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Flashcards in CARDIO Deck (27):
0

ACE Inhibitors

Cough

1

Adenosine

(3)?

- Hypotension
- Flushing
- Chest pain

2

Amiodarone

Toxicities (9 Categories)?

*** 40% IODINE by weight ***
*** S/E of ALL CLASSES of Antiarrhythmics because it
ALTERS LIPID MEMB. ***
*** Remember to check PFTs, LFTs & TFTs ***

- CV effects: Bradycardia, Heart Block, CHF
- Pulm Fibrosis
- Neuro effects
- Hypothyroidism / Hyperthyroidism (40% iodine by weight)
- Hepatotoxicity
- Constipation
- Corneal deposits
- Blue/Grey Skin deposits -> Photodermatitis
- Photosensitivity

3

Bile Acid Resins

Cholesterol Gallstones

4

Bretylium

(2)?

- Hypotension
- NEW arrhythmias

5

Class 1 Antiarrhythmics (Na Channel Blockers)

Cause of Toxicity?

Hyperkalemia

6

Class 1A Antiarrhythmics (Quinidine, Disopyramide + Procainamide)

(5)?

- Torsades de Pointes / ↑QT interval
- HF
- Thrombocytopenia
- Cinchonism
- Reversible SLE-like sx

6

Class 1B Antiarrhythmics (Lidocaine + Mexiletine)

(2)?

- CNS stim / depression
- CV depression

7

Class 1C Antiarrhythmics (Flecainide + Propafenone)

CI?

Proarrhytmic (*especially post-MI*)

CI: patients w structural + ischemic HD

8

Class 4 Antiarrhythmics (Ca Channel Blockers)

(4)?

- Edema
- Flushing
- CV effects: AV block, Sinus Node depression + CHF
- Constipation (↓gut mobility due to gastrin using Ca)

9

Class 3 Antiarrhythmics

Torsades de Pointes

10

Digoxin / Cardiac Glycosides #1

Interactions LEADING to Toxicity:
Drugs (6), Ionic States (3), Condition?

DRUGS: COMPETE for binding sites +↓Clearance
(all EXCEPT Diuretics)
- Quinidine (↓Digoxin clearance by displacing it from tis binding sites)
- Amiodarone
- NSAIDs
- CCBs
- B Blockers
- Diuretics (can produce Hypokalemia)

IONIC STATES:
-↓K (allows for Digoxin binding at K-binding sites on Na/K ATPase)
-↓Mg
-↑Ca

CONDITIONS:
- Renal Failure (↓Digoxin excretion)

12

Digoxin / Cardiac Glycosides #2

Toxicities (5, incl 3 EKG), Worsened By (3, incl 1 drug)?

TOX:
- Hyperkalemia
- Arrhythmia
- EKG:↑PR +↓QT, ST scooping, T wave insertion
- Cholinergic -> (nausea, vomiting, diarrhea, "blurry yellow vision")
- Gynecomastia

WORSENED BY:
- Hypokalemia (allows for↑digoxin binding at K-binding sites on NA/K ATPase)
- Renal failure (↓excretion)
- Quinidine (↓digoxin clearance & displaces digoxin from tis binding sites)

13

HMG-CoA Reductase Inhibitors / Statins

(3: 1 GI + 2 MSK)?

- Hepatotoxicity
- Myopathies
- Rhabdomyolysis

13

Diazoxide

Hyperglycemia (↓insulin release)

14

Fibrates

(5)?

- Hepatotoxicity
- Cholesterol Gallstones
- Diarrhea
- Myopathies
- Rhabdomyolysis

15

Niacin

(4)?

- Hyperglycemia
- Hyperuricemia -> Gout
- Cutaneous Flushing ("red flushed face")
*↓by Aspirin or long-term use.*
- Myopathies

16

Nitroglycerin

(6: 5 general + 1 dz/sx)?

- Hypotension
- Flushing
- Dizziness
- Headache
- Reflex tachycardia
- Monday Dz (in industrial exposure): devel of TOLERANCE for vasodilating action during work week / loss of tolerance during wknd -> toxicity symptoms (above) upon reexposure.

18

Nitroprusside

Cyanide toxicity (releases CN)

19

Sotalol

(2)?

- Torsades de Pointes
- Excessive b block

20

Verapamil

Gingival Hyperplasia

21

Drugs that Cause Arrhythmias

(3: 2 Antibiotics + 1 ANS)?

- Macrolides
- Amphotericin B

- Long-Acting b2-Agonists

22

Drugs that cause Coronary Vasospasm

(2)?

- Cocaine
- Sumatriptan

23

Drugs that cause Cutaneous Flushing

(4: "VANC" + -fungin)?

- Vancomycin
- Adenosine
- Niacin
- Ca Channel Blockers

- Antifungal 'Cell Wall Syn Inhibitors': -fungin

24

Drugs that cause Dilated Cardiomyopathy

(2)?

- Daunorubicin
- Doxorubicin

25

Drugs that cause Hypotension

(2 Antibiotics)?

- Sulfonamides
- Amphotericin B

26

Drugs that Prolong QT Interval / cause Torsades de Pointes

(7: "Some Risky Meds Can Prolong QT")?

- Sotalol + Ibutilide (Class III Antiarrhythmics)
- Risperidone
- Macrolides
- Chloroquine
- Protease Inhibitors
- Quinidine (Class IA Antiarrhythmic)
- Thiazides