Cardiovascular drugs

Question 1

thiazides, ACE inhibitors, AngII receptor blockers, dihydropyridine CCB

Answer 1

tx for primary/essential HTN

Question 2

diuretics, ACE inhib, ARBs, beta blockers, aldosterone antagon

Answer 2

tx for HTN with HF

beta blockers for compensated HF

Question 3

ACE inhib/ARBs, CCB, thiazides, beta blockers

Answer 3

tx for HTN + DM (protect against diabetic nephropathy)

Question 4

hydralazine, labetalol, methyldopa, nifedipine

Answer 4

tx for HTN in pregnancy (no ACE-I or ARBs!!)

Question 5

amlodipine, clevidipine, nicardipine, nifedipine, nimodipine

Answer 5

dihydropyridine CCB- act on vascular smooth m.

Question 6

diltiazem, verapamil

Answer 6

non dihydropyridine CCB- act on heart smooth m.

Question 7

CCB used to tx HTN, angina (Prinzmetal’s), Raynaud phenomenon

Answer 7

dihydropyridines (act on vasculature) EXCEPT for nimodipine

Question 8

CCB used to prevent cerebral vasospasm in SAH

Answer 8

nimodipine

Question 9

CCB used for HTN urgency or emergency

Answer 9

clevidipine

Question 10

CCB used to tx HTN, angina, a-fib or atrial flutter

Answer 10

non dihydropyridines

Question 11

increases cGMP to relax smooth m.
vasodilates arterioles > veins (reduces afterload)
used to tx severe HTN (acute), HF, safe for pregnancy
give w/ beta blocker to block reflex tachy

Answer 11

hydralazine

Question 12

these drugs are used as tx regimen for…

clevidipine, fenoldopam, labetalol, nicardipine, nitroprusside

Answer 12

HTN emergency

Question 13

short acting increase in cGMP via direct release of NO
may cause cyanide toxicity
used during HTN emergency

Answer 13

Nitroprusside

Question 14

D1 agonist causing coronary, peripheral, renal, splanchnic vasodilation - lowers BP, increases natriuresis
used during HTN emergency

Answer 14

fenoldopam

Question 15

vasodilate by increasing NO in vasc smooth m - increases cGMP & smooth m. relaxation
dilates veins»arteries, lowers preload
used to tx angina, acute coronary syndrome, pulm edema

Answer 15

nitrates: nitroglycerin, isosorbide dinitrate, isosorbide mononitrate

Question 16

partial beta agonists contraindicated in angina d/t partial increase in HR

Answer 16

pindolol & acebutolol

Question 17

inhib conversion of HMG CoA to mevalonate (cholest precursor), lowers mortality in CAD pt
lowers LDL***, raises HDL, lowers TG’s
best agents for reducing LDL levels

Answer 17

HMG CoA reductase inhibitors: lovastatin, pravastatin, simvastatin, atorvastatin, rosuvastatin

Question 18

prevent intestinal reabsorp of bile acids - liver must then use cholest to make more bile acids
lowers LDL, slightly raises HDL, slightly raises TGs

Answer 18

bile acid resins: cholestyramine, colestipol, colesevelam

Question 19

prevents cholest absorption at sm int brush border

lowers LDL

Answer 19

ezetimibe

Question 20

upregulate LPL - increased TG clearance
activates PPAR alpha to induce HDL synthesis
lowers LDL, raises HDL, lowers TGs**
the only significant tx to lower TGs

Answer 20

fibrates: gemfibrozil, clofibrate, bezafibrate, fenofibrate

Question 21

inhib lipolysis via hormone sensitive lipase in adipose tissue, reduces hepatic VLDL synthesis
lowers LDL, raises HDL***, lowers TGs

Answer 21

niacin (B3)

Question 22

direct inhibition of Na/K ATPase - indirect inhib of Na/Ca exchanger - increased intracell Ca - pos inotropy
stimulates vagus n to lower HR
use: to increase contractil for HF, decreases AV & SA conduction for a-fib

Answer 22

digoxin (cardiac glycoside)

Question 23

quinidine, procainamide, disopyramide

Answer 23

class IA anti arrhythmics- Na channel blockers

Question 24

slow/block conduction - slows phase 0 depol, selective to tissue that is frequently depolarized (tachy)
increases AP duration, increases ERF in vent AP, increases QT interval

Answer 24

class IA anti arrhythmics MOA

Question 25

tx for atrial & ventricular arrhythmias esp re-entrant & ectopic SVT & VT

Answer 25

class IA anti arrhythmics

Question 26

lidocaine, mexiletine

Answer 26

class IB anti arrhythmics- Na channel blockers

Question 27

slow/block conduction via slowing phase 0 depol | decreases AP duration, preferential to ischemic or depol Purkinje & ventricular tissue

Answer 27

class IB anti arrhythmics MOA

Question 28

tx for acute ventricular arrhythmias esp post MI, digitalis induced arrhythmias

Answer 28

class IB anti arrhythmics

Question 29

flecainide, propafenone

Answer 29

class IC anti arrhythmics- Na channel blockers

Question 30

slow/block conduction via slower phase 0 depol, selective to tachycardic tissue prolongs ERP in AV node & accessory bypass tracts no effect on ERP in purkinje or vent tissues, minimal effect on AP duration

Answer 30

class IC anti arrhythmics MOA

Question 31

tx for SVTs including a-fib | only as last resort in refractory VT

Answer 31

class IC anti arrhythmics

Question 32

metoprolol, propanolol, esmolol, atenolol, timolol, carvedilol

Answer 32

class II anti arrhythmics- beta blockers

Question 33

decrease SA & AV nodal activity by decreasing cAMP & Ca currents, suppress abnormal pacemakers by decr slope of phase 4 (resting potential) AV node esp sensitive- increased PR interval

Answer 33

class II anti arrhythmic beta blockers MOA

Question 34

tx for SVT, vent rate control for a-fib & a-flutter

Answer 34

class II anti arrhythmic beta blockers

Question 35

amiodarone, ibutilide, dofetilide, sotalol

Answer 35

class III anti arrhythmics- K channel blockers

Question 36

increase AP duration, increase ERP, increase QT

Answer 36

class III anti arrhythmic MOA

Question 37

tx for a-fib, a-flutter, vent tachy

Answer 37

``` class III anti arrhythmic amiodarone & sotalol for VT ```

Question 38

verapamil, diltiazem

Answer 38

class IV anti arrhythmics- CCB

Question 39

decrease conduction velocity, increase ERP, increase PR

Answer 39

class IV anti arrhythmics MOA

Question 40

used to prevent nodal arrhythmias (SVT), control rate in a-fib

Answer 40

class IV anti arrhythmics

Question 41

increases K exit of cells - hyperpolarizes cell & decreases conduction of Ca drug of choice to diagnose/abolish SVT very short acting (15sec) SE: sense of impending doom

Answer 41

adenosine

Question 42

effective for torsades de pointe & digoxin toxicity

Answer 42

Mg2+