CARDIO Flashcards
(451 cards)
1
Q
What are the 3 ways to reduce blood pressure?
A
- Reduce Blood Volume (Diuretics)
- Reduce Systemic Vascular Resistance (Alpha Resistance)
- Reduce Cardiac Output (Beta Blockers)
2
Q
What do Carbonic Anhydrase Inhibitors do?
A
They reduce reabsorption of bicarbonate in the PCT and are typically very weak diuretics.
An example is acetazolamide.
3
Q
What do Loop Diuretics do?
A
They work in the kidneys and significantly block the reabsorption of sodium.
An example is Furosemide or Lasix.
4
Q
What do Thiazide Diuretics do?
A
They work in the kidneys by mildly blocking reabsorption of sodium.
An example is HCTZ.
5
Q
What do Potassium Sparing Diuretics do?
A
They work in the kidneys by manipulating sodium and potassium exchange or by blocking aldosterone, usually used in combination with Loop and Thiazide Diuretics.
6
Q
What do Osmotic Diuretics do?
A
They work in the kidneys to decrease water reabsorption and are used mostly for reduction of intracranial pressure, increase urinary production of toxins, and promotion of urine production in acute kidney damage.
An example is Mannitol.
7
Q
What is a Renin Inhibitor?
A
Aliskiren (not covered)
A medication that inhibits the binding of renin to angiotensinogen.
8
Q
What are Angiotensin Converting Enzyme (ACE) Inhibitors?
A
Lisinopril, Captopril
Medications that block the conversion of Angiotensin I to Angiotensin II.
9
Q
What are Angiotensin Receptor Blockers (ARB)?
A
Losartan
Medications that block the binding of Angiotensin II to Vascular (AT1) Receptors.
10
Q
What is the mechanism of action of Renin Inhibitors?
A
Inhibits the binding of renin to angiotensinogen, elevates Bradykinin, reduces renal blood flow and risk of renal injury.
11
Q
What are Alpha Blockers?
A
Prazosin, Terazosin, Doxazosin, Tamsulosin
Medications that decrease systemic vascular resistance.
12
Q
What are Selective Beta Blockers?
A
Atenolol, Metoprolol
Medications that decrease cardiac output and systemic vascular resistance.
13
Q
What are Non-Selective Beta Blockers?
A
Carvedilol, Labetalol, Propranolol
Medications that decrease cardiac output, systemic vascular resistance, Renin, Angiotensin II, and Aldosterone.
14
Q
What are Dihydropyridines?
A
Medications include Amlodipine and Nicardipine.
15
Q
What are Non-Dihydropyridines?
A
Medications include Diltiazem and Verapamil.
16
Q
What is the mechanism of action for Dihydropyridines?
A
Inhibit calcium ion influx into vascular smooth muscle and myocardium, mainly affecting arterial vascular smooth muscle and lowering blood pressure by causing vasodilation.
17
Q
What are the effects of Dihydropyridines on heart muscle?
A
Decrease L-type Calcium channels in heart muscle leading to decreased heart contractility, decreased heart rate, and decreased heart conduction.
18
Q
What properties do Dihydropyridines have?
A
They have significant antiarrhythmic properties.
19
Q
What are Centrally Acting Adrenergic Agents?
A
Medications include Clonidine and Methyldopa.
20
Q
What is the mechanism of action for Centrally Acting Adrenergic Agents?
A
Block sympathetic activity in the brain, decreasing systemic vascular resistance and cardiac input.
21
Q
What is cardiac output (CO)?
A
The amount of blood being put out to the peripheral vascular system in a minute.
22
Q
What does inotropic refer to?
A
Contractility, which increases or decreases Ca 2+ ions and affects how hard the heart muscle squeezes.
23
Q
What does chronotropic refer to?
A
Heart rate, modulated by the parasympathetic or sympathetic nervous system. Beta blockers are negative chronotropes.
24
Q
What does dromotropic refer to?
A
Speed of conduction, mainly in the AV node, which pauses to allow for ventricle filling.
25
What is a positive dromotropic effect?
Increased conduction velocity that decreases the pause at the AV node, leading to a decrease in cardiac output (CO).
26
What is a negative dromotropic effect?
Decreased conduction velocity that increases the pause at the AV node, leading to an increase in cardiac output (CO).
27
What are thiazide diuretics?
Mildly increase the elimination of sodium and chloride by inhibiting their reabsorption in the distal convoluted tubules of the kidneys.
28
What are loop diuretics?
Most potent diuretics that increase the elimination of sodium and chloride by preventing reabsorption, primarily in the Ascending Loop of Henle.
29
What are the side effects of loop diuretics?
Hypokalemia, hypochloremia, and metabolic alkalosis. Useful for edema.
30
How quickly do loop diuretics act orally and IV?
Oral: 1 hour (torsemide) to 2 hours (furosemide). IV: 5-20 minutes.
31
What are potassium-sparing diuretics?
Medicines that increase urination without loss of potassium, often used in combination with thiazide and loop diuretics.
32
How do potassium-sparing diuretics work?
They work by interfering with the sodium-potassium exchange in the distal convoluted tubule or as antagonists at the aldosterone receptor.
33
How do ACE inhibitors work?
They monitor Na, K+, vascular volume, and blood pressure.
34
Why are ACE inhibitors frequently tested?
They block the conversion of angiotensin I to angiotensin II, affecting the RAAS system and involved in vasoconstriction.
35
What is a common side effect of ACE inhibitors?
A dry, persistent cough in 5-35% of patients.
36
What is the initial medication for hypertension in patients with type I diabetes?
ACE inhibitors, as they are nephroprotective.
37
What should patients with kidney disease know about ACE and ARB?
Starting an ACE or ARB is the first choice regardless of race, but patients should not take both due to the risk of renal dysfunction.
38
What are the clinical pearls of ACE inhibitors?
Elevation of bradykinin levels is thought to cause dry cough and angioedema. They improve outcomes in cardiovascular disease.
39
How do ARBs function?
They block the action of angiotensin II by acting as antagonists at AT-1 receptors.
40
What benefits do ACE inhibitors and ARBs provide?
They optimize preload, reduce afterload, decrease remodeling, control blood pressure, reduce proteinuria, and provide nephroprotection.
41
What are Non-Selective Alpha Blockers?
Prazosin (Minipress), Terazosin (Hytrin), Doxazosin (Cardura), Tamsulosin (Flomax), Phentolamine, Phenoxybenzamine.
42
Where do Non-Selective Alpha Blockers block Alpha-1 Receptors?
In vascular smooth muscle, bladder neck, and prostate gland.
43
How do Alpha Blockers work?
They block NE from binding with smooth muscle receptors, resulting in vasodilation and lowering of blood pressure.
44
What conditions are Alpha Blockers most often used for?
BPH (Benign Prostatic Hyperplasia) - Terazosin or Tamsulosin; HTN (Hypertension) - Doxazosin.
45
What are Beta Blockers?
Drugs that block the binding of norepinephrine and epinephrine to beta-adrenoreceptors.
46
What is the effect of Beta Blockers on the heart?
Decreased heart rate, delayed conduction in AV node, and reduced contractility.
47
What are the generations of Beta Blockers?
Generation 1: Non-selective; Generation 2: Beta-1 Selective; Generation 3: Non-Selective (Beta and Alpha-1) and Selective (Nitric Oxide and Calcium Channel).
48
Which Beta Blockers are Non-Selective?
Propranolol, Timolol, Carvedilol, Labetalol.
49
Which Beta Blockers are Beta-1 Selective?
Atenolol, Metoprolol, Nebivolol.
50
What should be avoided in patients with asthma?
Non-selective Beta Blockers.
51
What are the relative contraindications for the use of beta blockers?
Asthma and COPD (especially non-selective beta-blockers). Use selective beta blockers in COPD patients.
## Footnote
Cocaine Use: Should NOT be used for cocaine-induced acute coronary syndrome (CIACS) as it increases mortality!
