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Flashcards in Cardiovascular drugs Deck (61)
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1
Q

Antiherpertensive medication contraindicated in pregnancy

A

Losartan

2
Q

_______increases heart rate in a dose department manner

A

Minoxidil

  • vasodialtor
  • causes severe tchycardia that must be controlled with Beta blcokers
3
Q

Action of nifedipine in response to essential hypertension

A

decreases calcium influx into smooth muscle

  • Prototype L-type calcium channel blocker
  • Plasma renin level may increase as a result of the compensatory response
4
Q

Group of drug groups is most likely to cause postural hypotension

A

alpha1 - selective receptor blocker

5
Q

what is the most common manifestation of ACE inhibitor intolerance?

A

incessant cough

6
Q

constipation is a common side effect of __________

A

verapamil

  • l-type calcium channels in the colon
7
Q

prazosin and atenolol both ___________

A

increase sympathetic outflow from the CNS

8
Q

________associated with hematologic abnormalities

A

methyldopa

9
Q

_______ often cause mild hyperglycemia

A

Thiazide

10
Q

Metoprolol and verapamil __________ PR inteval

A

Increase

  • depresseion of calcium dependentd processes in the heart, therefore bradycardia and increased PR interval
11
Q

used in severe hypertensive emergencies, is short acting and acts on a G-protein coupled receptor, and must be given by IV infusion

A

Fenoldopam

12
Q

Very short actig and acts by releasing nitric oxide

A

Nitroprusside

13
Q

Hydrochlorothiazide/chlorthalidone

A

Diuretics

Blocks Na/Cl transported in distal convoluted tubule

Used in hypertension and mild edema

AE: hypokalemia, hyperglycemia, hyperuricemia, hyperlipidemia

14
Q

Furosemide

A

Block Na/K/2Cl transporter in thick ascending limb

Used in hypertension, heart failure, edema, hypercalcemia

AE; hypokalemia, hypovolemia, ototoxicity

15
Q

Clonidine

A

Agonist at alpha 2 receptors in CNS this results in decreased SANS ouitflow

used in hypertension

AE: sedation, danger of severe rebound hypertension if suddently stopped

16
Q

Methyldopa

A

Prodrug converted to methylnorepinephrine in CNS with effects like clonidine

Used in hypertension

AE: sedation, induces hemolytic antibodies

17
Q

verapamil blocks ___________

A

P-glycoprotein transporter

18
Q

Hydralazine

A

Probably causes release of nitroc oxide by endothelial cells. causes arteriolar dilation

Used in hypertension, also used heart failure in combiantion with isosorbide dinitrate

AE: rachycardia, salt and water retention, lupus-like syndrome

19
Q

Minoxidil

A

Prodrug, sulfate metabolite opens K channels, causes arteriolar smooth muscle hyperpolarization and vasodilation

Used in severe hypertension and male pattern baldness

AE: marked tachycardia, salt and water retention, hirsutism

20
Q

Nitroprusside

A

Releases, NO from drug molecule

Parenteral

used in hypertensive emergency and acute cardiac decompensation

AE: Excessive hypotension; tachycardia, calt and water retention. Prolonged infusion may cause thocyanate and cyanide toxicity

21
Q

Diazoxide

A

K channel opener in smooth muscle, secretory cells

Used in hypertensive emergency and hypoglycemia due to insulin secreting tumors

AE: hyperglycemia, edema, excessive hypotension

22
Q

Fenoldopam

A

D1 agonist. causes arteriolar dialtion

Used in hypertensive emergencies

AE: excessive hypotension; tachycardia, salt and water retention, angina

23
Q

Aliskiren

A

Renin inhibitor, reduces angiotensin I synthesis

used in hypertension

AE: angioedema, renal impairment

24
Q

Captopril

A

ACE inhibitor. reduces angiotensin II synthesis

used in hypertension, diabetes, renal disease, heart failure

AE: cough, hyperkalemia, teratogen

25
Q

Losartan

A

Blocks AT1 receptors

Used in hypertension, combination used in heart failure

AR: hyperkalemia, teratogen

26
Q

Common direct or reflex effect of nitroglycerin

A

Increased diastolic myocardial fiber tension

  • nitroglycerin increases heart rate and venous capacitance and decreases afterload and diastolic fiber tension
  • compensatory icnrease in sympathetic discharge
27
Q

Meningeal vasodialtion can be caused by ____________

A

nitroglycerin

  • Nitrates relax many types of smooth muscle, but the effect on motility on the colon is insignificant
28
Q

Useful for drugs for the prophylaxis of angina

A

Verapamil

  • CCBs and Beta blockers are generally effective in reducing the number of attacks of angina of effort, and most have durations of 4-8 h
29
Q

