Cardiovascular

Question 1

How is the INtrinsic thrombus pathway activated?

Answer 1

Foreign body or collagen

Question 2

How is the EXTRINSIC thrombus pathway activated?

Answer 2

Injury to endothelial tissue, exposing tissue factor to blood

Question 3

How is the extrinsic thrombus pathway activated?

Answer 3

Injury to endothelial tissue, exposing tissue factor to blood

Question 4

What does plasminogen do Once a clot forms?

Answer 4

Becomes plasmin, which breaks down fibrin and fibrinogen to BREAK the CLOT/thrombus

Question 5

What types of drugs prevent blood clots?

Answer 5

Blood thinners: antiplatelets anticoagulants

Clot busters: thrombol

Question 6

Define blood pressure & it’s major factors

Answer 6

BP=CO×PVR

Affected by blood volume, heart contractility, heart rate & blood vessels diameter

Question 7

Side effects of hydralazine

Answer 7

Peripheral edema 
Headache
Flushing
Reflex tachycardia 
Orthostatic HYPOtension
Drug induced lupus/like syndrome
Conjunctivitis & tearing

Question 8

How do diuretics help decrease BP

Answer 8

Help body rid Na (&H2O), increase urine output & cardiac output

Question 9

What are the 4 main types of diuretics

Answer 9

Thiazide
Loop
Potassium Sparing
Osmotic

Question 10

3 Thiazide diuretics

Answer 10

Hydrochlorothiazide
Chlorothiazide
Chlorthalidone

Question 11

Side effects of thiazide diuretics

Answer 11

Hypokalemia
Hyponatremia
Metabolic alkalosis

Question 12

The most effective (loop) diuretic. Why? What is it common for?

Answer 12

Furosemide, blocks more sodium reabsorption.

common to improve edema seen in congestive heart failure

Question 13

Side effects of loop diuretics

Answer 13

Hypokalemia
Hyponatremia
Metabolic alkalosis

Question 14

What drug interaction causes an idiosyncratic reaction in the eyes?

Answer 14

Thiazide & loop diuretics

Question 15

(2)common potassium sparing diuretics

Answer 15

Spironolactone

Triamterene

Question 16

Side effects of spironolactone & triamterene

Answer 16

Hyperkalemia
Hyponitremia
Metabolic acidosis

Question 17

Common osmotic diuretic

Answer 17

Mannitol

Question 18

Mannitol MOA

What is its IV use?

Answer 18

Filtered at glomerulus, not reabsorbed in tubules, brings in water all throughout to lower blood volume
IV- reduces cerebral edema & eye pressure

Question 19

Mannitol side effect

Answer 19

Excessive plasma volume expansion
If given too fast/with 2 much IV fluid, draws in too much water into plasma which leads to heart failure & pulmonary congestion
Contraindicated in heart failure & pulmonary edema

Question 20

Side effects of all diuretics

Answer 20

Dehydration/dizziness leads to hypotension & fainting
Dry eyes
Electrolyte imbalances & muscle cramps
Frequent urination

Question 21

Which classes of drugs inhibit RAAS?

Answer 21

Angiotensin Converting Enzyme (ACE) Inhibitors

Angiotensin Receptor Blockers (ARBs)

Question 22

What is the function of the Renin-Angiotensin-Aldpsterone System?

Answer 22

Increases BP by sensing low BP, kidneys release renin into bloodstream, which converts angiotensinogen from liver –> Angiotensin I +ACE->Angiotensin II

Question 23

How does Angiotensin II increase BP?

Answer 23

2 ways

Question 24

How do drugs inhibit effects of angiotensin II

Answer 24

Inhibit ACE or angiotensin II from binding to its receptors

Question 25

What is the function of ACE?

Answer 25

Aids conversion of Angiotensin 1-->2 | Breaks down bradykinin, a vasodilator

Question 26

Name 5 common ACE inhibitors | -pril

Answer 26

``` Quinapril Captopril Benazepril Lisinopril Enalapril Any w/suffix -pril ```

Question 27

Name 5 common ACE inhibitors

Answer 27

``` Quinapril Captopril Benazepril Lisinopril Enalapril Any w/suffix -pril ```

Question 28

Adverse effects of ACE inhibitors & ARBs | Why?

Answer 28

Hyperkalemia | Angioedema

Question 29

What is a unique side effect of ACE inhibitors? | Due to what?

