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Flashcards in Cardiac Pharm - Stuff Tom Can't Remember Deck (31):
1

Digoxin Toxicity
Symptoms

Nausea
Vomiting
Diarrhea
Hyperkalemia
Blurry yellow vision
Arrhythmias (DADs)
AV Block

2

List drug classes indicated in use in Primary (Essential) HTN

Thiazides
ACE Inhibitors
Angiotensin II Receptor Blockers
Dihydropyridine Ca2+ channel blockers (nifedipine)

3

What is Beck's Triad? What do these symptoms indicate?

1. Hypotension
2. Increased JVP (distended neck veins)
3. Distant, muffled heart sounds

Indicates acute cardiac tamponade!

4

What is Kussmaul's sign? What does it indicate?

Increase in JVP on inspiration instead of a normal decrease.
Seen in constrictive pericarditis, restrictive cardiomyopathies, RA or RA tumors.

5

What is pulsus paradoxus? What does that indicate?

Decrease in systolic BP by >10mmHg during inspiration.
Indicates cardiac tamponade, asthma, obstructive sleep apnea, pericarditis.

6

How are each of the three types of hyponatremia treated?

Hypovolemic hyponatremia -- saline injection

Euvolemic and Hypervolemic hyponatremia -- Vaptams may be used (ADH receptor antagonists)

7

What valvular defect presents with a holosystolic murmur?

Mitral regurgitation (intensity of murmur constant through systole)

8

What valvular defect presents with a midsystolic murmur (crescendo-decrescendo)?

Aortic stenosis

9

What valvular defect presents with a blowing diastolic murmur?

Aortic regurgitation

10

What valvular defect presents with a holosystolic machine like murmur?

PDA

11

What is the general MOA for fibrates?

Activate PPAR-alpha to induce HDL synthesis.
Activate LPL to clear more triglycerides from the blood.

12

List all of the Class I Anti Arrhythmics we discussed

Procainamide
Quinidine
Lidocaine
Mexiletine
Flecainide
Propafenone

13

What kinds of arrhythmias are indicated for Class IA anti-arrhythmics?

Atrial and ventricular arrhythmias

14

What kinds of arrhythmias are indicated for Class IB anti-arrhythmics?

Lidocaine is used for arrhythmias post MI
Ventricular tachycardia and fibrillation

15

What kinds of arrhythmias are indicated for Class IC anti-arrhythmics?

Supraventricular arrhythmias in otherwise normal hearts

16

What kinds of arrhythmias are indicated for Class II anti-arrhythmics?

Preventing recurrent infarction and sudden death after MI

Exercise induced arrhythmias

Atrial fibrillation
Atrial flutter
AV node reentry

17

What kinds of arrhythmias are indicated for Class III anti-arrhythmics?

Amiodarone
Recurrent ventricular tachycardia or fibrillation
Atrial fibrillation

DOC for out of hospital Cardiac arrest

Dronedarone currently used for atrial fibrillation/flutter

18

What kinds of arrhythmias are indicated for Verapamil?

Supraventricular arrhythmias
Reentry arrhythmias involving the AV node
Slowing ventricular rate in atrial fibrillation/flutter

19

What is the indication for adenosine?

Converting paraoxysmal supraventricular tachycardia to sinus rhythm

20

What drugs might you use to convert A fib or paraoxysmal supraventricular tachycardia to sinus rhythm?

Adenosine
Amiodarone
Flecainide

21

What drugs might you use to maintain sinus rhythm in A fib or paraoxysmal supraventricular tachycardia?

Amiodarone
Dronedarone
Flecainide
Propafenone

22

What drugs might you use for ventricular rate control in A fib or paraoxysmal supraventricular tachycardia?

Diltiazem or Verapamil
Propranalol or Esmolol

23

What would you use to treat ventricular tachycardia in a patient without heart disease?

Amiodarone
Lidocaine

24

What are the indications of spironolactone?

Primary or secondary hyperaldosteronism
Cirrhosis of the liver
Could be used with K+ wasting diuretics to prevent hypokalemia

25

Dabigatran
MOA

Oral anti-IIa (thrombin) agent

26

Riveroxiban
Apixiban
MOA

Oral anti-Xa agents

27

Bivalirudin
Hirudin (Refludan)
Argatroban
MOA

IV Anti-IIa (thrombin) agents

28

Icatibant
MOA
Indication?

B2 (bradykinin) receptor antagonist

Used for angio-neurotic edema

29

What is Dressler Syndrome?

Autoimmune pericarditis that occurs weeks to months after an MI

30

What are some big lab manifestations of DIC?

Thrombocytopenia
Shistocytes and fragmented RBCs on peripheral smear
Prolonged PT and APTT
Decreased fibrinogen level

31

What are the primary murmurs heard in HOCM?

First, you'd hear a crescendo-decrescendo systolic murmur due to outflow tract obstruction of the aortic valve.

If the HOCM gets bad enough, you may get mitral regurgitation (holosystolic murmur) as well.

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