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Cardiovascular Pharmacology Flashcards

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1
Q

What is the heart’s primary function?

A

The heart acts as a pump, circulating blood through the body’s vascular system.

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2
Q

What is heart failure?

A

Heart failure occurs when the heart cannot pump enough blood to meet the body’s metabolic needs, often due to myocardial injury from ischemia, inflammation, or chronic hypertension.

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3
Q

What is hypertension?

A

Hypertension is a condition where blood pressure is elevated due to increased blood volume or peripheral resistance.

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4
Q

What are arrhythmias?

A

Arrhythmias are irregular heartbeats caused by disruptions in the heart’s electrical conduction system.

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5
Q

What are angina and myocardial infarction?

A

Angina is chest pain due to insufficient blood flow to the heart, while myocardial infarction occurs when heart tissue dies due to prolonged lack of oxygen.

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6
Q

What do thiazide diuretics do?

A

Thiazide diuretics reduce blood pressure by inhibiting sodium and chloride reabsorption in the distal tubule, increasing urine output.

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7
Q

What do loop diuretics do?

A

Loop diuretics inhibit chloride reabsorption in the thick ascending loop of Henle, causing significant diuresis and often used in emergencies.

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8
Q

What do potassium-sparing diuretics do?

A

Potassium-sparing diuretics enhance sodium excretion while retaining potassium, often used to counteract potassium loss from other diuretics.

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9
Q

How do central antiadrenergics work?

A

Central antiadrenergics reduce sympathetic outflow from the brain, decreasing heart rate and blood pressure.

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10
Q

How do peripheral antiadrenergics work?

A

Peripheral antiadrenergics deplete norepinephrine in nerve terminals, reducing vasoconstriction and heart rate.

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11
Q

What do ACE inhibitors do?

A

ACE inhibitors block the production of angiotensin II, a potent vasoconstrictor, thereby reducing blood pressure.

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12
Q

How do thiazide diuretics work?

A

Thiazide diuretics inhibit sodium and chloride reabsorption in the distal tubule, leading to mild diuresis and potential potassium loss.

Thiazide diuretics are commonly used to treat hypertension and edema.

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13
Q

What is the effect of loop diuretics?

A

Loop diuretics inhibit chloride reabsorption in the thick ascending loop of Henle, causing a high loss of potassium and water.

Loop diuretics are often used in cases of heart failure and renal impairment.

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14
Q

How do potassium-sparing diuretics work?

A

These diuretics enhance sodium and water excretion while retaining potassium, often used in combination with other diuretics to prevent hypokalemia.

Common potassium-sparing diuretics include spironolactone and eplerenone.

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15
Q

What do osmotic diuretics do?

A

Osmotic diuretics draw water into the urine without affecting ion secretion or absorption, used in acute conditions like brain edema.

Mannitol is a widely used osmotic diuretic.

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16
Q

How do central antiadrenergics work?

A

Central antiadrenergics reduce sympathetic outflow from the brain by activating inhibitory α2 receptors, promoting parasympathetic dominance.

Examples include clonidine and guanfacine.

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17
Q

What do peripheral antiadrenergics do?

A

Peripheral antiadrenergics prevent norepinephrine release from nerve terminals, reducing blood pressure by decreasing peripheral resistance.

These medications can be used in the treatment of hypertension.

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18
Q

What is the effect of alpha blockers?

A

Alpha blockers inhibit vasoconstriction by blocking α1 receptors, reducing peripheral resistance and blood pressure.

Common examples include prazosin and doxazosin.

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19
Q

How do beta blockers work?

A

Beta blockers prevent adrenergic stimulation of the heart by blocking β1 receptors, reducing heart rate and contractility.

They are often prescribed for hypertension and heart conditions.

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20
Q

What do vasodilators do?

A

Vasodilators widen blood vessels, reducing blood pressure by decreasing peripheral resistance.

Examples include hydralazine and nitroglycerin.

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21
Q

How do ACE inhibitors work?

A

ACE inhibitors suppress the synthesis of angiotensin II, a potent vasoconstrictor, and may induce vasodilator production.

Common ACE inhibitors include lisinopril and enalapril.

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22
Q

How do ARBs work?

A

ARBs block the action of angiotensin II at its receptors, reducing vasoconstriction and blood pressure.

