Cardio exam 5 drugs Flashcards Preview

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Flashcards in Cardio exam 5 drugs Deck (60)
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1
Q

Meds to tx increased preload HF

A

diuretics
aldosterone antagonists
ANP

2
Q

Meds to tx increased afterload HF

A

ACE-I’s

ARBs

3
Q

Use of loop diuretics in HF

A

pulmonary edema

decreases volume and causes venodilation

4
Q

Metabolic changes with loop diuretics

A

increased Glc/urea

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

5
Q

Toxicity of loop diuretics

A

ototoxicity

6
Q

Metabolic changes with thiazide diuretics

A

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

increased Glc/urea/lipids/Ca2+

7
Q

Side effects of diuretics with HF

A
overdiuresis
electrolyte imbalance (Mg2+/K+) causing arrhythmia
8
Q

Action and use of nitrates

A

venous vasodilators

for angina and HF

9
Q

Problem with nitrate use

A

tolerance, alternatve every 12 hrs

10
Q

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

A

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

11
Q

What are ACE-I’s 1st line for?

A

systolic HF

ARBs with increased K+ or decreased renal fxn

12
Q

Hydralazine + IDN use and side effect

A

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

can cause lupus like syndrome

13
Q

Side effect of Na+ nitroprusside

A

cyanide and thiocyanate toxicity

14
Q

Use of nesiritide

A

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

15
Q

Use of sympathomimetic amines in HF

A

acute/decompensated HF

16
Q

Sympathomimetic amines used with HF

A

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

17
Q

Phosphodiesterase inhibitors

A

amrinone

milrinone

18
Q

Action of digoxin

A

increases vagal tone

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

19
Q

Dopamine doses and effects

A

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

20
Q

Electrolyte imbalances increasing digoxin toxicity

A

decreased K+/Mg2+

increased Ca2+

21
Q

Beta blockers increasing survival with HF

A

metoprolol succinate
bisoprolol
carvedilol

22
Q

Beta blockers excreted by kidneys (not liver)

A

atenolol
nadolol
sotalol
carteolol

23
Q

Benefit of aldosterone antagonists with systolic HF

A

decreased mortality and morbidity

24
Q

Side effect of aldosterone antagonists

A

gynecomastia

hyperkalemia

25
Q

Drug that decreases mortality perioperatively

A

beta blockers

26
Q

Antiarrhythmic not causing QT prolongation

A

propafenone`

27
Q

Major characteristics of class IA antiarrhythmics

A
can cause Torsades
discontinuation side effects
quinidine (cinchonism)
procainamide (lupus)
disopyramide (anticholinergic)
28
Q

Class IB uses

A

for ventricular arrhythmias

29
Q

Class IC use

A

PVC

30
Q

Side effects of class II antiarrhythmics

A

bronchoconstriction

AV block

31
Q

Class III antiarrhythmic toxicities

A

hyper/hypothyroidism
pulmonary toxicity
bradycardia
hepatic toxicity

32
Q

Use of sotalol

A

better efficacy with life threatening pts

beta blockers and K+ channel blocker

33
Q

Dofetilide uses

A

for A fib/flutter only

effects only I(kr) K+ current

34
Q

Dronedarone uses and contraindication

A
decreases A fib recurrence rates
contra in class IV HF or II/III HF with recent hospitalization
35
Q

Tx for pulseless VT or V fib

A

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

36
Q

What does amiodarone decrease mortality with?

A

CHF and acute MI

37
Q

Drug to use post MI

A

beta blockers

38
Q

Drugs to use for high risk or VT/VF

A

defib
amiodarone
sotalol

39
Q

Drugs causing Torsades

A

class IA and III antiarrhythmics

40
Q

Tx for Torsades

A

Mg2+

41
Q

Drugs for A fib/flutter

A

CCBs
beta blockers
digoxin

42
Q

Drug for PSVT

A

adenosine

does not effect VT

43
Q

Drugs decreasing mortality with CHF and MI

A

beta blockers

ACE-I’s

44
Q

ACE-I with sulfa allergy

A

captopril

45
Q

What do you monitor with ACE-I’s?

A

serum creatinine and K+ levels

46
Q

Population with benefit of hydralazine/ IDN

A

African Americans with class III/IV HF

47
Q

What is metolazone?

A

thiazide related

synergistic with loop diuretics for K+ loss

48
Q

What are tolvaptan/conivaptan?

A

vasopressin receptor blockers

tx hyponatremia

49
Q

Action of digoxin on heart (generally)

A

increased contractility

50
Q

Use of nicotinic acid

A

decrease TG mostly, and increase HDL

51
Q

Side effects of nicotinic acid

A

increased serum Glc
hyperuricemia
hepatotoxicity

52
Q

Use of fibrinic acids

A

decrease TG mostly

53
Q

Use of ezetimibe

A

synergistic with statins to decrease LDL

prevents absorption in GI lumen

54
Q

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

A

natriuetic peptide

vasodilators

55
Q

Drugs to tx decreased cardiac index

A

dobutamine
milrinone
Ca2+ sensitizers

56
Q

Tx unfractionated heparin OD bleeding

A

protamine sulfate for bleeding

57
Q

Tx unfractionated heparin thrombocytopenia

A

direct thrombin inhibitor

58
Q

LMW heparin inhibits what?

A

fractor Xa (don’t need to monitor)

59
Q

Direct thrombin inhibitors

A

leipuridin
bivalirudin
argatrovban

60
Q

Tx for 2nd degree AV block

A

atropine
dopamine
isoproterenol