Diabetes Mellitus: Beta blockers block epi, which is key for hypoglycemia signals in diabetics.
Hyperthyroidism: Can assist thyrotoxic patients, but use with caution as tachycardia is a monitoring tool.
Bradycardia or Heart Block: More absolute contraindication; beta blockers can severely depress AV node conduction.
52
What are the toxicities of amiodarones?
Bradycardia/Blue man syndrome, Interstitial lung disease, Thyroid (hyperthyroid or hypothyroid), Corneal/Cutaneous issues, Hepatic/Hypotension.
53
Describe Digoxin Toxicity.
Symptoms include N/V, abdominal pain, weakness, dizziness, arrhythmia, AMS, and vision changes (yellow vision or 'Xanthopsia'). Pathognomonic rhythms are atrial tachycardia with 2:1 block and bidirectional ventricular tachycardia.
## Footnote
Reverse with Digibind.
54
What are the key facts of nitrates?
General instructions: take ONE dose; if symptoms do not improve, repeat every 5 mins up to 3 doses. If symptoms do not improve, call 911. For stable angina, sublingual nitroglycerin may be sufficient. For Prinzmetal angina, nitroglycerin is used for acute pain, but a CCB is usually added for long-term treatment.
55
What are some key facts about bile acid sequestrants?
Resins bind bile acids in the intestine. Triglyceride levels may increase, so use caution in individuals with hypertriglyceridemia (do not use if >500). Expect a reduction of 10-25% in LDL with insignificant effects on HDL. May be used with traditional statin therapy.
56
What are some key facts about nicotinic acid?
First lipid-lowering agent associated with reduced total mortality. Niacin reduces VLDL particles. Expect a reduction in LDL (15-25%) and triglycerides, and an increase in HDL (25-35%). About 50% of patients cannot tolerate the max dose due to side effects like flushing. Can cause gout flare in susceptible individuals; taking a 325 mg aspirin 30 min prior can help reduce flushing.
57
Hypertension meds of choice for Black patients
CCB or thiazide diuretics
58
Hypertension meds of choice for non-Black patients
ARB or ACE inhibitor
59
Hypertension meds of choice for patients with CKD
ARB or ACE inhibitor
60
Mechanism of Loop Diuretics
Inhibits loop of Henle and proximal and distal convoluted tubule sodium and chloride reabsorption
61
Uses of Furosemide (Lasix)
Edema, HTN, Acute Pulmonary Edema, Hypercalcemia
62
Common reactions to Furosemide (Lasix)
Urinary frequency, dizziness, N/V, weakness, muscle cramps, hypokalemia, hypomagnesemia, orthostatic hypotension
63
Serious reactions to Furosemide (Lasix)
Severe hypokalemia, severe electrolyte imbalance, metabolic alkalosis, hypovolemia/dehydration
64
Duration of action for Furosemide (Lasix)
Lasts six hours
65
Warnings for Furosemide (Lasix)
BB WARNING: fluid and electrolyte depletion
66
Caution for Furosemide (Lasix)
Caution in renal impairment and disease
67
What is the mechanism of action for Triamterene (Dyrenium)?
Inhibits Na reabsorption at the distal convoluted tubule, decreasing water reabsorption and increasing K retention.
68
What are the uses of Triamterene (Dyrenium)?
Peripheral edema, HTN.
69
What are common reactions to Triamterene (Dyrenium)?
Nausea/Vomiting.
70
What are serious reactions to Triamterene (Dyrenium)?
Hyperkalemia.
71
What are the safety precautions for Triamterene (Dyrenium)?
Avoid in pregnancy. BB WARNING: Hyperkalemia.
72
What monitoring is required for Triamterene (Dyrenium)?
BUN/Cr, Electrolytes especially potassium at baseline then periodically including at dose change and during illness, CBC.
73
What is the mechanism of action for Spironolactone (Aldactone)?
Antagonizes aldosterone-specific mineralocorticoid receptors primarily in the distal convoluted tubule, decreasing Na and water reabsorption and increasing K retention.
74
What are the uses of Spironolactone (Aldactone)?
Edematous conditions for patients with: CHF, Cirrhosis + edema, nephrotic syndrome, essential hypertension, severe heart failure.
75
What is a key benefit of Spironolactone (Aldactone)?
Prevents absorbing too much salt and keeps potassium levels from getting too low.
76
What are common reactions to Spironolactone (Aldactone)?
Gynecomastia, hyperkalemia, electrolyte abnormalities, nausea/vomiting/diarrhea, abdominal cramps, muscle cramps, headache, confusion, dizziness.
77
What are the safety precautions for Spironolactone (Aldactone)?
Avoid in pregnancy but may be used in lactation. Contraindicated in patients with Addison’s disease.
78
What is the mechanism of action for Thiazide diuretics?
Inhibits distal convoluted tubule sodium and chloride reabsorption.
79
What are the common uses for Hydrochlorothiazide (HCTZ)?
Hypertension, Peripheral edema, Generally a last line treatment for HTN for African American pts.
80
What are common reactions to Hydrochlorothiazide (HCTZ)?
Hypokalemia, hypochloremia, Hyponatremia, hypomagnesemia, hypercalcemia, hyperuricemia, hyperglycemia.
81
What are serious reactions to Hydrochlorothiazide (HCTZ)?
Severe hypokalemia, electrolyte imbalance, arrhythmias, cholestatic jaundice, pancreatitis.
82
Why is Hydrochlorothiazide (HCTZ) useful for patients with osteoporosis?
HCTZ retains calcium, which can be beneficial for osteoporosis.
83
What are the pregnancy risks associated with Hydrochlorothiazide (HCTZ)?
Pregnancy risks include placental tearing. Avoid lactation with a dosage over 50 mg a day.
84
What is the mechanism of action for Lisinopril?
Inhibits angiotensin-converting enzyme, interfering with conversion of angiotensin I to angiotensin II.
85
What are the common uses for Lisinopril?
Hypotension, CHF, MI, Generally a 1st line treatment for nonblack pts younger than 60 or with chronic kidney disease.
86
What are common reactions to Lisinopril?
Hypotension, dizziness, fatigue, cough (dry and persistent), increased BUN/Cr.
87
What are the safety precautions for Lisinopril?
Avoid use in pregnancy and lactation. BB WARNING: fetal toxicity (D/C ASAP if pregnancy detected).
88
What should patients be cautious of when taking Lisinopril?
Can cause dizziness and orthostatic hypotension. Document this.
89
What is the mechanism of action for Captopril?
Inhibits angiotensin-converting enzyme, interfering with conversion of angiotensin I to angiotensin II.
90
What are the common uses for Captopril?
Hypotension, CHF, MI, pts with diabetes for nephroprotection.
91
What are common reactions to Captopril?
Hypotension, dizziness, fatigue, cough (dry and persistent), increased BUN/Cr.
92
What are the safety precautions for Captopril?
Avoid use in pregnancy and lactation. BB WARNING: fetal toxicity (D/C ASAP if pregnancy detected).
93
What is the mechanism of action for Losartan?
Selectively antagonizes angiotensin II AT1 receptors.
94
What are the common uses for Losartan?
Hypertension, Diabetic Nephropathy, stroke prevention.
95
What are common reactions to Losartan?
Diarrhea, fatigue/asthenia, musculoskeletal pain, chest pain, cough (less persistent than ACE).
96
What are serious reactions to Losartan?
Angioedema, anaphylaxis, severe hypotension.
97
What are the safety precautions for Losartan?
Avoid use in pregnancy and lactation. BB WARNING: fetal toxicity (D/C ASAP if pregnancy detected).
98
What is the mechanism of action of Alpha Blockers?
Alpha Blockers antagonize peripheral alpha-1 adrenergic receptors.
99
What are the uses of Prazosin (Minipress)?
Prazosin is used for hypertension (HTN), benign prostatic hypertrophy, and PTSD nightmares.
100
What are common reactions to Prazosin (Minipress)?
Common reactions include first-dose hypotension, asthenia, dizziness, headache (HA), somnolence, palpitations, nausea, and orthostatic hypotension.