If a beta blocker were to be used for prophylaxis in this patient what is the most probable mechanism

A

Block of exercise-induced tachycardia

30
Q

Common adverse effect of nitroglycerin and prazosin

A

Othostatic hypertension

31
Q

Drug that can cause methemeglobinemia

A

amyl nitrite

32
Q

Drugs in high doses can cause extreme bradycardia

A

verapamil

33
Q

which nitroglycerin by inhibiting the metabolism of cGMP

A

sildenafil

34
Q

Nitroglycerin, SL

A

Short-acting nitrates

Releases NO, increases cGMP (cyclic guanosine monophosphate

Used in acute angina pectoris and acute coronary syndrome

AE: tachycardia, orthostaichypotension, headache

35
Q

nitroglycerin, oral

A

Intermiediate-acting nitrates

Like Notroglycerin SL, active metabolite dinitroglycerin

used for prophylaxis of angina

36
Q

ranolazine

A

Blocks late Na current in myocardium, reduces cardiac work

Used in angina

AE: QT prolongation on ECG, inhibits CYP3A and 2D6

37
Q

Ivabradine

A

Blocks pacemaker Na current in myocardium, reduces cardiac work

Ued in heart failure, invesitgaional in angina

AE: excessive bradycaria

38
Q

Best documented mechanism of beneficial action of cardiac glycosides

A

An increase in systolic cytoplasmic calcium levels

  • It increases calcium by inhibiting Na/K transport by the ATPase sodium pump and indirectly altering Na/Ca exchange
39
Q

Most likely cause the arrythmogenic effect of digoxin

A

Increased intracellular calcium

  • decreased sympathetic discharge and increased increased extracellular potassium and magnesium reduce digitalis arrhythmogenesis
40
Q

A common effect of digoxin (at therapeutic blood levels) that can be almost entirely blocked by atropine is

A

Increased PR interval on ECG

  • the parasympathomimetic effeects of digitalis can be blocked by muscarinic blockers such as atropine
    • manifestation of slowed AV cinduction
41
Q

drug shown to reduce mortality in chronic heart failure

A

Spironolactone

42
Q

Increases endogenous BNP and also blocks angiotensin receptors

A

Sacubitril

43
Q

initial treatment or heart failure f

A

furosemide

44
Q

shown to prolong life in patients with chronic congestive failure

A

Carvedilol

45
Q

The drug of choice in severe, massive overdose with any cardiac glycoside is __________

A

digoxin antibody

46
Q

________– should be avoided to reduce the likelihood of procainamide toxicity

A

Hyperkalemia

47
Q

Most effective therapy for procainamide and quinidine toxicity

A

sodium lactate

  1. increase sodium current by icnreasing the sodium ion gradient
  2. reduce drug-receptor binding by alkalinizing the tissue
48
Q

_____ are most effective against acute thyrotoxic arrhythmias

A

Beta blockers

49
Q

effective in both treating and precenting supracentricular AV nodla tachycardias

A

Calcium channel blockers

50
Q

________ used in emergency treatment of myocardial infarction arrhythmia is one of the most important

A

Lidoacaine

51
Q

_________ very short acting parenteral agent often used for AV nodal arrythmias

A

adenosine

52
Q

Longest half-life of all the antiarrythmics

A

amiodarone

53
Q

Group 1 antiarryhtmics

A

Sodium channel blockers

  • Group 1A
    • both atrial and ventricular arrythmias
    • prolongs AP
    • block one or more repolarizing K currents
  • Group IB
    • selectively affect ischemic or depolarized Purkinje and ventricular tissue
    • reduce AP
  • Group IC
    • no effect on ventricular AP duration
    • powerful depresants of sodium current
    • increase QRS duration of the ECG
54
Q

Group 2 antiarrhythmics

A

Beta blockers

  • reduction of CAMP
  • modest reduction of both sodium and calcium
  • the AV node is particularly sensitive
  • Prolonged PR interval
  • may have some direct local anesthetic (sodium channel blocking)
55
Q

Group 3 Antiarrythmics

A

Potassium K channel blockers

Common used in Afib

Prolongs AP

56
Q

carbonic anhydrase inhibitors

A

Acetazolamide

57
Q

diurets useful in the prevention of calcium stones

A

thiazides

58
Q

loop diuretics _________urinary calcium excretion and __________blood pressure

A

Increase

Decrease

59
Q

Acetazolamide causes ______________

A

metabolic acidosis

60
Q

A drug that increases the formation of dilute urine is used to treat SIADH

A

Tolvaptan

61
Q
A