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Pharmacology > Cardiovascular drugs > Flashcards

Cardiovascular drugs Flashcards

1
Q

Examples of Thiazide diuretics

A 
Hydrochlorothiazide
Chlorthalidone
Chlorthiazide
Indapamide
Metolazone
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2
Q

MOA of Thiazide Diuretics

A

Inhibit Na/Cl transporter in the DCT and reduced excretion of calcium

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3
Q

Side effects of thiazide diuretics

A 
Hypokalemic metabolic alkalosis; Sulfa allergy
Hyperglycemia
Hyperlipidemia
Hyperuricemia
Hypercalcemia
(HYPER-GLUC)
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4
Q

Examples of Loop Diuretics

A

Furosemide, Bumetanide, Torsemide, Ethracrynic acid

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5
Q

MOA of Loop Diuretics

A

Inhibit Na/K/2Cl transporter in the Thick ascending loop of Henle and increased Ca excretion

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6
Q

Loop diuretic which does not trigger sulfa allergy

A

Ethracrynic Acid

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7
Q

Drugs that irreversibly blocks the vesicular monoamine transporter (VMAT)

A

Nerve terminal blocker:
GUANETHIDINE
RESERPINE

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8
Q

Side effect of reserpine

A

Suicidal ideation

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9
Q

A vasodilator that alters intracellular calcium metabolism thus causing relaxation of the arteriolar smooth muscle, decreases afterload

A

Hydralazine

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10
Q

Drugs that induces Lupus

A

Hydralazine, Isoniazid, Procainamide, Penicillamine

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11
Q

What is the use of hydralazine in heart failure

A

when combined with ISDN, more effective in treating acute heart failure in Blacks

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12
Q

Side effect of hydralazine

A

reflex tachycardia

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13
Q

A hypertensive drug that is used in the treatment of alopecia

A

Minoxidil

MOA for hypertension: opening of K+ Channels –> hyperpolarization –> vasodilation

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14
Q

Examples of Non-dihydropyridine calcium channel blocker (inhibits voltage-gated L type receptors)

A

verapamil, diltiazem

Cardiac>vascular

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15
Q

Side effects of non-dihydropyridine receptors blockers

A

Constipation, Pretibial edema, gingival hyperplasia

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16
Q

Besides its antihypertensive property, what are the other Uses of nondihydropyridine receptors Ca channel blockers

A

Angina, SVT

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17
Q

Examples of dihydropyridine receptors Ca channel blockers

A

Amlodipine, felodipine, Nicardipine, Nisoldipine, Isradipine

Vascular>Cardiac

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18
Q

Side effect of dihydropyridine ca channel blockers

A

Pretibial edema, flushing, constipation

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19
Q

A parenteral vasodilator that relaxes venous and arteriolar smooth muscle (decreasing both preload and afterload)

A

Nitroprusside

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20
Q

Side effect of Nitroprusside

A

Cyanide Toxicity

Tx: Inhaled Amyl Nitrite, IV sodium nitrite, IV sodium thiosulfate

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21
Q

What is the side effect for the treatment of the side effect of nitroprusside

A

Methemglobinemia

Tx: oxygen supplement and methylene blueA

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22
Q

A dopamine agonist which is a parenteral vasodilator

A

Fenoldopam
Used in hypertensive emergencies
May cause hypokalemia

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23
Q

Anti-hypertensive which is a Renin antagonist

A

Aliskiren

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24
Q

Treatment for malignant hypertension

A

Nitroprusside, fenoldopam, diazoxide (vasodilators) plus diuretics (furosemide) and beta-blockers

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25
Q

Ultrashort acting nitrite used in the treatment of cyanide poisoning (MOA: releases NO, increases cGMP and relaxes smooth muscle)

A

Amyl nitrite

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26
Q

Short-acting nitrite used in the treatment of angina and acute coronary syndromes

A 
Isosorbide dinitrate
Isosorbide mononitrate (maintenance)
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27
Q

Side effects of nitrites

A

Headache
Tolerance (transdermal)
dangerous hypotension when combined with phosphodiesterase (PDE) inhibitors (e.g. sildenafil, vardenafil and tadalafil)

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28
Q

DOC for Prinzmetal’s angina

A

Diltiazem

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29
Q

Anti-angina drug that can be used in the treatment of raynaud’s phenomenon

A

Diltiazem

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30
Q

drugs that can cause gingival hyperplasia

A

Nifedipine, Cyclosporin, Phenytoin, Verapamil

NapaCa Pangit ng gingiVa mo

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31
Q

What drugs can be used in the treatment for migraine and performance anxiety

A

Beta-blockers

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32
Q

Excessive beta-block blockade will cause what problems?