101
What precautions should be taken with Prazosin (Minipress)?
Caution in pregnancy and lactation. May cause profound hypotension if used with PDE5 inhibitors such as sildenafil.
102
What is the mechanism of action of Terazosin (Hytrin)?
Terazosin antagonizes peripheral alpha-1 adrenergic receptors.
103
What are the uses of Terazosin (Hytrin)?
Terazosin is used for hypertension (HTN) and benign prostatic hypertrophy.
104
What are common reactions to Terazosin (Hytrin)?
Common reactions include dizziness, headache (HA), fatigue/malaise, somnolence, edema, rhinitis, and dyspnea.
105
What are serious reactions to Terazosin (Hytrin)?
Serious reactions include orthostatic hypotension and syncope.
106
What precautions should be taken with Terazosin (Hytrin)?
Caution in pregnancy and avoid lactation. May cause profound hypotension if used with PDE5 inhibitors such as sildenafil.
107
What is the mechanism of action of Tamsulosin (Flomax)?
Tamsulosin selectively antagonizes prostate alpha-1a adrenergic receptors, relaxing smooth muscle and improving urine flow.
108
What are the uses of Tamsulosin (Flomax)?
Tamsulosin is used for benign prostatic hypertrophy and nephrolithiasis.
109
What is a key note regarding Tamsulosin (Flomax)?
This alpha-blocker is NOT indicated for hypertension (HTN).
110
What are common reactions to Tamsulosin (Flomax)?
Common reactions include abnormal ejaculation, dizziness, rhinitis, and cough.
111
What are serious reactions to Tamsulosin (Flomax)?
Serious reactions include orthostatic hypotension.
112
What precautions should be taken with Tamsulosin (Flomax)?
Caution in pregnancy and avoid lactation. May cause profound hypotension if used with PDE5 inhibitors such as sildenafil.
113
What is the mechanism of action of Metoprolol (Lopressor)?
Metoprolol selectively antagonizes beta-1 adrenergic receptors.
114
What are the uses of Metoprolol (Lopressor)?
Metoprolol is used for hypertension (HTN), angina, CHF, migraine HA prophylaxis, and more.
115
What are common reactions to Metoprolol (Lopressor)?
Common reactions include bradycardia, hypotension, fatigue, dizziness, cold extremities, and depression.
116
What are serious reactions to Metoprolol (Lopressor)?
Serious reactions include CHF, severe bradycardia, and heart block.
117
What is the BB warning for Metoprolol (Lopressor)?
Avoid abrupt discontinuation. Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, and sinus bradycardia.
118
What is the mechanism of action of Propranolol (Inderal)?
Propranolol non-selectively antagonizes beta-1 and beta-2 adrenergic receptors.
119
What are the uses of Propranolol (Inderal)?
Propranolol is used for hypertension, angina, cardiovascular event prevention, post-MI, and more.
120
What are common reactions to Propranolol (Inderal)?
Common reactions include bradycardia, hypotension, fatigue, dizziness, cold extremities, and depression.
121
What are serious reactions to Propranolol (Inderal)?
Serious reactions include CHF, severe bradycardia, and heart block.
122
What is the BB warning for Propranolol (Inderal)?
Avoid abrupt discontinuation. Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, and sinus bradycardia.
123
What is the mechanism of action of Carvedilol (Coreg)?
Carvedilol selectively antagonizes alpha-a adrenergic receptors and antagonizes beta-1 and beta-2 adrenergic receptors.
124
What are the uses of Carvedilol (Coreg)?
Carvedilol is used for CHF and cardiovascular event prevention.
125
What are common reactions to Carvedilol (Coreg)?
Common reactions include bradycardia, hypotension, fatigue, dizziness, cold extremities, and depression.
126
What are serious reactions to Carvedilol (Coreg)?
Serious reactions include CHF, severe bradycardia, and heart block.
127
What are the contraindications for Carvedilol (Coreg)?
Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, and sinus bradycardia.
128
What is the mechanism of action of Labetalol (Normodyne)?
Labetalol selectively antagonizes alpha-a adrenergic receptors and antagonizes beta-1 and beta-2 adrenergic receptors.
129
What are the uses of Labetalol (Normodyne)?
Labetalol is used for hypertension (HTN) and hypertensive emergency (crisis).
130
What are common reactions to Labetalol (Normodyne)?
Common reactions include bradycardia, hypotension, fatigue, dizziness, cold extremities, and depression.
131
What are serious reactions to Labetalol (Normodyne)?
Serious reactions include CHF, severe bradycardia, and heart block.
132
What are the precautions for Labetalol (Normodyne)?
Causes fetal growth restriction in pregnancy. Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, and sinus bradycardia.
133
What are Calcium Channel Blockers?
Medications that inhibit calcium ion influx into vascular smooth muscle and myocardium.
134
What are the uses of Amlodipine (Norvasc)?
Hypertension (HTN), Coronary Artery Disease (chronic stable angina, vasospastic angina, or angiographically documented CAD).
135
What are common reactions to Amlodipine?
Peripheral edema, fatigue, palpitations, dizziness, nausea, flushing.
136
What are serious reactions to Amlodipine?
Angina exacerbation, myocardial infarction (MI), acute hypotension.
137
What caution is advised for Amlodipine?
Caution in pregnancy and lactation.
138
What are the uses of Verapamil (Isoptin)?
Hypertension (HTN), angina, PSVT conversion, atrial fibrillation/flutter, migraine headache prophylaxis.
139
What are common reactions to Verapamil?
Constipation, dizziness, nausea, hypotension, headache, edema, congestive heart failure (CHF), fatigue.
140
What are serious reactions to Verapamil?
CHF, severe hypotension, AV block, severe bradycardia, hepatotoxicity, paralytic ileus.
141
What caution is advised for Verapamil?
Caution in pregnancy and lactation.
142
What are the uses of Diltiazem (Cardizem)?
Hypertension (HTN), angina, PSVT conversion, atrial fibrillation/flutter, IV infusion for heart rate control in atrial fibrillation.
143
What are common reactions to Diltiazem?
Peripheral edema, headache, nausea, dizziness, asthenia, orthostatic hypotension.
144
What are serious reactions to Diltiazem?
Bradycardia, AV block, arrhythmias, severe hypotension.
145
What caution is advised for Diltiazem?
May use with caution in specific conditions.
146
What is the mechanism of action of Prazosin (Minipress)?
Antagonizes peripheral alpha-1 adrenergic receptors.
147
What are the uses of Prazosin (Minipress)?
HTN, benign prostatic hypertrophy, PTSD nightmares.
148
What are common reactions to Prazosin (Minipress)?
First-dose hypotension, asthenia, dizziness, HA, somnolence, palpitations, nausea, orthostatic hypotension.
149
What precautions should be taken with Prazosin (Minipress)?
Caution in pregnancy and lactation. May cause profound hypotension if used with PDE5 inhibitors such as sildenafil.
150
What is the mechanism of action of Terazosin (Hytrin)?
Antagonizes peripheral alpha-1 adrenergic receptors.
151
What are the uses of Terazosin (Hytrin)?
HTN, benign prostatic hypertrophy.
152
What are common reactions to Terazosin (Hytrin)?
Dizziness, HA, fatigue/malaise, somnolence, edema, rhinitis, dyspnea.
153
What are serious reactions to Terazosin (Hytrin)?
Orthostatic hypotension, syncope.
154
What precautions should be taken with Terazosin (Hytrin)?
Caution in pregnancy and avoid lactation. May cause profound hypotension if used with PDE5 inhibitors such as sildenafil.
155
What is the mechanism of action of Tamsulosin (Flomax)?
Selectively antagonizes prostate alpha-1a adrenergic receptors, relaxing the smooth muscle and improving urine flow.
156
What are the uses of Tamsulosin (Flomax)?
Benign prostatic hypertrophy, nephrolithiasis.
157
What are common reactions to Tamsulosin (Flomax)?
Abnormal ejaculation, dizziness, rhinitis, cough.