Examples include losartan and valsartan.

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23
Q

What is the mechanism of action of Lidocaine?

A

Na+ channel blockage, preferentially binds to Na+ channels in the deactivated state

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24
Q

What is a key indication for Lidocaine?

A

Acute ventricular arrhythmia secondary to myocardial infarction, digitalis toxicity, cardiac manipulation

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25
What are the key toxicities associated with Lidocaine?
* Cardiotoxicity: arrhythmia, bradycardia * Neurotoxicity: excitation/depression
26
What is the mechanism of action of Procainamide?
Na+ channel blockage, preferentially binds to Na+ channels in the deactivated state
27
What is a key indication for Procainamide?
* Ventricular arrhythmia * Supraventricular arrhythmia
28
What is a key toxicity associated with Procainamide?
SLE-like syndrome, increased incidence in slow acetylators
29
What is the mechanism of action of Quinidine?
Na+ channel blockage, preferentially binds to Na+ channels in the activated state
30
What are the key indications for Quinidine?
* Ventricular arrhythmia/tachycardia * Atrial fibrillation/flutter
31
What are the key toxicities associated with Quinidine?
* Cinchonism * ↑ QT interval
32
What is the mechanism of action of Amiodarone?
K+, Ca2+, and Na+ channel blocker: broad-spectrum anti-arrhythmic
33
What are the key indications for Amiodarone?
Most types of arrhythmias
34
What are the key toxicities associated with Amiodarone?
* Pulmonary fibrosis * Hyper- or hypothyroidism * Blue pigment of the skin * Corneal deposits * Hepatotoxic * Photophobia
35
What is the mechanism of action of Bretylium?
Unknown
36
What is a key indication for Bretylium?
Ventricular arrhythmia resistant to typical antiarrhythmic therapy
37
What are the key toxicities associated with Bretylium?
* Orthostatic hypotension * Nausea * Vomiting
38
What is the mechanism of action of Sotalol?
β-blocker and K+ channel blocker
39
What are the key indications for Sotalol?
* Ventricular arrhythmia * Atrial fibrillation/flutter
40
What is a key toxicity associated with Sotalol?
Torsades de pointes
41
What is the mechanism of action of Amlodipine?
Ca2+ channel blocker preferentially in vasculature
42
What are the key indications for Amlodipine?
* Angina * Hypertension
43
What are the key toxicities associated with Amlodipine?
* Peripheral edema * Pulmonary edema * Flushing/dizziness * Reflex tachycardia * Gingival hyperplasia
44
What is the mechanism of action of Diltiazem?
Ca2+ channel blocker preferentially in vasculature
45
What are the key indications for Diltiazem?
* Supraventricular tachycardia * Angina * Hypertension
46
What are the key toxicities associated with Diltiazem?
* Cardiac depression * Constipation
47
What is the mechanism of action of Adenosine?
Adenosine receptor agonist: ↓ cAMP via Gi
48
What is a key indication for Adenosine?
AV nodal arrhythmia, paroxysmal supraventricular tachycardias
49
What are the key toxicities associated with Adenosine?
* Impending doom * Vasodilation * Dyspnea secondary to bronchoconstriction
50
What is the mechanism of action of Atropine?
Muscarinic antagonist
51
What is a key indication for Atropine?
Sinus bradycardia, AV block
52
What are the key toxicities associated with Atropine?
Antimuscarinic/cholinergic effects
53
What is the mechanism of action of Digoxin?
Cardiac Na+/K+ ATPase inhibitor
54
What are the key indications for Digoxin?
* Heart failure * Atrial fibrillation
55
What are the key toxicities associated with Digoxin?
* Arrhythmia * Nausea * Vomiting * Diarrhea * Blurry yellow vision
56
What is the mechanism of action of Epinephrine?
β- and α-agonist: β > α
57
What is a key indication for Epinephrine?
Anaphylactic reactions, hypotension
58
What are the key toxicities associated with Epinephrine?
* Hypotension secondary to β- and α-adrenergic receptor effects * Anxiety * Respiratory difficulties
59
What is the mechanism of action of Atenolol?
β-blocker, β1 > β2
60
What are the key indications for Atenolol?