A

Bronchospasm, AV block, Heart Failure, CNS sedation

Other side effect: erectile dysfunction

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33
Q

What is the disadvantage in giving beta-blockers in patients with diabetes?

A

Masks hypoglycemia in Diabetic patients

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34
Q

What drug is a cardiac glycoside which inhibits Na/K ATPase?

A

Digoxin

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35
Q

Side effects of digoxin

A

Narrow therapeutic index
arrhythmias - increased by hypokalemia, hypomagnesemia, hypercalcemia
visual changes (remember Van Gogh)

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36
Q

Drugs with narrow therapeutic index

A 
warfarin
aminoglycosides
lithium
amphotericin B
carbamazepine
Phenobarbital
Phenytoin
Vancomycin
Theophylline
Digoxin
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37
Q

treatment for digitalis toxicity

A

DOC: lidocaine (anti-arrhythmia)

Digibind (digoxin anti-bodies

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38
Q

First line drugs for systolic and diastolic failure

A

diuretics
furosemide: immediate reduction of pulmonary congestion and edema
Spironolactone and eplerenone: has significant long-term benefits

39
Q

First line drug for chronic heart failure

A

angiotensin antagonists

40
Q

Other than the diuretics, what are the other Drugs useful in acute heart failure

A

Beta-selective sympathomimetics (Dobutamine and Dopamine)

41
Q

Should beta-blockers be used in treatment for acute heart failure?

A

NO. They have no value

42
Q

What are the beta-blockers which have beta and alpha activity

A

Carvedilol and Labetalol

43
Q

What are the phosphodiesterase inhibitors used in the treatment for acute heart failure

A

Inamirinone and Milrinone

(Note: should not be used in chronic heart failure since they can increase morbidity and mortality

44
Q

What are the vasodilators that can be used in acute severe failure with congestion

A

Nitroprusside or Nitroglycerin

45
Q

What drugs are used in the treatment of CHF in African Americans

A

Hydralazine and Isosorbide Dinitirate

46
Q

What is the ECG morphology of Torsade de Pointes

A

Polymorphic ventricular tachycardia, waxing and waning of QRS complex

47
Q

What disease is associated with Torsade de Pointes

A

Long QT syndrome: mutations in the Ik or Ina Channel proteins

48
Q

Group I antiarrythmics MOA

A

Sodium channel blockers

  • slow or block conduction in ischemic and depolarized cells and slow or abolish abnormal pacemakers wherever these processes depend on sodium channels
  • use dependent or state dependent (they selectively depress tissues that is frequently depolarizing or tissue that is relatively deporlarized during rest)
49
Q

Group IA

A

Procainamide, Disopyramide, Quinidine

(I am the Queen who Proclaimed Diso’s Pyramid

50
Q

Group IA effect

A

prolongs AP duration`

51
Q

Group IB effect

A

shorten AP duration

52
Q

Group IB drugs

A

Mexiletene, Tocainide, Lidocaine

I buy mexican tacos from Lily

53
Q

Group IC effect

A

no effect on AP duration

54
Q

Group IC drugs

A

Fleicanide, Propafenone, Encainide, Moricizine

55
Q

Advantage of IC drugs over group IA and IB

A

Can be used in Refractory arrhythmia

56
Q

Side effects of IC drugs

A

increased proarrhythmic effect (contraindicated for post MI Arrythmia

57
Q

Drugs that cause agranulocytosis

A

Colchicine, clozapine, co-trimoxzaole, aminopyrine, phenylbutazone, PTU/methimazole, indomethacin, tocainide

58
Q

What drug causes cinchonism (headache, vertigo, tinnitus)

A

Quinidine

59
Q

What is the beta blocker that is used as post-MI prophylaxis against sudden death and as treatment for thyrotoxicosis

A

Propranolol

60
Q

what is the beta-blocker that has class 3 properties

A

Sotalol

61
Q

What is the beta blocker used in the treatment of supraventricular arrhythmias?

A

Esmolol

62
Q

What is the beta-blocker used in acute perioperative and thyrotoxic arrythmias

A

esmolol

63
Q

Class 3 anti-arrythmias

A

Dofetilide, Ibutilide, Sotalol, Amiodarone

AIDS

64
Q

What drug is used in the treatment and prophylaxis for atrial fibrillation which has a MOA of selective Ik block?

A

Dofetilide, Ibutilide

65
Q

What is a class 3 anti-arrythmic drug that has group 1 activity?