158
What are serious reactions to Tamsulosin (Flomax)?
Orthostatic hypotension.
159
What precautions should be taken with Tamsulosin (Flomax)?
Caution in pregnancy and avoid lactation. May cause profound hypotension if used with PDE5 inhibitors such as sildenafil.
160
What is the mechanism of action of Metoprolol (Lopressor)?
Selectively antagonizes beta-1 adrenergic receptors.
161
What are the uses of Metoprolol (Lopressor)?
HTN, angina, CHF, migraine HA prophylaxis.
162
What are common reactions to Metoprolol (Lopressor)?
Bradycardia, hypotension, fatigue, dizziness, cold extremities, depression.
163
What are serious reactions to Metoprolol (Lopressor)?
CHF, severe bradycardia, heart block.
164
What is the black box warning for Metoprolol (Lopressor)?
Avoid abrupt discontinuation. Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, sinus bradycardia.
165
What is the mechanism of action of Propranolol (Inderal)?
Non-selectively antagonizes beta-1 and beta-2 adrenergic receptors.
166
What are the uses of Propranolol (Inderal)?
Hypertension, angina, cardiovascular event prevention, post-MI, a fib/flutter, supraventricular arrhythmias, migraine HA prophylaxis, essential tremor, idiopathic hypertrophic subaortic stenosis (IHSS), pheochromocytoma.
167
What are common reactions to Propranolol (Inderal)?
Bradycardia, hypotension, fatigue, dizziness, cold extremities, depression.
168
What are serious reactions to Propranolol (Inderal)?
CHF, severe bradycardia, heart block.
169
What is the black box warning for Propranolol (Inderal)?
Avoid abrupt discontinuation. Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, sinus bradycardia.
170
What is the mechanism of action of Carvedilol (Coreg)?
Selectively antagonizes alpha-a adrenergic receptors, antagonizes beta-1 and beta-2 adrenergic receptors.
171
What are the uses of Carvedilol (Coreg)?
CHF, cardiovascular event prevention, post-MI.
172
What are common reactions to Carvedilol (Coreg)?
Bradycardia, hypotension, fatigue, dizziness, cold extremities, depression.
173
What are serious reactions to Carvedilol (Coreg)?
CHF, severe bradycardia, heart block.
174
What are the contraindications for Carvedilol (Coreg)?
Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, sinus bradycardia.
175
What is the mechanism of action of Labetalol (Normodyne)?
Selectively antagonizes alpha-a adrenergic receptors, antagonizes beta-1 and beta-2 adrenergic receptors.
176
What are the uses of Labetalol (Normodyne)?
HTN, hypertensive emergency (crisis).
177
What are common reactions to Labetalol (Normodyne)?
Bradycardia, hypotension, fatigue, dizziness, cold extremities, depression.
178
What are serious reactions to Labetalol (Normodyne)?
CHF, severe bradycardia, heart block.
179
What are the contraindications for Labetalol (Normodyne)?
Causes fetal growth restriction in pregnancy. Contraindicated in 2nd or 3rd-degree AV block, decompensated heart failure, sinus bradycardia.
180
What is the mechanism of action of Amlodipine (Norvasc)?
Inhibits calcium ion influx into vascular smooth muscle and myocardium.
181
What are the uses of Amlodipine (Norvasc)?
HTN, coronary artery disease (chronic stable angina, vasospastic angina, or angiographically documented CAD).
182
What are common reactions to Amlodipine (Norvasc)?
Peripheral edema, fatigue, palpitations, dizziness, nausea, flushing.
183
What are serious reactions to Amlodipine (Norvasc)?
Angina exacerbation, MI, acute hypotension.
184
What precautions should be taken with Amlodipine (Norvasc)?
Caution in pregnancy and lactation.
185
What is the mechanism of action of Verapamil (Isoptin)?
Inhibits calcium ion influx into vascular smooth muscle and myocardium (class IV antiarrhythmic).
186
What are the uses of Verapamil (Isoptin)?
HTN, angina, PSVT conversion, a-fib/flutter, migraine HA prophylaxis.
187
What are common reactions to Verapamil (Isoptin)?
Constipation, dizziness, nausea, hypotension, HA, edema, CHF, fatigue.
188
What are serious reactions to Verapamil (Isoptin)?
CHF, severe hypotension, AV block, severe bradycardia, hepatotoxicity, paralytic ileus.
189
What precautions should be taken with Verapamil (Isoptin)?
Caution in pregnancy and lactation.
190
What is the mechanism of action of Diltiazem (Cardizem)?
Inhibits calcium ion influx into vascular smooth muscle and myocardium, relaxing smooth muscle.
191
What are the uses of Diltiazem (Cardizem)?
HTN, angina, PSVT conversion, a-fib/flutter, IV infusion for heart rate control in Afib.
192
What are common reactions to Diltiazem (Cardizem)?
Peripheral edema, HA, nausea, dizziness, asthenia, orthostatic hypotension.
193
What are serious reactions to Diltiazem (Cardizem)?
Bradycardia, AV block, arrhythmias, severe hypotension.
194
What is the mechanism of action of Methyldopa?
Stimulates alpha-2 adrenergic receptors (centrally-acting antihypertensive).
195
What are the uses of Methyldopa?
HTN mod-severe.
196
What are common reactions to Methyldopa?
Sedation and HA.
197
What are serious reactions to Methyldopa?
Myocarditis, hemolytic anemia, thrombocytopenia.
198
What precautions should be taken with Methyldopa?
May use in pregnancy and lactation.
199
What is the mechanism of action of Nitroprusside (Nipride)?
Directly dilates peripheral vessels, reducing peripheral resistance and venous return.
200
What are the uses of Nitroprusside (Nipride)?
Hypertensive emergency crisis, hypotension induction controlled, acute CHF, post-resuscitation stabilization.
201
What are common reactions to Nitroprusside (Nipride)?
Nausea, dizziness, restlessness, abdominal pain.
202
What are serious reactions to Nitroprusside (Nipride)?
Severe hypotension, cyanide toxicity.
203
What precautions should be taken with Nitroprusside (Nipride)?
Caution in pregnancy. Lactation: weigh risk/benefit.
204
What is the mechanism of action of Adenosine?
Slows AV node conduction time, interrupts AV node re-entry pathways.
205
What are the uses of Adenosine?
Paroxysmal supraventricular tachycardia (PSVT).
206
What are common reactions to Adenosine?
Flushing, dyspnea, chest discomfort, nausea, HA, lightheadedness.
207
What are serious reactions to Adenosine?
Cardiac arrest, ventricular arrhythmias, severe bradycardia, MI, 3rd degree AV block.
208
What is the mechanism of action of Amiodarone (Cordarone)?
Prolongs action potential phase 3.
209
What are the uses of Amiodarone (Cordarone)?
ACLS, VF/pulseless VT, wide complex tachycardia, a fib (off label).
210
What are common reactions to Amiodarone (Cordarone)?
Corneal deposits, malaise/fatigue, ataxia, tremor, hyperkinesia, peripheral neuropathy, N/V, constipation, anorexia.
211
What are serious reactions to Amiodarone (Cordarone)?
Severe bradycardia, AV block, QT prolongation, torsades de pointes.
212
What is the mechanism of action of Atropine?
Antagonizes ach receptors (anticholinergic).
213
What are the uses of Atropine?
ACLS, symptomatic bradycardia, neuromuscular blockade reversal adjunct, organophosphate nerve agent poisoning.
214
What are common reactions to Atropine?
Xerostomia, blurred vision, tachycardia, difficulty urinating, confusion, HA, dizziness, flushing.
215
What precautions should be taken with Atropine?
Caution in pregnancy and lactation.
216
What is the mechanism of action of Epinephrine?
Stimulates alpha and beta adrenergic receptors.
217
What are the uses of Epinephrine?
ACLS asystole/PEA, VF/pulseless VT, ACLS bradycardia, anaphylaxis, severe asthma exacerbation, septic shock.