Answer 29

Dry Cough | Due to increased bradykinin in lungs

Question 30

4 Common antihypertensive drug combinations

Answer 30

Hydrochlorothiazide-triamterene Metoprolol-hydrochlorothiazide Hydrochlorothiazide-lisinopril Atenolol-chlorthalidone

Question 31

What are 3 classes of drugs for angina?

Answer 31

B-blockers | Non-dihydropyridine Ca-channel blockerorhanic Organic nitrates aka nitrodilators

Question 32

What's the MOA of B-blockers and non-dihydropyridine Ca-channel blockers for angina?

Answer 32

Decrease heart rate/contractility--> reduce work of heart & its oxygen demand

Question 33

What's the MOA of organic nitrates/nitrodilators for angina?

Answer 33

Strong vasodilator, improve coronary blood flow by reversing coronary artery vasospasm

Question 34

Distinguish between sublingual & topical nitroglycerin.

Answer 34

Sublingual is for acute angina | Topical/transdermal patch is to prevent it

Question 35

What's the MOA of nitroglycerin? | (It is an organic nitrate "nitrodilators"

Answer 35

Becomes nitric oxide-> activates cGMP in blood vessel wall-> blocks Ca entry --> vasodilation Plus: In coronary arteries this increases O2 delivery to <3

Question 36

Common Side effects of all diuretcs

Answer 36

Dry eyes | Frequent urination, dehydration, electrolyte imbalances, muscle cramps, hyperkalemia & hyponatremia

Question 37

3 thiazide diuretics for hypertension

Answer 37

Hydrochlorothiazide (HCTZ) Chlorothiazide Chlorthalidone

Question 38

FUROSEMIDE

Answer 38

Loop diuretic for hypertension

Question 39

2 POTASSIUM SPARING DIURETICS

Answer 39

Spironolactone | Triamterene

Question 40

Classes of HTN drugs that inhibit RAAS

Answer 40

``` ACE inhibitors (-pril) ARBs (-sartan) ```

Question 41

Common side effects of RAAS inhibitors (ACEI & ARBS)

Answer 41

Hyperkalemia | Angioedema

Question 42

Alpha-1 blockers for HTN | 3, ending -osin

Answer 42

Doxazosin Terazosin Prazosin

Question 43

How do alpha-1 blockers lower blood pressure? (MOA)

Answer 43

Inhibit a1 receptors on blood vessels causing vasodilation

Question 44

Side effects of all alpha-1 blockers

Answer 44

``` Intraoperative floppy iris syndrome Reflex tachycardia Orthostatic hypotension Headache Flushing peripheral edema ```

Question 45

What is CLONIDINE? | Class, MOA, side effects

Answer 45

Centrally acting sympathetic agonist for HTN Stimulates alpha2 receptors in 🧠 decreasing sym. outflow to ❤️ (decrease ❤️ rate/contractions, & blood vessels (vasodilation) Bradycardia, impotence/erectile dysfunction, tiredness/ sedation, lower IOP Sudden discontinuation can cause severe rebound hypertension

Question 46

Common MOA of all diuretucs

Answer 46

Increase excretion of Na/H2O to lower blood volume thereby lowering BP

Question 47

Side effects of nitroglycerine (for angina)

Answer 47

peripheral edema, headache, flushing, reflex tachycardia, orthostatic hypotension

Question 48

Name (5) NONSELECTIVE B-blockers for hypertension and angina (B1,B2 inhibition)

Answer 48

Labetalol & carvedilol which also have a1 blocking effects, and propranolol

Question 49

Name (2) SELECTIVE B-blockers for hypertension and angina

Answer 49

Metoprolol & atenolol

Question 50

Side effects of ALL B-blockers

Answer 50

Bradycardia, fatigue, depression, impotence, may mask hypoglycemia symptoms, decrease IOP (aq. humor production)

Question 51

Unique side effect of NONSELECTUVE B-blockers

Answer 51

Bronchoconstriction, not used in asthma/COPD

Question 52

Name the direct acting vasodilator & its MOA

Answer 52

hydralazine; MOA unknown, unpredictable actions

Question 53

Name (2) non-dihydropyridine calcium channel blockers for ANGINA & HTN

Answer 53

diltiazem, verapamil

Question 54

MOA of non-dihydropyridine CCBs

Answer 54

inhibit L-type Ca-channels in cardiac myocytes & SA/AV node of heart, reducing heart rate

Question 55

Side effects of diltiazem & verapamil (NCCBs)

Answer 55

bradycardia, riskier with B-blocker

Question 56

classes of drugs used for angina

Answer 56

B-blockers, , Non-dihydropyridine CCBs, and 1 nitrodilator