Cardiovascular Drugs Flashcards Preview

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Flashcards in Cardiovascular Drugs Deck (95):
0

Target BP in hypertensives with no comorbidities?
With DM?
With CKD?

No comorbidities: <125/75

1

Inhibits Na/Cl transporter in DCT, increasing reabsorption
Drug for HPN, can decrease BP by 10-15 mmHg
SE: sulfa allergy

Hydrochlorothiazide
(Chlorthalidone, Indapamide, Metolazone)

2

Toxicities of HCTZ

Hyper GLUC
HyperGLYCEMIA
HyperLIPIDEMIA
HyperURICEMIA
HyperCALCEMIA

3

Identify Sulfa drugs:

Allergies to these drugs can cause fever, UTI, SJS, hemolytic anemia, thrombocytopenia, agranulocytosis, urticaria

Popular FACTSSS

Probenecid
Furosemide
Acetazolamide
Celecoxib
Thiazides
Sulfonamide
Sulfasalazine
Sulfonylureas

4

Inhibits Na/K/2Cl transporter in TAL of Loop of henle
Causes powerful diuresis and increase Ca excretion
Drug for HPN, Pulmonary edema, Hypercalcemia, ARF
SE: Ototoxicity, Dehydration, Sulfa allergy

Furosemide
(Bumetanide, Torsemide, Ethacrynic Acid)

5

Ganglion blocker (nonselective)
Drug previously used for HPN (obsolete)
SE: postural hypotension

Hexamethonium

6

Nerve terminal blocker (NE, Dopa, Serotonin)
Drug previously used for HPN (obsolete)
Irreversible Vesicular Monoamine Transporter (VMAT) blocker
SE: rebound suicide

Reserpine

(Guanethidine)

7

Drugs for BP control in Pheochromocytoma

Phenoxybenzamine
Phentolamine
Labetalol
Carvedilol

8

Oral Vasodilator
Alters Ca2+ metabolism
Relaxes ARTERIOLAR smooth muscle, decreases Afterload
Drug for HPN, Pre-eclampsia
SE: reflex tachycardia, Drug induced Lupus

Hydralazine

9

Drugs that can cause lupus

Hydralazine
Isoniazid
Procainamide
Penicillamine

HIPP to have Lupus
Test with Anti-histone

10

Vasodilator
Opens K channels in Vascular smooth muscle, causing hyperpolarization, muscle relaxation and vasodilation (decreased afterload)
Drug for HPN and ALOPECIA
SE: Reflex tachycardia, Hypertrichosis

Minoxidil

11

Non-dihydropyridine CCB
blocks voltage gated L-type calcium channels (cardiac>vascular)
Drugs for SVT (in OPD), Arrhythmia
SE: GINGIVAL HYPERPLASIA, heart failure, AV Block, Sinus node depression

Verapamil

12

Non-dihydropyridine CCB
blocks voltage gated L-type calcium channels (cardiac>vascular)
Drugs for SVT (in OPD), Arrhythmia
SE: REYNAUD'S PHENOMENON, heart failure, AV Block, Sinus node depression

Diltiazem

13

Dihydropyridine CCB
blocks voltage gated L-type calcium channels (vascular>cardiac)
No cardiodepressant effects
Drugs for HPN, angina
SE: pre-tibial edema, flushing, gingival hyperplasia

Nifedipine
(Amlodipine, Felodipine, Nicardipine, Nisoldipine, Israpidine)

14

Vasodilator
Activates guanylyl cyclase, inc cGMP, NO release
Decreases both preload and afterload
Drug for Hypertensive emergency
SE: Cyanide toxicity (to Thiocyanate via Rhodanase)

Nitroprusside

15

Dopamine 1 agonist
Increases renal blood flow, by ARTERIOLAR vasodilation of afferent and efferent arterioles
Drug for hypertensive emergency
SE: Hypokalemia

Fenoldopam

16

ACE inhibitor
Inhibits ACE and formation of Angiotensin II
Decreases Aldosterone secretion
Drug for HPN, Heart failure, Post-MI, DM Nephropathy
SE: COUGH, Hyperkalemia, angioedema
Contraindicated in bilateral Renal Artery Stenosis

Captopril
(Enalapril, Benazepril, Fosinopril, Lisinopril, Quinapril, Ramipril, Trandolapril)

17

Slows ventricular remodeling and increases survival in heart failure
Delays progression of DM nephropathy (micro to macroalbuminuria)
RENOPROTECTIVE

ACE Inhibitors
ARBs

18

Drug class that is essential for Heart Failure

Diuretics

19

Drug class that is essential for MI

Beta blocker

20

Drug class that is essential for Diabetes

ACE Inhibitor
Or ARB?