218
What are common reactions to Epinephrine?
Palpitations, tachycardia, respiratory difficulty, N/V, diaphoresis, dizziness, weakness, tremor, apprehension, nervousness/anxiety/restlessness.
219
What are serious reactions to Epinephrine?
Respiratory difficulty, pulmonary edema, arrhythmias, HTN.
220
What precautions should be taken with Epinephrine?
Caution advised in pregnancy. Lactation benefits outweigh risks while breastfeeding.
221
What is the mechanism of action of Digoxin (Lanoxin)?
Inhibits sodium-potassium ATPase.
222
What are the uses of Digoxin (Lanoxin)?
CHF, a fib, PSVT conversion.
223
What are common reactions to Digoxin (Lanoxin)?
Dizziness, HA, N/V/D.
224
What are serious reactions to Digoxin (Lanoxin)?
AV block, severe bradycardia, ventricular arrhythmias.
225
What is the mechanism of action of Procainamide (Pronestyl)?
Stabilizes membranes, depresses action potential phase 0.
226
What are the uses of Procainamide (Pronestyl)?
Ventricular arrhythmias (wide QRS), sustained monomorphic ventricular tachycardia.
227
What are common reactions to Procainamide (Pronestyl)?
Hypotension, bradycardia, flushing, urticaria, pruritus, angioedema.
228
What are serious reactions to Procainamide (Pronestyl)?
Ventricular fibrillation, asystole, QT prolongation, torsades de pointes.
229
What precautions should be taken with Procainamide (Pronestyl)?
Caution in pregnancy and lactation. BB Warning: Blood Dyscrasias, Proarrhythmic effects.
230
What is the mechanism of action of Dobutamine IV?
Stimulates beta-1 adrenergic receptors, producing hypertensive, mild chronotropic, arrhythmogenic and vasodilatory effects.
231
What are the uses of Dobutamine IV?
Cardiac decompensation, cardiac output maintenance.
232
What are common reactions to Dobutamine IV?
HTN, tachycardia, PVCs, nausea.
233
What are serious reactions to Dobutamine IV?
HTN, tachycardia, PVCs, severe hypotension, ventricular tachycardia.
234
What precautions should be taken with Dobutamine IV?
Caution in lactation and pregnancy.
235
What is the mechanism of action of Vasopressin (Pitressin)?
Directly stimulates V1 and V2 receptors, resulting in vasoconstriction and antidiuresis.
236
What are the uses of Vasopressin (Pitressin)?
Diabetes insipidus, vasodilatory shock.
237
What are common reactions to Vasopressin (Pitressin)?
Abdominal cramps, nausea.
238
What are serious reactions to Vasopressin (Pitressin)?
Anaphylaxis, tachyarrhythmias, bradycardia, angina, MI.
239
What precautions should be taken with Vasopressin (Pitressin)?
Caution in lactation and pregnancy.
240
What is the mechanism of action of Norepinephrine (Levophed)?
Directly stimulates alpha-1 and beta-1 adrenergic receptors, produces inotropic and vasopressor effects.
241
What are the uses of Norepinephrine (Levophed)?
Acute hypotension, first-line pressor in septic shock.
242
What are common reactions to Norepinephrine (Levophed)?
HA, anxiety, bradycardia.
243
What are serious reactions to Norepinephrine (Levophed)?
Anaphylaxis, tachyarrhythmias, bradycardia, severe hypertension, extravasation necrosis.
244
What precautions should be taken with Norepinephrine (Levophed)?
Caution in lactation and pregnancy. BB WARNING: to prevent necrosis, promptly liberally irrigate area with saline and phentolamine.
245
What is the mechanism of action of Sodium Bicarbonate?
Increases serum bicarbonate, raising pH, neutralizes gastric acidity.
246
What are the uses of Sodium Bicarbonate?
Acute and chronic metabolic acidosis (pH less than 7.25), urinary alkalization, dyspepsia, salicylate overdose, tricyclic antidepressant overdose.
247
What are common reactions to Sodium Bicarbonate?
Flatulence (PO use), gastric distension (PO use), metabolic acidosis, edema, hypernatremia, injection site pain.
248
What are serious reactions to Sodium Bicarbonate?
Metabolic acidosis, CHF exacerbation, seizures, tetany, extravasation cellulitis (IV use).
249
What precautions should be taken with Sodium Bicarbonate?
Caution in lactation and pregnancy.
250
What is the mechanism of action of Cilostazol (Pletal)?
Inhibits phosphodiesterase type 3, reducing platelet aggregation, suppresses cAMP degradation, producing vasodilation.
251
What are the uses of Cilostazol (Pletal)?
Intermittent claudication.
252
What are common reactions to Cilostazol (Pletal)?
HA, diarrhea, abnormal stools, palpitations, dizziness.
253
What are serious reactions to Cilostazol (Pletal)?
Bleeding, angina, MI, tachyarrhythmias, thrombocytopenia, leukopenia, agranulocytosis.
254
What precautions should be taken with Cilostazol (Pletal)?
BB WARNING: contraindicated in CHF, decreased survival compared to placebo in class III-IV CHF.
255
What is the mechanism of action of Nitroglycerin (Nitro-Bid) topical?
Stimulates cGMP production, resulting in vascular smooth muscle relaxation.
256
What are the uses of Nitroglycerin (Nitro-Bid) topical?
Angina prophylaxis.
257
What are common reactions to Nitroglycerin (Nitro-Bid) topical?
HA, dizziness, paresthesia, weakness, flushing, rash, orthostatic hypotension.
258
What precautions should be taken with Nitroglycerin (Nitro-Bid) topical?
Caution in lactation and pregnancy. Do not take ED meds while using.
259
What is the mechanism of action of Nitroglycerin (Nitrostat) sublingual?
Stimulates cGMP production, resulting in vascular smooth muscle relaxation.
260
What are the uses of Nitroglycerin (Nitrostat) sublingual?
Acute angina, angina prophylaxis.
261
What are common reactions to Nitroglycerin (Nitrostat) sublingual?
HA, dizziness, paresthesia, weakness, flushing, rash, orthostatic hypertension.
262
What are serious reactions to Nitroglycerin (Nitrostat) sublingual?
Severe hypertension, syncope, anaphylactoid reaction.
263
What is the significance of sublingual nitroglycerin?
It is the drug of choice for stable angina.
264
What is the mechanism of action of Nitroglycerin (Nitrostat)?
Stimulates cGMP production, resulting in vascular smooth muscle relaxation.
265
What are the common reactions to Nitroglycerin (Nitrostat)?
HA, dizziness, paresthesia, weakness, flushing, rash, orthostatic hypertension.
266
What are the serious reactions to Nitroglycerin (Nitrostat)?
Severe hypertension, syncope, anaphylactoid reaction.
267
What is the primary use of sublingual nitroglycerin?
Acute angina, angina prophylaxis; it is the drug of choice for stable angina.
268
What caution is advised for Nitroglycerin (Nitrostat)?
Caution in lactation and pregnancy.
269
What is the mechanism of action of Omega-3 Fatty Acid formulations?
Exact mechanism of action unknown, reduces hepatic triglyceride synthesis.
270
What is the primary use of DHA EPA acid (Lovaza)?
Severe hypertriglyceridemia.
271
What are the common reactions to DHA EPA acid (Lovaza)?
Eructation, taste changes, dyspepsia, constipation, GI disorder, vomiting, ALT, AST increasing.
272
What are the serious reactions to DHA EPA acid (Lovaza)?
Anaphylaxis.
273
What caution is advised for DHA EPA acid (Lovaza)?
Caution advised in pregnancy.
274
What is the recommended dosage of DHA plus EPA during lactation?
1000 mg DHA plus EPA recommended.
275
What is the mechanism of action of Atorvastatin (Lipitor)?
Inhibits HMG-CoA reductase, inhibiting cholesterol synthesis.
276
What are the primary uses of Atorvastatin (Lipitor)?
Hypercholesterolemia, cardiovascular event prevention, atherosclerotic disease.
