Cardio Pharm Indications

Question 1

Nifedipine

Answer 1

Anti-HTN. Used in conjunction with beta blocker to prevent reflex tachy. Contraindicated post-MI./CHF.

Question 2

Amlodipine

Answer 2

Anti-HTN. Used in conjunction with beta blocker to prevent reflex tachy. Contraindicated post-MI./CHF

Question 3

Diltiazem

Answer 3

Paroxysmal supraventricular dysrhythmias. Not as strong as Verapamil, low side effects. Not effective against HTN.

Question 4

Verapamil

Answer 4

Paroxysmal supraventricular dysrhythmias, angina (decreases demand for O2 and increases coronary blood flow, HTN (reduces SVR).

Question 5

Furosemide

Answer 5

Anti-HTN, CHF.

Question 6

HCTZ (hydrochorthiazide)

Answer 6

First line for uncomplicated Anti-HTN. SEs: sulfa allergy, hypokalemia, insulin resistance, increased TG + LDL.

Question 7

Losartan

Answer 7

Anti-HTN, can be used to treat aortic dilation.

Question 8

Enlalapril

Answer 8

Anti-HTN.

Question 9

Direct Renin Inhibitors

Answer 9

Anti-HTN. Not really used.

Question 10

Phenoxybenzamine

Answer 10

3rd line Anti-HTN. Also used in treatment of BPH.

Question 11

Prazosin

Answer 11

3rd line Anti-HTN. Also used in treatment of BPH.

Question 12

Doxazosin/Terazosin

Answer 12

3rd line Anti-HTN. Also used in treatment of BPH.

Question 13

Clonidine

Answer 13

Anti-HTN, (Watch out for brady), rebound HTN after discontinuation is a big problem.

Question 14

Spironolactone

Answer 14

Anti-HTN.

Question 15

Hydralazine

Answer 15

Used for HTN during preg, pre-ecclampsia, usually in combo w/ beta blockers to prevent reflex SNS. Tox: excessive dilation – flushing, sweating, hypotension, angina, palps, Lupus-like.

Question 16

Sodium nitroprusside

Answer 16

Drug of choice for HTN emergency! Rapid onset, IV. Use beta blockers before withdrawing infusion.

Question 17

Nitrates

Answer 17

Anti-HTN. Anti-angina.

Question 18

Propranolol

Answer 18

Severe HTN

Question 19

Metoprolol

Answer 19

Severe HTN

Question 20

Carvedilol

Answer 20

Systolic dysfunction heart failure.

Question 21

Epinephrine

Answer 21

Commonly used after cardiopulmonary bypass or in resuscitations to restart cardiac contractions (rarely used in CHF)

Question 22

Norepinephrine

Answer 22

Hypotension, Distributive Shock

Question 23

Dopamine

Answer 23

CHF, Hypotension, Bradycardia (med doses), Shock (med and high doses). Side effects: tachy, HTN, vomiting.

Question 24

Dobutamine

Answer 24

Can diagnose CAD, simulate exercise.

Question 25

Isoproterenol

Answer 25

Post-transplant to drive heart rate and decrease PVR. Can also be used to increase SA node rate if bradycardia is present.

Question 26

Phenylephrine

Answer 26

Hypotension, Distributive Shock

Question 27

Milrinone

Answer 27

CHF, CAD. Risk of hypotension and shock.

Question 28

Digoxin

Answer 28

Atrial arrhythmias (fib), CHF classes II-IV, not great for acute MI (increases cardiac metabolic demand). Drug interactions common - low dose very important. Contra - premature vent contractions, v-tach, AV block, bradycardia, SA node disease w/out pacemaker, uncontrolled hypokalemia, right sided heart failure, hypertrophic myopathy, WPW.

Question 29

Atropine

Answer 29

Stops vagal reaction, restores AV conduction in disorders with prolonged AV nodal refractoriness (such as inferior MI or dig toxicity).

Question 30

Acetylcholine

Answer 30

Not used clinically.

Question 31

Edrophonium

Answer 31

IV bolus, lasts for 30 seconds, used to treat break SVTs due to AV nodal reentry or AV bypass tract. Used to diagnose SVTs.

Question 32

Physostigmine

Answer 32

No active clinical use.

Question 33

Neostigmine

Answer 33

No active clinical use.

Question 34

Anything-astatin

Answer 34

Hypercholesterolemia. 1st line therapy for LDL reduction, very effective. Can cause rhabdomyolysis, myalgia, myopathy.

Question 35

Fibrates

Answer 35

HyperTGemia to prevent pancreatitis. Adjunct to statins.

Question 36

Niacin

Answer 36

Hyperlipidemia.

Question 37

Cholesterol absorption inhibitor

Answer 37

Used with statins or with statin-intolerant patients.

Question 38

Bile acid sequestrant

Answer 38

Add to statin therapy, or with statin-intolerant patients.

Question 39

Aspirin

Answer 39

NSTEMI, STEMI

Question 40

Clopidogrel

Answer 40

NSTEMI, STEMI (bleeding risk)

Question 41

Glycoprotein Iib/IIIa inhibitor

Answer 41

NSTEMI, STEMI (bleeding risk)

Question 42

t-PA, streptokinase, urokinase

Answer 42

STEMI (bleeding risk)

Question 43

Heparin

Answer 43

NSTEMI, STEMI (bleeding risk)

Question 44

Procainamide/Quinidine

Answer 44

V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)

Question 45

Lidocaine

Answer 45

V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)

Question 46

Flecainide

Answer 46

V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)

Question 47

Amiodarone

Answer 47

V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)

Question 48

Sotalol

Answer 48

V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)

Question 49

Adenosine

Answer 49

Reentry arrhythmias that require AV node: AVNRT, AVRT, WPW. Contra: 2nd, 3rd degree heart block, sick sinus, long QT, severe hypotension