A

Amiodarone

Dronedarone

66
Q

What is the mechanism of action of amiodarone

A

Strong Ik block produces marked prolongation of action potential and refractory period
Group 1 activity slows conduction velocity
Groups 2 and 4 activity confer additional antiarrythmic activity

67
Q

What is the side effect of amiodarone?

A 
microcrystalline deposits in cornea and skin
pulmonary fibrosis
paresthesias
tremors
thyroid dysfunction
68
Q

What is the MOA of class 4 antiarrythmic drugs

A

State and use dependent selective depression of calcium currents

69
Q

What is the ECG findings in class 4 antiarrythmic drugs?

A

PR interval is consistently prolonged (AV conduction velocity is decreased and effective refractory period increased)

70
Q

What is the major use of calcium channel blockers in arrythmias?

A

Convert nodal tachycardia (AV nodal reentry) to normal sinus rhythm

71
Q

What is an antiarrythmic drug that increases the diastolic Ik of AV node that causes marked hyperpolarization and conduction block; and reduced Ica

A

Adenosine

72
Q

What is the drug of choice for paroxysmal supraventricular tachycardia?

A

Adenosine

73
Q

What should be checked in patients who will undergo treatment for arrythmia?

A

Serum potassium
potassium ion depresses ectopic pacemakers including those caused by digitalis toxicity. Hypokalemia is associated with an increased incidence of arrythmia in digitalis toxicity while excessive hypokalemia will depress conduction and can cause reentry arrythmias

74
Q

What drug can be used in the treatment of torsade de pointes

A

Magnesium. MOA is poorly understood but possibly it increases Na/K ATPase activity

75
Q

What are the ECG changes in hyperkalemia? Hypokalemia?

A

Hyperkalemia: Peak T wave
Hypokalemia: Depressed T wave

76
Q

what is the drug that is used in the treatment of glaucoma, mountain sickness and edema with alkalosis which inhibits the Na-H antiport in the proximal tubule

A

ACETAZOLAMIDE, dorzolamide, brinzolamide, dichlorophenamide, methazolamide
(carbonic anhydrase inhibitors)

77
Q

what are the side effects associated with loop diuretics?

A 
ototoxicity
hypokalemia
dehydration
allergy to sulfa
nephritis
gout
78
Q

what are examples of potassium sparing diuretics that inhibits cytoplasmic aldosterone receptor in the cortical collecting ducts?

A

spironolactone

eplerenone

79
Q

what are the examples of potassium sparing diuretics that inhibits the epithelial sodium channel in cortical collecting duct?

A

amiloride

triamterene

80
Q

what drugs that can cause gynecomastia

A 
Spironolactone
digoxin
cimetidine
alcohol
ketoconazole
81
Q

give examples of diuretics that osmotically retains water in the tubules by reducing reabsorption?

A

mannitol, glycerin, isosorbide, urea

82
Q

What are examples of ADH antagonist?

A

Conivaptan, Lixivaptan
Demeclocycline
Lithium

83
Q

A tetracycline-derived drug which can also be used as an ADH antagonist

A

Demeclocycline

Side effect: bone and teeth abnormalities (similar to that of the tetracyclines)

84
Q

What are the adverse effects of giving fibrates with statins?

A

Rhabdomyolysis and myopathy

85
Q

What are examples of lipid-lowering drugs that prevents reabsorption of bile acids by binding them

A

Cholestyramine, Colesevelam, Colestipol

86
Q

Why bile acid binders are not given in patients with high triglycerides?

A

It increases triglycerides and VLDL in patients with high triglycerides?

87
Q

what drug is used in hypercholesterolemia which inhibits NPC1L1 (a specific transporter in jejunal electrocyte), decreasing intestinal absorption of cholesterol and other phytosterols?

A

Ezetimibe

88
Q

What drug is used in hypercholesterolemia which acts as a cholesterol analog, thus decreases absorption of cholesterol and phytosterols?

A

Sitosterol

89
Q

Ezetimibe and statins have synergistic LDL-lowering effect, however, it also increases the risk of developing what abnormality?

A

Hepatotoxicity

90
Q

What drug is the most effective agent in increasing HDL levels?

A

Niacin

91
Q

What drug is given before giving niacin to prevent flushing?

A

Aspirin

92
Q

What are the drugs that cause cutaneous flushing

A

Vancomycin
Adenosin
Niacin
Calcium channel blockers

93
Q

What is the drug of choice in treating hypertriglyeridemia?

A

Gemfibrozil, Fenofibrate, Bezafibrate

MOA: activates PPAR alpha and increases expression of lipoprotein lipase and apolipoproteins

Pharmacology (13 decks)

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