na channel blocker)
Increase AP duration
Increase ERP in ventricular AP
Increase QT interval

62

Quinidine - use? (3)

Atrial arrhythmias
Ventricular arrhythmias
Re-entrant and ectopic SVT/VTs

63

Quinidine - side fx? (3)

Cinchonism (headache, tinnitus)
Thrombocytopenia
Torsades de pointes due to increased QT interval

64

Procainamide - mech? (4)

Class IA antiarrhythmic (Na channel blocker)
Increase AP duration
Increase ERP in ventricular AP
Increase QT interval

65

Procainamide - use? (3)

Atrial arrhythmias
Ventricular arrhythmias
Re-entrant and ectopic SVT/VTs

66

Procainamide - side fx? (3)

Reversible SLE-like syndrome
Thrombocytopenia
Torsades de pointes due to increased QT interval

67

Disopyramide - mech? (4)

Class IA antiarrhythmic (Na channel blocker)
Increase AP duration
Increase ERP in ventricular AP
Increase QT interval

68

Disopyramide- use? (3)

Atrial arrhythmias
Ventricular arrhythmias
Re-entrant and ectopic SVT/VTs

69

Disopyramide - side fx? (3)

Heart failure
Thrombocytopenia
Torsades de pointes due to increased QT interval

70

Lidocaine - mech? (2)

Class IB antiarrhythmic (Na channel blocker)
Decrease AP duration
Prefers affect ischemic or depolarized Purkinje and ventricular tissue

71

Lidocaine - use? (2)

Acute ventricular arrhythmias (ESP POST MI)
Digitalis-induced arrhythmias

72

Lidocaine - side fx? (2)

CNS stimulation/depression
CV depression

73

Mexiletine - mech? (2)

Class IB antiarrhythmic (Na channel blocker)
Decrease AP duration
Prefers affect ischemic or depolarized Purkinje and ventricular tissue

74

Mexiletine - use? (2)

Acute ventricular arrhythmias (ESP POST MI)
Digitalis-induced arrhythmias

75

Mexiletine - side fx? (2)

CNS stimulation/depression
CV depression

76

Flecainide - mech? (3)

Significantly prolongs ERP in AV node and accessory bypass tracts
No effect on ERP in Purkinje and ventricular tissue
Minimal effect on AP duration

77

Flecainide - use? (2)

SVTs, including AFib
Last resort in refractory VT

78

Flecainide - side fx?

Proarrhythmic, especially post-MI (contraindicated)

79

Propafenone - mech? (3)

Significantly prolongs ERP in AV node and accessory bypass tracts
No effect on ERP in Purkinje and ventricular tissue
Minimal effect on AP duration

80

Propafenone - use? (2)

SVTs, including AFib
Last resort in refractory VT

81

Propafenone - side fx?

Proarrhythmic, especially post-MI (contraindicated)

82

B-blockers (-olol) - mech (4)

Class II Antiarrhythmics
Decrease SA and AV nodal activity by decreasing cAMP, Ca currents.
Decreases slope of phase 4
AV node is particularly sensitive - increases PR interval

83

B-blockers (-olol) - use (2)

SVT
Ventricular rate control for AFib/flutter

84

B-blockers (-olol) - side fx? (5)

Impotence
Exacerbation of COPD and asthma
CV fx (bradycardia, AV block, HF)
CNS fx (sedation)
Mask hypoglycemia

85

Propanolol - side fx?

Exacerbate vasospasm in Prinzmetal angina

86

Metoprolol - side fx?

Dyslipidemia

87

B-blockers (-olol) - antidote? (3)

Saline
Atropine
Glucagon

88

Amiodarone - mech? (5)

Class III Antiarrhythmic - K channel blocker
Increases AP duration
Increases ERP
Increases QT interval
Has Class I - 4 effects

89

Amiodarone - use

AFib/Flutter
VT

90

Amiodarone - side fx (7)

Pulmonary fibrosis
Hepatotoxicity
Hypo/hyperthyroidism
Neurologic fx
Constipation
CV effects (bradycardia, heart block, HF)
Check PFTs, LFTs, and TFTs

91

Ibutilide - mech? (4)

Class III Antiarrhythmic - K channel blocker
Increases AP duration
Increases ERP
Increases QT interval

92

Ibutilide - use

AFib/Flutter

93

Ibutilide - side fx

Torsades de pointes

94

Dofetilide - mech? (4)

Class III Antiarrhythmic - K channel blocker
Increases AP duration
Increases ERP
Increases QT interval

95

Dofetilide - use

AFib/Flutter

96

Dofetilide - side fx

None

97

Sotalol - mech? (4)

Class III Antiarrhythmic - K channel blocker
Increases AP duration
Increases ERP
Increases QT interval

98

Sotalol - use

AFib/Flutter
VT

99

Sotalol - side fx

Torsades de pointes
Excessive B blockade

100

Adenosine - mech & considerations (2)

Shifts K out of cells to hyperpolarize and decrease Ca
Very short acting
Effects blunted by theophylline and caffeine

101

Adenosine - use

Diagnosing and abolishing SVT

102

Adenosine - side fx

Flushing
hTN
Chest pain
Sense of impending doom
Bronchospasm