Cardiovascular 1 Flashcards Preview

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Flashcards in Cardiovascular 1 Deck (162):
1

Drug class for Isosorbide dinitrate

vasodilator: nitrates

2

MoA for Isosorbide dinitrate

smooth muscle dilation of arteries & veins

3

Indications for Isosorbide dinitrate

frequent stable angina, CHF

4

SE/ADRs for Isosorbide dinitrate

HA, hypotension, tachycardia, rebound HTN

5

Contra-indications for Isosorbide dinitrate

hypersensitivity
head trauma
severe dehydration

6

Dx-Dx interactions for Isosorbide dinitrate

PDE-5 inhibitors

7

Monitoring for Isosorbide dinitrate

chest pain, BP

8

What is an off label use for Isosorbide denitrate?

esophageal spastic disorders

9

Drug class for Nitroglycerin

vasodilators: nitrates

10

MoA for Nitroglycerin

smooth muscle dilation of arteries & veins

11

Indications for Nitroglycerin

angina, CHF

12

SE/ADRs for Nitroglycerin

HA
hypotension
tachycardia

13

Contra-indications for Nitroglycerin

hypersensitivity
head trauma
severe dehydration

14

Dx-Dx interactions for Nitroglycerin

PDE-5 inhibitors

15

Monitoring for Nitroglycerin

chest pain

16

Drug class for Dihydropyridine: amlodipine

vasodilator: calcium channel blockers

17

MoA for Dihydropyridine: amlodipine

vasodilation due to blocking calcium channels in vascular smooth muscle & myocardium

18

Indications for Dihydropyridine: amlodipine

angina (chronic stable & vasospastic), HTN

19

SE/ADRs for Dihydropyridine: amlodipine

nausea, palpitations
peripheral edema
elderly-hypotension

20

Contra-indications for Dihydropyridine: amlodipine

hypersensitivity

21

Dx-Dx interaction for Dihydropyridine: amlodipine

grapefruit juice

22

Monitoring for Dihydropyridine: amlodipine

BP, chest pain

23

PG category for Dihydropyridine: amlodipine

PG C, but avoid

24

Drug class for Dihydropyridine: nifedipine

vasodilator: calcium channel blockers

25

MoA for Dihydropyridine: nifedipine

vasodilation due to blocking calcium channels in vascular smooth muscle & myocardium

26

Indications for Dihydropyridine: nifedipine

angina (chronic stable & vasospastic), HTN

27

SE/ADRs for Dihydropyridine: nifedipine

nausea, palpitations
peripheral edema
elderly-hypotension

28

Contra-indications for Dihydropyridine: nifedipine

hypersensitivity

29

Dx-Dx interactions for Dihydropyridine: nifedipine

grapefruit juice

30

Monitoring for Dihydropyridine: nifedipine

BP, chest pain

31

Drug class for Nondihydropuridine: diltiazem

vasodilator: calcium channel blockers

32

MoA for Nondihydropuridine: diltiazem

dilate coronary arteries & decrease myocardial oxygen demands

33

Indications for Nondihydropuridine: diltiazem

angina, HTN, A fib, A flutter, PSVT

34

SE/ADRs for Nondihydropuridine: diltiazem

edema, HA, dyspepsia

35

Contra-indications for Nondihydropuridine: diltiazem

bradycardia, SSS if no pacer

36

Dx-Dx interactions for Nondihydropuridine: diltiazem

grapefruit juice

37

Monitoring for Nondihydropuridine: diltiazem

BP, chest pain, LFTs

38

Drug class for Nondihydropuridine: verapamil

vasodilator: calcium channel blocker

39

MoA for Nondihydropuridine: verapamil

dilate coronary arteries & decrease myocardial oxygen demands

40

Indications for Nondihydropuridine: verapamil

angina, HTN, PSVT, A fib, A flutter

41

SE/ADRs for Nondihydropuridine: verapamil

HA, gingival hyperplasia, constipation, fatigue

42

Contra-indications for Nondihydropuridine: verapamil

bradycardia, SSS if not pacer

43

Dx-Dx interactions for Nondihydropuridine: verapamil

grapefruit juice

44

Monitoring for Nondihydropuridine: verapamil

chest pain, BP, LFTs

45

Drug class for Propranolol

beta blocks: nonselective (B1 & B2)

