Cardio exam 5 drugs

Question 1

Meds to tx increased preload HF

Answer 1

diuretics
aldosterone antagonists
ANP

Question 2

Meds to tx increased afterload HF

Answer 2

ACE-I’s

ARBs

Question 3

Use of loop diuretics in HF

Answer 3

pulmonary edema

decreases volume and causes venodilation

Question 4

Metabolic changes with loop diuretics

Answer 4

increased Glc/urea

decreased H+/Na+/Mg2+/K+

Question 5

Toxicity of loop diuretics

Answer 5

ototoxicity

Question 6

Metabolic changes with thiazide diuretics

Answer 6

decreased K+/Mg2+/Na+/H+

increased Glc/urea/lipids/Ca2+

Question 7

Side effects of diuretics with HF

Answer 7

overdiuresis
electrolyte imbalance (Mg2+/K+) causing arrhythmia

Question 8

Action and use of nitrates

Answer 8

venous vasodilators

for angina and HF

Question 9

Problem with nitrate use

Answer 9

tolerance, alternatve every 12 hrs

Question 10

ACE-I’s/ARBs with HF and beneficial group to use with

Answer 10

decrease preload and afterload
also tx HTN
pts with renal insufficiency (slows progression)

Question 11

What are ACE-I’s 1st line for?

Answer 11

systolic HF

ARBs with increased K+ or decreased renal fxn

Question 12

Hydralazine + IDN use and side effect

Answer 12

for pts who cannot use ACE-I’s or ARBs

can cause lupus like syndrome

Question 13

Side effect of Na+ nitroprusside

Answer 13

cyanide and thiocyanate toxicity

Question 14

Use of nesiritide

Answer 14

for acute decompensated HF
supresses neurohormonal stimulation
recombinant B type natriuetic peptide

Question 15

Use of sympathomimetic amines in HF

Answer 15

acute/decompensated HF

Question 16

Sympathomimetic amines used with HF

Answer 16

dopamine (increases renal fxn)
dobutamine
NE/epi
isoproterenol (increases vasodilation)

Question 17

Phosphodiesterase inhibitors

Answer 17

amrinone

milrinone

Question 18

Action of digoxin

Answer 18

increases vagal tone

inhibits Na+/K+ ATPase in sarcolemma (which increases refractory and increases Ca2+ stored in SR)

Question 19

Dopamine doses and effects

Answer 19

10um/kg/min for peripheral vasoconstriction (alpha1)

Question 20

Electrolyte imbalances increasing digoxin toxicity

Answer 20

decreased K+/Mg2+

increased Ca2+

Question 21

Beta blockers increasing survival with HF

Answer 21

metoprolol succinate
bisoprolol
carvedilol

Question 22

Beta blockers excreted by kidneys (not liver)

Answer 22

atenolol
nadolol
sotalol
carteolol

Question 23

Benefit of aldosterone antagonists with systolic HF

Answer 23

decreased mortality and morbidity

Question 24

Side effect of aldosterone antagonists

Answer 24

gynecomastia

hyperkalemia

Question 25

Drug that decreases mortality perioperatively

Answer 25

beta blockers

Question 26

Antiarrhythmic not causing QT prolongation

Answer 26

propafenone`

Question 27

Major characteristics of class IA antiarrhythmics

Answer 27

``` can cause Torsades discontinuation side effects quinidine (cinchonism) procainamide (lupus) disopyramide (anticholinergic) ```

Question 28

Class IB uses

Answer 28

for ventricular arrhythmias

Question 29

Class IC use

Answer 29

PVC

Question 30

Side effects of class II antiarrhythmics

Answer 30

bronchoconstriction | AV block

Question 31

Class III antiarrhythmic toxicities

Answer 31

hyper/hypothyroidism pulmonary toxicity bradycardia hepatic toxicity

Question 32

Use of sotalol

Answer 32

better efficacy with life threatening pts | beta blockers and K+ channel blocker

Question 33

Dofetilide uses

Answer 33

for A fib/flutter only | effects only I(kr) K+ current

Question 34

Dronedarone uses and contraindication

Answer 34

``` decreases A fib recurrence rates contra in class IV HF or II/III HF with recent hospitalization ```

Question 35

Tx for pulseless VT or V fib

Answer 35

CPR + shock, then epi/vasopressin then amiodarone (or Mg2+ if Torsades)

Question 36

What does amiodarone decrease mortality with?

Answer 36

CHF and acute MI

Question 37

Drug to use post MI

Answer 37

beta blockers

Question 38

Drugs to use for high risk or VT/VF

Answer 38

defib amiodarone sotalol

Question 39

Drugs causing Torsades

Answer 39

class IA and III antiarrhythmics

Question 40

Tx for Torsades

Answer 40

Mg2+

Question 41

Drugs for A fib/flutter

Answer 41

CCBs beta blockers digoxin

Question 42

Drug for PSVT

Answer 42

adenosine | does not effect VT

Question 43

Drugs decreasing mortality with CHF and MI

Answer 43

beta blockers | ACE-I's

Question 44

ACE-I with sulfa allergy

Answer 44

captopril

Question 45

What do you monitor with ACE-I's?

Answer 45

serum creatinine and K+ levels

Question 46

Population with benefit of hydralazine/ IDN

Answer 46

African Americans with class III/IV HF

Question 47

What is metolazone?

Answer 47

thiazide related | synergistic with loop diuretics for K+ loss

Question 48

What are tolvaptan/conivaptan?

Answer 48

vasopressin receptor blockers | tx hyponatremia

Question 49

Action of digoxin on heart (generally)

Answer 49

increased contractility

Question 50

Use of nicotinic acid

Answer 50

decrease TG mostly, and increase HDL

Question 51

Side effects of nicotinic acid

Answer 51

increased serum Glc hyperuricemia hepatotoxicity

Question 52

Use of fibrinic acids

Answer 52

decrease TG mostly

Question 53

Use of ezetimibe

Answer 53

synergistic with statins to decrease LDL | prevents absorption in GI lumen

Question 54

Drugs to tx increased pulmonary capillary wedge pressure (pulmonary HTN)

Answer 54

natriuetic peptide | vasodilators

Question 55

Drugs to tx decreased cardiac index

Answer 55

dobutamine milrinone Ca2+ sensitizers

Question 56

Tx unfractionated heparin OD bleeding

Answer 56

protamine sulfate for bleeding

Question 57

Tx unfractionated heparin thrombocytopenia

Answer 57

direct thrombin inhibitor

Question 58

LMW heparin inhibits what?

Answer 58

fractor Xa (don't need to monitor)

Question 59

Direct thrombin inhibitors

Answer 59

leipuridin bivalirudin argatrovban

Question 60

Tx for 2nd degree AV block

Answer 60

atropine dopamine isoproterenol