cardio pharm.

Question 1

hypertension drugs that can be used in pregnancy

Answer 1

hypertensive moms love nifedipine

hydralazine
methyldopa
labetalol
nifedipine

Question 2

hypertension drugs that cannot be used in pregnancy

Answer 2

ace inhibitor

arbs

Question 3

what drugs must be used cautiously in decompensated HF

Answer 3

beta blockers

Question 4

what drugs are contraindicated in cardiogenic shock

Answer 4

beta blockers

Question 5

hypertension with heart failure

Answer 5

diuretics/ace inhibitors/arbs

Question 6

minidoxil MOA

Answer 6

opens K+ channels, hyperpolarizing smooth muscle causing relaxation of vascular smooth muscle

Question 7

hypertrichosis, hypotension, reflex tachycardia, fluid retention/edema

Answer 7

minidoxil side effects

Question 8

orthostatic hypotension with first few doses

Answer 8

alpha 1 blockers (-zosin)

Question 9

drug-induced lupus (Anti-histone ab)

Answer 9

hydralazine

Question 10

minoxidil compensatory responses

Answer 10

marked salt/water retention and marked tachycardia (all others have less compensation)

Question 11

sudden discontinuation of what drug can cause severe rebound hypertension?

Answer 11

clonidine

Question 12

pt with second degree AV block + constipation

Answer 12

non-dihydropyridine toxicity (verapamil)

Question 13

what calcium channel blocker is used in patients with subarachnoid hemorrhage and why

Answer 13

nimodipine to prevent cerebral vasospasm (rmr Nemo)

Question 14

hyperprolactinemia

Answer 14

verapamil toxicity

Question 15

gingival hyperplasia

Answer 15

calcium channel blocker toxicity

Question 16

hydralazine MOA

Answer 16

increases cGMP –> smooth muscle relaxation

Question 17

does hydralazine affect arterioles or veins

Answer 17

arterioles > veins thus causes decreased afterload

Question 18

why is hydralazine administered with a beta blocker

Answer 18

to prevent reflex tachycardia

Question 19

what is contraindicated in CAD and why

Answer 19

hydralazine because it causes compensatory tachycardia which would increased O2 stress on myocardium

Question 20

what calcium channel blocker can be used in hypertensive emergency

Answer 20

clevidipine

Question 21

nitroprusside moa

Answer 21

increases cGMP via direct release of NO

venodilator ~ arterioles ( decreases preload and afterloda)

Question 22

what toxicity can nitroprusside cause

Answer 22

cyanide

Question 23

fenoldopam MOA

Answer 23

dopamine D1 receptor agonist

coronary peripheral renal splanchnic vasodilation (good for renal failure)

Question 24

does fendoldopam work on arterioles or veins

Answer 24

arterioles

Question 25

common side effect of nitrates

Answer 25

headache (vc it vasodilates veins in meninges)

Question 26

MOA nitrates

Answer 26

increases NO in smooth muscle, increases cGMP and smooth muscle relaxation venodilator, so decreases preload and thus decreases cardiac work

Question 27

how do you treat reflex tachycardia

Answer 27

propranolol - beta blockers

Question 28

explain nitrate tolerance

Answer 28

patients on nitrates need to have a nitrate free period every day to avoid tolerance - usually done at night when patient is sleeping and cardiac work is the least

Question 29

how do verapamil and diltiazem affect HR?

Answer 29

decrease (inhibit SA and AV nodes)

Question 30

does minoxidil cause reflex tach?

Answer 30

yes so much so that it must be controlled with beta blockers | dose-dependent rise in HR

Question 31

hypertension + diabetes drugs

Answer 31

ACE inhibitors or ARBs because they not only lower BP but also slow diabetic nephropathy

Question 32

statins decrease what the most

Answer 32

LDL

Question 33

statins upregulate what

Answer 33

LDL receptor

Question 34

bile acid resins decerease what (cholestyramine)

Answer 34

LDL

Question 35

what lipid lowering agent has a gritty unpleasant taste

Answer 35

bile acid resins / cholestyramine

Question 36

what LLA causes decreased absorption of vitamins or other drugs from intestinal tract

Answer 36

bile acid resins/ cholestyramine

Question 37

hepatotoxicity, rhabdomyolysis/myopathy

Answer 37

side effect of statins

Question 38

bile acid resins MOA

Answer 38

prevent intestinal reabsorption of bile acids (decreased reabsorption of cholesterol)

Question 39

statins MOA

Answer 39

competitively inhibit hmg coa reductase (rate limiting enzyme in cholesterol synth) - reduces hmg-coa converstion to malevonate

Question 40

how do statins affect HDL

Answer 40

increase

Question 41

how do bile acid resins affect HDL

Answer 41

slightly increase

Question 42

how do bile acid resins affect triglycerides

Answer 42

slightly increase

Question 43

how to statins affect triglycerides

Answer 43

decrease

Question 44

what does ezetimbe reduce

Answer 44

LDL

Question 45

how does ezetemibe affect HDL/Triglyerides?

Answer 45

no affect

Question 46

if ezetimibe and statins are given together, what side effect risk is increased

Answer 46

hepatotoxicity

Question 47

ezetimibe moa

Answer 47

prevent cholesterol reabsorption at small intestine brush border

Question 48

cutaneous flushing is a common adverse affect of what lipid lowering agent

Answer 48

niacin

Question 49

what drug do you give if someone has low HDL

Answer 49

niacin

Question 50

how can you reduce cutaneous flushing due to niacin

Answer 50

pretreatment with aspirin/nsaid

Question 51

if someone is on niacin, how do you need to adjust the rest of their drugs?

Answer 51

niacin causes hyperglycemia - increase diabetes drugs | niacin potentiates hypertension drugs so decrease dose

Question 52

fibrates MOA

Answer 52

increases synthesis of lipoprotein lipase by adipocytes via interaction with ppar-alpha protein - increases triglyceride clearance

Question 53

fibrates decrease what the most

Answer 53

triglycerides

Question 54

fibrates increase the risk of developing what

Answer 54

choelsterol gallstones

Question 55

what two lipid lowering agents shouldnt be used together because they both increase risk of choelsterol gallstones and increased risk for mypoathy

Answer 55

statins and fibrates

Question 56

what lipid lowering agent will exacerbate gouty arthritis

Answer 56

niacin

Question 57

what lipid lowering agents are teratogenic?

Answer 57

statins (hmg coa reductase inhibitors)