21

Blocks Angiotensin I receptors in vascular smooth muscle and adrenal cortex, dec Aldosterone secretion
Drug for HPN, Heart failure, DM Nephropathy
SE: Teratogen, Hyperkalemia
Given in pxs with ACEi intolerance

Losartan
(Candesartan, Valsartan, Irbesartan, Eprosartan, Telmisartan)

22

Pathophysiology of hyperkalemia in ACE I and ARBs

Aldosterone inc K secretion, its inhibition leads to hyperkalemia

23

Renin antagonist
Prevents conversion of Angiotensinogen to Angiotensin I
Drug for HPN

Aliskiren

24

Severe hypertension with rapidly progressing end organ damage

Disease?

Malignant hypertension

25

Target BP for Malignant HPN

Lower BP to 140-160/90-110
Any BP lower than this may cause hypoperfusion of organs

26

Drugs for Malignant HPN

Vasodilators (Nitroprusside, Fenoldopam, or Diazoxide)
Diuretics
Beta blockers

27

Ultra short acting nitrate
NO release, inc cGMP
Drug for Cyanide poisoning
SE: Methemoglobinemia

Amyl Nitrite

28

Cyanide affects which portion of ETC?

Complex IV: Cytochrome Oxidase

29

Antidote for Cyanide Poisoning

Inhaled Amyl Nitrite
IV Sodium Nitrite
IV Sodium Thiosulfate

30

Disease caused by occupational exposure to nitrates

Monday Disease

31

Short acting nitrate with shortest onset of action
NO release, inc cGMP, relaxes smooth muscle (esp. Veins)
Drug for Angina, ACS
SE: Headache, Tolerance, reflex tachycardia, orthostatic hypotension

Nitroglycerin
(Isosorbide dinitrate, Isosorbide mononitrate)

31

Which does not bypass first pass effect?
Nitroglycerin
ISDN
ISMN

ISMN

32

Pathophysiology of throbbing headaches in pxs taking nitroglycerin

Menigeal artery vasodilation

33

Drugs that cause gingival hyperplasia

Verapamil
Cyclosporine (Calcineurin Inhibitor)
Nifedipine
Phenytoin

Very Chaka NgiPin

34

Cardiovascular drug that causes this paradoxic effect:
reflex increase in HR and contractility

Nitrates alone

35

Cardiovascular drug that causes this paradoxic effect:
increase in End Diastolic Pressure and Increase in Ejection Time

Beta blocker or CCB Alone

36

Cardiovascular drugs that causes this paradoxic effect:
decreases HR, Arterial Pressure, End Diastolic Pressure

Nitrate + Beta blocker OR CCB

37

Decreases ventricular remodeling (cardioprotective)
First line drugs for chronic heart failure

ARBs
ACEI

38

Drugs that reduce progression of Chronic Heart Failure

Beta Blockers
(Carvedilol, Labetalol, Metoprolol)

Not of value in Acute heart failure

39

Drugs that inc cAMP, inc intracellular Ca2+, vasodilation
Not for use in chronic failure as they increase morbidity and mortality

Phosphodiesterase inhibitors
(Inamrinone, Milrinone)

40

Drug with no value in CHF

CCB

41

Drugs that improve survival in heart failure

ABA! Buhay ka pa!
ACE Inhibitors
Beta blockers
ARBs

42

Class_____ Antiarrhythmics:
Na channel blockers

1

43

Class_____ Antiarrhythmics:
Beta-adrenoreceptor blockers

2

44

Class_____ Antiarrhythmics:
K channel blockers

3

45

Class_____ Antiarrhythmics:
Ca channel blockers

4

46

Class I__ Antiarrhythmic:
Prolongs AP duration

A

47

Class I__ Antiarrhythmic:
Shortens AP duration

B

48

Class I__ Antiarrhythmic:
No effect on AP duration

C

49

Identify Class IA Antiarrhythmic drugs

QUIN PROtects DIS(o)PYRAMID
Quinidine
Procainamide
Disopyramide

50

Class IA antiarrhythmic
Drug for Atrial/ventricular arrhythmia esp post MI
SE: lupus-like syndrome

Procainamide

HIPP

51

Class IA Antiarrhythmic
SE: marked anti-muscarinic effects, heart failure

Disopyramide

52

Class IA Antiarrhythmic
Drug for malaria
SE: Torsades, Chinconism (headache, vertigo, tinnitus), Autoimmune rxns
Reduces Digoxin clearance

Quinidine

53

Triad of:
Headache
Vertigo
Tinnitus
Seen in pxs taking Quinidine

Cinchonism

54

Tx for class IA antiarrhythmic induced arrhythmia

Sodium Lactate

55

Most selective of ischemic tissues among class I antiarrhythmics
Little effect on normal cardiac cells, little effect on ECG

IB

56

Class IB Antiarrhythmics
DOC for ventricular arrhythmia post MI and Digoxin induced arrhythmia
SE: Seizures, Agranulocytosis (in Tocainide)

Lidocaine
(Melexitine, Tocainide, Phenytoin)

57

Drugs that cause agranulocytosis

COCO CAPIT Pa!
Cotrimoxazole
Colchicine
Clozapine
Aminopyrine
PTU
Indomethacin
Tocainide
Phenylbutazone