46

MoA for Propranolol

adrenergic B1 & B2 receptor inhibitor; reduction in myocardial oxygen demand

47

Indications for Propranolol

angina, HTN, tachy arrhythmias, essential tremor, migraine PX, anxiety

48

SE/ADRs for Propranolol

fatigue, sleep, disturbance, depression

49

Contra-indications for Propranolol

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression, bronchospasm

50

Dx-Dx interactions for Propranolol

ethanol (may increase or decrease concentration)

51

Monitoring for Propranolol

BP, chest pain, HR, LFTs

52

Drug class for Metoprolol

beta blockers: selective (B1)

53

MoA for Metoprolol

selective B1 adrenergic receptor inhibitor

54

Indications for Metoprolol

angina, HTN, hemodynamically stable MI

55

SE/ADRs for Metoprolol

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

56

Contra-indications for Metoprolol

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression

57

Dx-Dx interactions for Metoprolol

multiple

58

Monitoring for Metoprolol

BP, HR, LFTs

59

Drug class for Atenolol

beta blockers: selective (B1)

60

MoA for Atenolol

selective B1 adrenergic receptor inhibitor

61

Indications for Atenolol

angina, HTN, hemodynamically stable post MI

62

SE/ADRs for Atenolol

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN

63

Contra-indications for Atenolol

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression

64

Dx-Dx interactions for Atenolol

multiple

65

Monitoring for Atenolol

BP, HR, eGFR

66

Drug class for Carvedilol

beta blockers: nonselective (B1, B2, & Alpha 1)

67

MoA for Carvedilol

mixed alpha, beta receptor inhibition

68

Indications for Carvedilol

angina (off label), HTN, stable HF, stable post-MI

69

SE/ADRs for Carvedilol

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

70

Contra-indications for Carvedilol

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression, bronchospasm, severe liver failure

71

Dx-Dx interactions for Carvedilol

multiple

72

Monitoring for Carvedilol

BP, HR, eGFR, LFTs

73

Drug class for Ranolazine

anti-anginal: miscellaneous

74

MoA for Ranolazine

inhibits inward Na channel in ischemic cardiac myocytes during depolarization thereby reducing Na/Ca exchange which relaxes cardiac muscle & reduces myocyte oxygen consumption

75

Indications for Ranolazine

chronic angina

76

SE/ADRs for Ranolazine

constipation, HA, hyperhidrosis, bradycarida, hypotensions, QT prolongation

77

Contra-indications for Ranolazine

-any degree of hepatic cirrhosis
-concurrent strong CYP3A4 inhibitors/inducers
-not for acute angina

78

Dx-Dx interactions for Ranolazine

-CYP3A4 inhibitors (diltiazem, erythromycin, verpamil)
-P-glycoprotein inhibitors (cyclosporin)
-w/ Simvastatin max dose is 20mg/day
-grapefruit juice & St John's wort

79

Monitoring for Ranolazine

BP, HR, eGFR, LFTs

80

PG category for Ranolazine

PG C

81

Drug class for Aspirin

anti-platelet drug: COX-1 inhibitor

82

MoA for Aspirin

irreversible inactivation (via acetylation) of COX-1- inhibits synthesis of thromboxane A2, prevents platelet aggregation & vasoconstriction by thromboxane A2

83

Indications for Aspirin

secondary prophylaxis for MI, CVA

84

SE/ADRs for Aspirin

30% gastritis, dyspepsia, bleeding, tinnitus (high dose)