277
What are the common reactions to Atorvastatin (Lipitor)?
URI, HA, arthralgia, diarrhea, extremity pain, nausea, musculoskeletal pain, myalgia.
278
What are the serious reactions to Atorvastatin (Lipitor)?
Myopathy, including immune-mediated, tendon rupture, rhabdomyolysis.
279
What is the contraindication for Atorvastatin (Lipitor)?
CONTRAINDICATED IN PREGNANCY.
280
What caution is advised for Atorvastatin (Lipitor) during lactation?
Consider alternatives.
281
What patient education should be provided for Atorvastatin (Lipitor)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
282
What is the mechanism of action of Pravastatin (Pravachol)?
Inhibits HMG-CoA reductase, inhibiting cholesterol synthesis.
283
What are the primary uses of Pravastatin (Pravachol)?
Hypercholesterolemia, cardiovascular event prevention, atherosclerotic disease.
284
What are the common reactions to Pravastatin (Pravachol)?
URI, HA, arthralgia, diarrhea, extremity pain, nausea, musculoskeletal pain, myalgia.
285
What are the serious reactions to Pravastatin (Pravachol)?
Myopathy, including immune-mediated, tendon rupture, rhabdomyolysis.
286
What is the safety profile of Pravastatin (Pravachol) in liver disease?
Fewest side effects and safest in liver disease.
287
What is the contraindication for Pravastatin (Pravachol)?
CONTRAINDICATED IN PREGNANCY.
288
What caution is advised for Pravastatin (Pravachol) during lactation?
Consider alternatives.
289
What patient education should be provided for Pravastatin (Pravachol)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
290
What is the mechanism of action of Rosuvastatin (Crestor)?
Inhibits HMG-CoA reductase, inhibiting cholesterol synthesis.
291
What are the primary uses of Rosuvastatin (Crestor)?
Hypercholesterolemia, cardiovascular event prevention, atherosclerotic disease.
292
What are the common reactions to Rosuvastatin (Crestor)?
URI, HA, arthralgia, diarrhea, extremity pain, nausea, musculoskeletal pain, myalgia.
293
What are the serious reactions to Rosuvastatin (Crestor)?
Myopathy, including immune-mediated, tendon rupture, rhabdomyolysis.
294
What is the unique feature of Rosuvastatin (Crestor) compared to other statins?
Lowers LDL the MOST.
295
What is the contraindication for Rosuvastatin (Crestor)?
CONTRAINDICATED IN PREGNANCY.
296
What caution is advised for Rosuvastatin (Crestor) during lactation?
Consider alternatives.
297
What patient education should be provided for Rosuvastatin (Crestor)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
298
What is the mechanism of action of Fenofibrate (Tricor)?
Exact mechanism of action unknown, inhibits triglycerides synthesis and stimulates catabolism of triglyceride-rich lipoproteins.
299
What are the primary uses of Fenofibrate (Tricor)?
Hypercholesterolemia, mixed dyslipidemia.
300
What are the common reactions to Fenofibrate (Tricor)?
ALT, AST elevated, abnormal LFTs.
301
What are the serious reactions to Fenofibrate (Tricor)?
Hepatitis, cirrhosis, cholelithiasis, pancreatitis, myositis, myopathy, rhabdomyolysis.
302
What is the contraindication for Fenofibrate (Tricor)?
CONTRAINDICATED IN PREGNANCY.
303
What caution is advised for Fenofibrate (Tricor) during lactation?
Consider alternatives.
304
What patient education should be provided for Fenofibrate (Tricor)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
305
What is the mechanism of action of Gemfibrozil (Lopid)?
Inhibits peripheral lipolysis, decreases hepatic free fatty acid extraction, inhibits synthesis and increases clearance of VLDL carrier apolipoprotein B.
306
What are the primary uses of Gemfibrozil (Lopid)?
Hypercholesterolemia, mixed dyslipidemia.
307
What are the common reactions to Gemfibrozil (Lopid)?
Abnormal LFTs, abdominal pain.
308
What are the serious reactions to Gemfibrozil (Lopid)?
Myositis, myopathy, rhabdomyolysis, cholelithiasis, jaundice, acute appendicitis.
309
What is the contraindication for Gemfibrozil (Lopid)?
CONTRAINDICATED IN PREGNANCY.
310
What caution is advised for Gemfibrozil (Lopid) during lactation?
Consider alternatives.
311
What patient education should be provided for Gemfibrozil (Lopid)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
312
What is the mechanism of action of Ezetimibe (Zetia)?
Inhibits cholesterol absorption at small intestine brush border, decreasing hepatic cholesterol stores and increasing blood cholesterol clearance.
313
What are the primary uses of Ezetimibe (Zetia)?
Hypercholesterolemia, mixed dyslipidemia.
314
What are the common reactions to Ezetimibe (Zetia)?
URI, diarrhea, nasopharyngitis, arthralgia, sinusitis, myalgia, rhabdomyolysis, pancreatitis.
315
What caution is advised for Ezetimibe (Zetia)?
Caution advised in pregnancy.
316
What patient education should be provided for Ezetimibe (Zetia)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
317
What is the mechanism of action of Cholestyramine (Questran)?
Binds to intestinal bile acids, increasing bile acid fecal elimination and preventing reabsorption.
318
What are the primary uses of Cholestyramine (Questran)?
Hypercholesterolemia.
319
What are the common reactions to Cholestyramine (Questran)?
Constipation, abdominal pain, flatulence, N/V, dyspepsia.
320
What are the serious reactions to Cholestyramine (Questran)?
Fecal impaction, intestinal obstruction, metabolic acidosis, fat-soluble vitamin deficiency, folate levels decreasing, osteoporosis (long-term use).
321
What is the special instruction for taking Cholestyramine (Questran)?
Cholestyramine should not be taken within 1 hour after or 4 hours before you take either medication.
322
What caution is advised for Cholestyramine (Questran) during pregnancy and lactation?
Advised.
323
What is the mechanism of action of Colesevelam (Welchol)?
In hypercholesterolemia, binds intestinal bile acids, increasing bile acid fecal elimination and preventing reabsorption; in diabetes mellitus, exact mechanism of action unknown.
324
What are the primary uses of Colesevelam (Welchol)?
Hypercholesterolemia, DMT2.
325
What are the common reactions to Colesevelam (Welchol)?
Constipation, dyspepsia, URI symptoms, nausea.
326
What are the serious reactions to Colesevelam (Welchol)?
Hypersensitivity reaction, esophageal obstruction, intestinal obstruction, fecal impaction.
327
What caution is advised for Colesevelam (Welchol) during pregnancy and lactation?
Caution advised.
328
Adenosine mechanism of action
Slows AV node conduction time, interrupts AV node re-entry pathways, activates A1 and A2 adenosine receptors, producing coronary vasodilation and increasing blood flow.
329
Adenosine uses
Paroxysmal supraventricular tachycardia (PSVT), ACLS, tachycardia cardiac stress testing.
330
Adenosine common reactions
Flushing, dyspnea, chest discomfort, nausea, headache, lightheadedness.
331
Adenosine serious reactions
Cardiac arrest, ventricular arrhythmias, severe bradycardia, myocardial infarction, 3rd degree AV block.
332
Amiodarone mechanism of action
Prolongs action potential phase 3.
333
Amiodarone uses
ACLS, VF/pulseless VT, ACLS wide complex tachycardia, atrial fibrillation (off label).
334
Amiodarone common reactions
Corneal deposits (>6mo use), malaise/fatigue, ataxia, tremor, hyperkinesia, peripheral neuropathy (long-term use), nausea/vomiting, constipation, anorexia.
335
Amiodarone serious reactions
Severe bradycardia, AV block, QT prolongation, torsades de pointes.
336
Atropine mechanism of action
Antagonizes acetylcholine receptors (anticholinergic).
337
Atropine uses
ACLS, symptomatic bradycardia, neuromuscular blockade reversal adjunct, organophosphate nerve agent poisoning.