58

Depressant of Na current
Can slow conduction velocity in atrium and ventricle
Drug for refractory arrhythmia
SE: increased arrhythmia
Contraindicated for Post MI

Flecainide
(Propafenone, Encainide, Moricizine)

C: PROject & FLECs (Flex), Every Morning

59

Which Class I antiarrhythmic?
All types of arrhythmia
Arrhythmia in acute MI
Procainamide and Amiodarone for WPW

Class IA

60

Which Class I antiarrhythmic?
Acute Ventricular arrhythmia, esp post MI
Digitalis-induced arrhythmia

Class IB

61

Which Class I antiarrhythmic?
Refractory Arrhythmia

Class IC

62

Identify which class of antiarrhythmic drugs:
Prolonged PR interval
Acts on Phase 4
Cardiac beta blockade
Reduction in cAMp

Class II

63

Class II antiarrhythmic drug
Drug for post MI prophylaxis vs sudden death, thyrotoxicosis
SE: bronchospasm, AV block, Hypotension
Reduces progression of CHF and decrease incidence of potentially fatal arrhythmia

Propranolol
(Metoprolol, Timolol)

64

Class II antiarrhythmic
Selective beta 1 blocker
Drug for acute perioperative and thyrotoxic arrhythmia, SVT
SE: bronchospasm

Esmolol

65

Identify the Beta Blocker:
Nonselective

Propranolol
Timolol

66

Identify the Beta Blocker:
Beta1 selective

Acebutolol
Betaxolol
Esmolol
Atenolol
Metoprolol

A BEAM

67

Identify the Beta Blocker:
Partial agonist

Pindolol
Acebutolol

68

Identify the Beta Blocker:
Lacking local anesthetic effect

Timolol
Betaxolol

69

Identify the Beta Blocker:
Low lipid solubility

Atenolol

70

Identify the Beta Blocker:
Shortest acting

Esmolol

71

Identify the Beta Blocker:
Longest acting

Nadolol

72

Identify the Beta Blocker:
Combined alpha and beta blockade

Carvedilol
Labetalol

73

Identify which class of antiarrhythmic drugs:
Acts on Phase 3
Increase Effective Refractory Period
Increased QT interval
Most TOXIC & EFFECTIVE

Class III

74

Identify Class III antiarrhythmic drugs

(D)AIDS
Dronedarone
Amiodarone
Ibutilide
Dofetilide
Sotalol

75

Sx of Amiodarone Toxicity

PUtek PAre Tinik Talaga Sa Chicks
Pulmonary fibrosis
Paresthesia
Thyroid dysfunction
Tremors
Skin deposits
Corneal deposits

76

Identify which class of antiarrhythmic drugs:
PR interval is consistently increased
AV conduction velocity is decreased and effective refractory period increased
Causes a state- and use-dependent selective depression of Calcium currents

Class IV

77

Why are dihydropiridine CCBs ineffective for arrhythmia?

They evoke compensatory sympathetic discharge which facilitates arrhythmia rather than terminate them

78

Identify antiarrhythmic drug and class:
Prolongs PR interval

Propranolol, Class II
Verapamil, Class IV

79

Identify antiarrhythmic drug and class:
Prolongs QT interval

Dofetilide, Class III

80

Identify antiarrhythmic drug and class:
Prolongs QRS duration

Flecainide, Class IC

81

Miscellaneous antiarrhythmic drug
Causes marked hyperpolarization and conduction block
Drug for AV nodal arrhythmia, DOC for Paroxysmal SVT
SE: flushing

Adenosine

82

____________ Ion: depresses ectopic pacemakers
Decrease can cause increased incidence of arrhythmia
Increase can depress conduction and cause reentry arrhythmia

Potassium

83

____________ Ion: possible MOA is increase in Na/K/ATPase activity
Effective in some cases of Torsades
Similar depressant effects as K on Digitalis-induced arrhythmia

Magnesium

84

Cardiac glycoside
Inhibits Na/K ATPase, inc intracellular Ca, inc contractility
Drug for heart failure and arrhythmia
SE: Narrow therapeutic window, Arrhythmia, visual changes

Digoxin

84

Reduced clearance with quinidine
Arrhythmogenesis increased by HypoK, HypoMg, HyperCal

Digoxin

85

Drugs with Narrow Therapeutic Index

WALA Cyang PaPa, Very Tragic Day
Warfarin
Aminoglycosides
Lithium
Amphotericin B
Carbamazepine
Phenytoin
Phenobarbital
Vancomycin
Theophylline
Digoxin

85

Drug of choice for arrythmia secondary to Digoxin

Lidocaine

85

First line therapy for chronic heart failure

Loop diuretics
Spironolactone

Spironolactone + Eplerenone can reduce mortality in HF

86

First line drug for ACUTE heart failure

Furosemide

87

First line drugs for CHRONIC heart failure

ACEi
ARB

88

Drugs that improve survival in CHF

ACEi/ARB
Beta blocker
Spironolactone

89

Decreases hospitalizations in CHF

Digoxin

90

Improves survival in pxs of African-American descent

Hydralazine + ISDN