85

Contra-indications for Aspirin

hypersensitivity, nasal polyposis + bronchospasm

86

Dx-Dx interactions for Aspirin

other anticoagulants, NSAIDs

87

Monitoring for Aspirin

H&H, melana

88

Drug class for Clopidogrel

platelet ADP inhibitor

89

MoA for Clopidogrel

irreversibly blocks ADP receptor on platelets preventing platelet/fibrinogen binding & platelet aggregation

90

Indications for Clopidogrel

secondary prevention AMI, CVA, PAD

91

SE/ADRs for Clopidogrel

27% gastritis, abd pain, dyspepsia; thrombocytopenia, leukopenia (rare)

92

Contra-indications for Clopidogrel

active bleeding, hypersensitivity

93

Dx-Dx interactions for Clopidogrel

-other anti platelet or anticoags (increase)
-atorvastatin (decrease)
-macrolide abx (decrease)
-ginko biloba (increase)

94

Monitoring for Clopidogrel

H&H

95

PG category for Clopidogrel

no impact on PG metabolism

96

Drug class for Furosemide

diuretics: loop diuretics

97

MoA for Furosemide

inhibits Na/K/2Cl symporter in TAL of loop & distal tubule

98

Indications for Furosemide

edema secondary to CHF, renal failure, liver failure

99

SE/ADRs for Furosemide

hypotension, dehydration, hyperglycemia, incr then dec serum uric acid, electrolyte abnormalities, cholestatic jaundice

100

Contra-indications for Furosemide

hypersensitivity to sulfa

101

Dx-Dx interactions for Furosemide

increase impact of anti-HTN, lithium
corticosteroids increase Furosemide impact

102

Monitoring for Furosemide

serum electrolytes, BUN, CrCl

103

Drug class for Torsemide

diuretics: loop diuretics

104

MoA for Torsemide

inhibits Na/K/2Cl symporter in TAL of loop & distal tubule

105

Indications for Torsemide

edema of cardiac, renal, hepatic failure
HTN

106

SE/ADRs for Torsemide

constipation, diarrhea

107

Contra-indiciations for Torsemide

anuria, sulfa sensitivity

108

Dx-Dx interactions for Torsemide

other K+ wasting drugs

109

Monitoring for Torsemide

serum K, BP, daily wt, eGFR

110

PG Category for Torsemide

avoid

111

Drug class for Ethacrynic acid

diuretics: loop diuretics

112

MoA for Ethacrynic acid

inhibits Na/K/2Cl symporter in TAL of loop & distal tubule

113

Indications for Ethacrynic acid

edema secondary to CHF, renal failure, liver failure

114

SE/ADRs for Ethacrynic acid

hypotension, dehydration, hyperglycemia, incr then dec serum uric acid, electrolyte abnormalities, jaundice

115

Contra-indications for Ethacrynic acid

hypersensitivity, hx of severe water diarrhea w/ ethacrynic acid

116

Dx-Dx interactions for Ethacrynic acid

increase impact of anti-HTN, lithium
corticosteroids increase Furosemide impact

117

Monitoring to Ethacrynic acid

serum electrolytes, BUN, CrCl, BP

118

PG Category for Ethacrynic acid

PG B

119

Drug class for Spironolactone

diuretics: aldosterone antagonists

120

MoA for Spironolactone

aldosterone receptor antagonist in distal rental tubule & blood vessels

121

Indications for Spironolactone

excessive aldosterone excretion or heart failure, HTN, hyokalemia, liver cirrhosis w/ edema or ascites, nephrotic syndrome

122

SE/ADRs for Spironolactone

ataxia, SJS, gynecomastia, amenorrhea, agranulocytosis, hepatotoxicity

123

Contra-indications for Spironolactone

anuria, acute renal insufficiency, hyperkalemia, Addison's disease

124

Dx-Dx interactions for Spironolactone

multiple

125

Monitoring for Spironolactone

serum K, eGFR, BP, daily wt, gynecomastia

126

PG Category for Spironolactone

avoid

127

Drug class for Eplerenone

diuretic: aldosterone antagonist

128

MoA for Eplerenone

more specific aldosterone receptor antagonist is kidney, heart, blood vessels, brain; reduces vascular & cardiac fibrosis