338
Atropine common reactions
Xerostomia, blurred vision, tachycardia, difficulty urinating, confusion, headache, dizziness, flushing.
339
Epinephrine mechanism of action
Stimulates alpha and beta adrenergic receptors.
340
Epinephrine uses
ACLS asystole/PEA, VF/pulseless VT, ACLS bradycardia, anaphylaxis, severe asthma exacerbation, septic shock.
341
Epinephrine common reactions
Palpitations, tachycardia, respiratory difficulty, nausea/vomiting, diaphoresis, dizziness, weakness, tremor, apprehension, nervousness/anxiety/restlessness.
342
Epinephrine serious reactions
Respiratory difficulty, pulmonary edema, arrhythmias, hypertension.
343
Digoxin mechanism of action
Inhibits sodium-potassium ATPase.
344
Digoxin uses
Congestive heart failure (CHF), atrial fibrillation, PSVT conversion.
345
Digoxin common reactions
Dizziness, headache, nausea/vomiting/diarrhea.
346
Digoxin serious reactions
AV block, severe bradycardia, ventricular arrhythmias.
347
Procainamide mechanism of action
Stabilizes membranes, depresses action potential phase 0.
348
Procainamide uses
Ventricular arrhythmias (wide QRS), sustained monomorphic ventricular tachycardia, hemodynamically stable supraventricular arrhythmias.
349
Procainamide common reactions
Hypotension, bradycardia, flushing, urticaria, pruritus, angioedema.
350
Procainamide serious reactions
Ventricular fibrillation, asystole, QT prolongation, torsades de pointes.
351
Dobutamine mechanism of action
Stimulates beta-1 adrenergic receptors, producing hypertensive, mild chronotropic, arrhythmogenic and vasodilatory effects.
352
Dobutamine uses
Cardiac decompensation, cardiac output maintenance.
353
Dobutamine common reactions
Hypertension, tachycardia, PVCs, nausea.
354
Dobutamine serious reactions
Hypertension, tachycardia, PVCs, severe hypotension, ventricular tachycardia.
355
Vasopressin mechanism of action
Directly stimulates V1 and V2 receptors, resulting in vasoconstriction and antidiuresis.
356
Vasopressin uses
Diabetes insipidus, vasodilatory shock.
357
Vasopressin common reactions
Abdominal cramps, nausea.
358
Vasopressin serious reactions
Anaphylaxis, tachyarrhythmias, bradycardia, angina, myocardial infarction.
359
Norepinephrine mechanism of action
Directly stimulates alpha-1 and beta-1 adrenergic receptors, produces inotropic and vasopressor effects.
360
Norepinephrine uses
Acute hypotension, first-line pressor in septic shock.
361
Norepinephrine common reactions
Headache, anxiety, bradycardia.
362
Norepinephrine serious reactions
Anaphylaxis, tachyarrhythmias, bradycardia, severe hypertension, extravasation necrosis.
363
What is the mechanism of Sodium Bicarbonate?
Increases serum bicarbonate, raising pH, neutralizes gastric acidity
364
What are the uses of Sodium Bicarbonate?
Acute and chronic metabolic acidosis (pH less than 7.25), urinary alkalization, dyspepsia, salicylate overdose, tricyclic antidepressant overdose
365
What are common reactions to Sodium Bicarbonate?
Flatulence (PO use), gastric distension (PO use), metabolic acidosis, edema, hypernatremia, injection site pain
366
What are serious reactions to Sodium Bicarbonate?
Metabolic acidosis, CHF exacerbation, seizures, tetany, extravasation cellulitis (IV use)
367
What precautions should be taken with Sodium Bicarbonate?
Caution in lactation and pregnancy
368
What is the mechanism of Cilostazol (Pletal)?
Inhibits phosphodiesterase type 3, reducing platelet aggregation, suppresses cAMP degradation, producing vasodilation
369
What is the use of Cilostazol (Pletal)?
Intermittent claudication
370
What are common reactions to Cilostazol (Pletal)?
HA, diarrhea, abnormal stools, palpitations, dizziness
371
What are serious reactions to Cilostazol (Pletal)?
Bleeding, angina, MI, tachyarrhythmias, thrombocytopenia, leukopenia, agranulocytosis
372
What precautions should be taken with Cilostazol (Pletal)?
Caution in lactation and pregnancy
## Footnote
BB WARNING contraindicated in CHF decreased survival compared to placebo in class III-IV CHF, contraindicated in CHF OF ANY SEVERITY
373
What is the mechanism of action for Nitroglycerin (Nitro-Bid)?
Stimulates cGMP production, resulting in vascular smooth muscle relaxation.
374
What are the uses of Nitroglycerin (Nitro-Bid)?
Angina prophylaxis.
375
What are common reactions to Nitroglycerin (Nitro-Bid)?
HA, dizziness, paresthesia, weakness, flushing, rash, orthostatic hypotension.
376
What precautions should be taken with Nitroglycerin (Nitro-Bid)?
Caution in lactation and pregnancy. Do not take ED meds while using nitroglycerin topical.
377
What is the mechanism of action for Nitroglycerin (Nitrostat)?
Stimulates cGMP production, resulting in vascular smooth muscle relaxation.
378
What are the uses of Nitroglycerin (Nitrostat)?
Acute angina, angina prophylaxis, sublingual nitroglycerin is the drug of choice for stable angina.
379
What are common reactions to Nitroglycerin (Nitrostat)?
HA, dizziness, paresthesia, weakness, flushing, rash, orthostatic hypertension.
380
What are serious reactions to Nitroglycerin (Nitrostat)?
Severe hypertension, syncope, anaphylactoid reaction.
381
What precautions should be taken with Nitroglycerin (Nitrostat)?
Caution in lactation and pregnancy.
382
What is the mechanism of action for DHA EPA acid (Lovaza)?
Exact mechanism of action unknown, reduces hepatic triglyceride synthesis.
383
What are the uses of DHA EPA acid (Lovaza)?
Severe hypertriglyceridemia.
384
What are common reactions to DHA EPA acid (Lovaza)?
Eructation (burping), taste changes, dyspepsia, constipation, GI disorder, vomiting, ALT, AST increasing.
385
What are serious reactions to DHA EPA acid (Lovaza)?
Anaphylaxis.
386
What precautions should be taken with DHA EPA acid (Lovaza)?
Caution advised in pregnancy. Lactation: 1000 mg DHA plus EPA recommended.
387
What is the mechanism of action for Atorvastatin (Lipitor)?
Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, inhibiting cholesterol synthesis.
388
What are the uses of Atorvastatin (Lipitor)?
Hypercholesterolemia, cardiovascular event prevention, atherosclerotic disease.
389
What are common reactions to Atorvastatin (Lipitor)?
URI, HA, arthralgia, diarrhea, extremity pain, nausea, musculoskeletal pain, myalgia.
390
What are serious reactions to Atorvastatin (Lipitor)?
Myopathy, including immune-mediated, tendon rupture, rhabdomyolysis.
391
What precautions should be taken with Atorvastatin (Lipitor)?
CONTRAINDICATED IN PREGNANCY. Lactation consider alternatives.
392
What is the patient education for Atorvastatin (Lipitor)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
393
What is the mechanism of action for Pravastatin (Pravachol)?
Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, inhibiting cholesterol synthesis.
394
What are the uses of Pravastatin (Pravachol)?
Hypercholesterolemia, cardiovascular event prevention, atherosclerotic disease.
395
What are common reactions to Pravastatin (Pravachol)?
URI, HA, arthralgia, diarrhea, extremity pain, nausea, musculoskeletal pain, myalgia.
396
What are serious reactions to Pravastatin (Pravachol)?
Myopathy, including immune-mediated, tendon rupture, rhabdomyolysis.
397
What precautions should be taken with Pravastatin (Pravachol)?
CONTRAINDICATED IN PREGNANCY. Lactation consider alternatives.
398
What is the patient education for Pravastatin (Pravachol)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
399
What is the mechanism of action for Rosuvastatin (Crestor)?
Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, inhibiting cholesterol synthesis.
400
What are the uses of Rosuvastatin (Crestor)?
Hypercholesterolemia, cardiovascular event prevention, atherosclerotic disease.
401
What are common reactions to Rosuvastatin (Crestor)?
URI, HA, arthralgia, diarrhea, extremity pain, nausea, musculoskeletal pain, myalgia.
402
What are serious reactions to Rosuvastatin (Crestor)?
Myopathy, including immune-mediated, tendon rupture, rhabdomyolysis.
403
What precautions should be taken with Rosuvastatin (Crestor)?
CONTRAINDICATED IN PREGNANCY. Lactation consider alternatives.
404
What is the patient education for Rosuvastatin (Crestor)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
405
What are fibrates?
Fibrates are medications that inhibit triglyceride synthesis and stimulate catabolism of triglyceride-rich lipoproteins.
406
What is the mechanism of action of Fenofibrate (Tricor)?
Exact mechanism of action unknown, inhibits triglycerides synthesis and stimulates catabolism of triglyceride-rich lipoproteins.
407
What are the uses of Fenofibrate (Tricor)?
Used for hypercholesterolemia and mixed dyslipidemia.
408
What are common reactions to Fenofibrate (Tricor)?
Common reactions include elevated ALT, AST, and abnormal LFTs.
409
What are serious reactions to Fenofibrate (Tricor)?
Serious reactions include hepatitis, cirrhosis, cholelithiasis, pancreatitis, myositis, myopathy, and rhabdomyolysis.
410
What is a key safety consideration for Fenofibrate (Tricor)?
CONTRAINDICATED IN PREGNANCY. Lactation consider alternatives.
411
What patient education should be provided for Fenofibrate (Tricor)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
412
What is the mechanism of action of Gemfibrozil (Lopid)?
Inhibits peripheral lipolysis, decreases hepatic free fatty acid extraction, inhibits synthesis and increases clearance of VLDL carrier apolipoprotein B.
413
What are the uses of Gemfibrozil (Lopid)?
Used for hypercholesterolemia and mixed dyslipidemia.
414
What are common reactions to Gemfibrozil (Lopid)?
Common reactions include abnormal LFTs and abdominal pain.
415
What are serious reactions to Gemfibrozil (Lopid)?
Serious reactions include myositis, myopathy, rhabdomyolysis, cholelithiasis, jaundice, and acute appendicitis.
416
What is a key safety consideration for Gemfibrozil (Lopid)?
CONTRAINDICATED IN PREGNANCY. Lactation consider alternatives.
417
What patient education should be provided for Gemfibrozil (Lopid)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
418
What is the mechanism of action of Ezetimibe (Zetia)?
Inhibits cholesterol absorption at small intestine brush border, decreasing hepatic cholesterol stores and increasing blood cholesterol clearance.
419
What are the uses of Ezetimibe (Zetia)?
Used for hypercholesterolemia and mixed dyslipidemia.
420
What are common reactions to Ezetimibe (Zetia)?
Common reactions include URI, diarrhea, nasopharyngitis, arthralgia, sinusitis, myalgia, rhabdomyolysis, and pancreatitis.
421
What is a key safety consideration for Ezetimibe (Zetia)?
Caution advised in pregnancy.
422
What patient education should be provided for Ezetimibe (Zetia)?
This med can cause the breakdown of muscle tissue, which can lead to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark urine.
423
What is the mechanism of action of Cholestyramine (Questran)?
Binds to intestinal bile acids, increasing bile acid fecal elimination and preventing reabsorption.
424
What are the uses of Cholestyramine (Questran)?
Used for hypercholesterolemia.
425
What are common reactions to Cholestyramine (Questran)?
Common reactions include constipation, abdominal pain, flatulence, nausea/vomiting, and dyspepsia.
426
What are serious reactions to Cholestyramine (Questran)?
Serious reactions include fecal impaction, intestinal obstruction, metabolic acidosis, fat-soluble vitamin deficiency, decreasing folate levels, and osteoporosis (long-term use).
427
What are key safety considerations for Cholestyramine (Questran)?
Should not be taken within 1 hour after or 4 hours before taking other medications. Pregnancy and lactation advised.
428
What is the mechanism of action of Colesevelam (Welchol)?
Binds intestinal bile acids, increasing bile acid fecal elimination and preventing reabsorption; in diabetes mellitus, exact mechanism of action unknown.
429
What are the uses of Colesevelam (Welchol)?
Used for hypercholesterolemia and type 2 diabetes mellitus.
430
What are common reactions to Colesevelam (Welchol)?
Common reactions include constipation, dyspepsia, URI symptoms, and nausea.
431
What are serious reactions to Colesevelam (Welchol)?
Serious reactions include hypersensitivity reactions, esophageal obstruction, intestinal obstruction, and fecal impaction.
432
What are key safety considerations for Colesevelam (Welchol)?
Caution advised in pregnancy and lactation.
433
What is the mechanism of action of Niacin (Niaspan)?
Participation in tissue respiration oxidation-reduction reactions, decreases hepatic LDL and VLDL production, inhibits adipose tissue lipolysis, decreases hepatic triglyceride esterification, increases lipoprotein lipase activity.
434
What are the uses of Niacin (Niaspan)?
Used for hypercholesterolemia, hypertriglyceridemia, cardiovascular event prevention, and coronary artery disease.
435
What are common reactions to Niacin (Niaspan)?
Common reactions include flushing, pruritus, paresthesia, nausea, and dyspepsia.
436
What are serious reactions to Niacin (Niaspan)?
Serious reactions include hepatotoxicity.
437
What patient education should be provided for Niacin (Niaspan)?
Taking a 325 mg aspirin 30 min prior can help reduce flushing. Take with a low-fat meal. DO NOT crush or chew.
438
What are key safety considerations for Niacin (Niaspan)?
Caution advised in pregnancy and lactation. DO NOT take if severe liver disease, a stomach ulcer, or active bleeding.
439
What drugs are contraindicated in pregnancy due to teratogenic effects?
ACE inhibitors (e.g., lisinopril, enalapril), ARBs (e.g., losartan, valsartan), Statins (e.g., atorvastatin, simvastatin), Amiodarone, Warfarin (during 1st trimester), Direct oral anticoagulants (DOACs: apixaban, rivaroxaban).
440
What are the risks associated with ACE inhibitors in pregnancy?
Risk of fetal renal damage, oligohydramnios, skull hypoplasia, neonatal renal failure.
441
What are the risks associated with ARBs in pregnancy?
Similar to ACE inhibitors; cause fetal toxicity.
442
What is the concern with statins during pregnancy?
Cholesterol synthesis inhibition may disrupt fetal development.
443
What issues are associated with Amiodarone in pregnancy?
Associated with fetal hypothyroidism and neurodevelopmental issues.
444
What is the risk of Warfarin during the first trimester of pregnancy?
Crosses placenta, associated with fetal warfarin syndrome (nasal hypoplasia, stippled epiphyses, CNS abnormalities).
445
What is the recommendation for Direct oral anticoagulants (DOACs) in pregnancy?
Limited data, but animal studies suggest risk; not recommended.
446
What medications may be used in pregnancy if benefits outweigh risks?
Beta-blockers (e.g., metoprolol, labetalol), Calcium channel blockers (e.g., nifedipine), Heparin (unfractionated or LMWH), Digoxin, Hydralazine.
447
What are the concerns with using beta-blockers in pregnancy?
Generally safe, but can cause fetal bradycardia or growth restriction; labetalol is preferred in pregnancy.
448
What should be monitored when using calcium channel blockers in pregnancy?
Maternal hypotension affecting uteroplacental perfusion.
449
Why is heparin preferred for anticoagulation in pregnancy?
It doesn’t cross the placenta.
450
What is important to monitor when using Digoxin during pregnancy?
Therapeutic levels must be monitored.
451
What is the use of Hydralazine in pregnancy?
Often used for severe hypertension; may cause maternal hypotension or tachycardia.