129

Indications for Eplerenone

excessive aldosterone excretion or heart failure, HTN, hypokalemia, liver cirrhosis w/ edema or ascites, nephrotic syndrome

130

Drug class for Captopril

vasodilators: ACE inhibitor

131

MoA for Captopril

competitive inhibitor of ACE prevention conversion of AT1 to AT2 decreasing vasoconstriction by A2 & decreases aldosterone secretion

132

Indications for Captopril

HTN, heart failure, left ventricular dysfunction after MI, diabetic neuropathy

133

Drug class for Lisinopril

vasodilators: ACE inhibitor

134

MoA for Lisinopril

competitive inhibitor of ACE prevention conversion of AT1 to AT2 decreasing vasoconstriction by A2 & decreases aldosterone secretion

135

Indications for Lisinopril

heart failure, left ventricular dysfunction

136

Drug class for Fosinopril

vasodilator: ACE inhibitor

137

MoA for Fosinopril

competitive inhibitor of ACE prevention conversion of AT1 to AT2 decreasing vasoconstriction by A2 & decreases aldosterone secretion

138

Indications for Fosinopril

heart failure, left ventricular dysfunction

139

Drug class for Losartan

vasodilators: angiotensin II receptor blockers (ARBs)

140

MoA for Losartan

selectively & competitively blocks AT1 & AT2 receptors

141

Indications for Losartan

HTN, diabetic neuropathy in T2DM, stroke risk reduction in HTN, LVH

142

Drug class for Hydralazine & Isosorbide dinitrate

direct-acting vasodilator

143

MoA for Hydralazine & Isosorbide dinitrate

direct acting ateriolar vasodilator

144

Indications for Hydralazine & Isosorbide dinitrate

adjunctive tx in HF, esp in Afro-Americans

145

Drug class for Digoxin

positive inotropic agents: cardiac glycosides

146

MoA for Digoxin

inhibits Na/K ATPase pump in myocardial cells promoting influx Ca leading to increased contractility; also direct suppressor of AV node decreasing ventricular rate

147

Indications for Digoxin

mild to moderate HF; A fib rate control

148

Drug class for Dobutamine

positive inotropic agents: B-agonists

149

MoA for Dobutamine

stimulates B1 adrenergic receptors increasing cardiac contractility & HR; little impact on B2 or alpha receptors

150

Indications for Dobutamine

short-term management of cardiac decompensation

151

Drug class for Milrinone

positive inotropic agents: PDE inhibitors

152

MoA for Milrinone

selective PDE inhibitor in cardiac & vascular tissue producing vasodilation & inotropic effects w/ little chronotropic activity

153

Indications for Milrinone

short-term IV therapy of acutely decompensated HF

154

Drug class for Nesiritide

miscellaneous: recombinant BNP

155

MoA for Nesiritide

increases intracellular GMP in vascular smooth muscle cells & endothelium resulting in smooth muscle relaxation reducing pulmonary capillary wedge pressure & systemic arterial pressure

156

Indications for Nesiritide

acutely decompensated HF w/ dyspnea at rest or w/ minimal activity

157

Drug class for Aliskiren

miscellaneous: direct renin inhibitor

158

MoA for Aliskiren

direct renin inhibitor prevention conversion of angiotensinogen to AT1 which reduces conversion to A2 producing arteriolar vasodilation

159

Indications for Aliskiren

HTN

160

Drug class for Ivabradine

miscellaneous: SA node If channel inhibitor

161

MoA for Ivabradine

selective & specific inhibition of If within SA node & prolonging diastolic depolarization & reducing HR

162

Indications for Ivabradine

-stable HR w/ EF less than 35%, in sinus rhythm w/ HR greater than 70, & are max tolerated doses on B-blocker or unable to take B-blocker