* Hypertension * Angina * Post-MI secondary prevention
61
What are the key toxicities associated with Atenolol?
* Bradycardia * Heart failure * AV block
62
What is the mechanism of action of Esmolol?
β-blocker, β1 > β2
63
What is a key indication for Esmolol?
Supraventricular tachycardia
64
What are the key toxicities associated with Esmolol?
* Bradycardia * Hypotension
65
What is the mechanism of action of Metoprolol?
β-blocker, β1 > β2
66
What are the key indications for Metoprolol?
* Hypertension * Angina * Acute myocardial infarction in hemodynamically stable patients
67
What are the key toxicities associated with Metoprolol?
* Hypotension * Bradycardia * AV block * Dyslipidemia
68
What is the mechanism of action of Benazepril?
Angiotensin-converting enzyme (ACE) inhibitor
69
What are the key indications for Benazepril?
* Hypertension * Heart failure * Diabetic kidney disease
70
What are the key toxicities associated with Benazepril?
* Cough * Hyperkalemia * Teratogen * Angioedema * ↓ Glomerular filtration rate (GFR) * Hypotension
71
What is the mechanism of action of Losartan?
Angiotensin receptor blocker (ARB)
72
What are the key indications for Losartan?
* Hypertension * Heart failure * Diabetic kidney disease
73
What are the key toxicities associated with Losartan?
* Hyperkalemia * Teratogen * ↓ Glomerular filtration rate (GFR) * Hypotension
74
What is the mechanism of action of Clonidine?
α2-agonist
75
What are the key indications for Clonidine?
* Hypertension * Attention deficit hyperactive disorder (ADHD) * Tourette syndrome * Opioid withdrawal
76
What are the key toxicities associated with Clonidine?
* Depression of the CNS * Respiratory depression * Bradycardia * Hypotension * Miosis
77
What is the mechanism of action of Amrinone?
Phosphodiesterase (PDE) inhibitor
78
What is a key indication for Amrinone?
Heart failure
79
What are the key toxicities associated with Amrinone?
Arrhythmia
80
What is the mechanism of action of Dobutamine?
β- and α-agonist, β1 > β2, α
81
What is a key indication for Dobutamine?
Heart failure
82
What are the key toxicities associated with Dobutamine?
Tachyarrhythmia, hypotension
83
What is the mechanism of action of Norepinephrine?
β- and α-agonist, α > β
84
What are the key indications for Norepinephrine?
* Hypotension * Cardiac arrest * Septic shock
85
What are the key toxicities associated with Norepinephrine?
* Hypertension * Bradycardia * Arrhythmia * Anxiety * Dyspnea
86
What is the mechanism of action of Hydralazine?
↑ cGMP, leading to smooth muscle relaxation
87
What are the key indications for Hydralazine?
* Severe hypertension * Heart failure
88
What are the key toxicities associated with Hydralazine?
* Tachycardia * SLE
89
What is the mechanism of action of Bumetanide?
Inhibit Na+/K+/2Cl− transporter of thick ascending limb of loop of Henle
90
What are the key indications for Bumetanide?
* Hypertension * Edema due to heart failure, liver failure, nephrotic syndrome
91
What are the key toxicities associated with Bumetanide?
* Ototoxicity * Metabolic hypokalemic alkalosis * Hypovolemia * Sulfa allergy * Interstitial nephritis * Gout * Efficacy is decreased when used with NSAIDs
92
What is the mechanism of action of Acetazolamide?
Carbonic anhydrase inhibitor
93
What are the key indications for Acetazolamide?
* Edema * Mountain sickness * Glaucoma * Idiopathic intracranial hypertension
94
What are the key toxicities associated with Acetazolamide?
* Metabolic acidosis * Hyperammonemia * Paresthesias * Sulfa allergy
95
What is the mechanism of action of Atorvastatin?
HMG-CoA reductase inhibitor
96
What are the key indications for Atorvastatin?
Vascular disease secondary to atherosclerosis
97
What are the key toxicities associated with Atorvastatin?
* Myopathy * Hepatotoxicity * Potential for teratogenicity, contraindicated in pregnancy
98
What is the mechanism of action of Aspirin?
Irreversible COX inhibitor
99
What are the key indications for Aspirin?
Treatment and prevention of arterial thrombosis
100
What are the key toxicities associated with Aspirin?
* Tinnitus * Gastrointestinal toxicity * Renal toxicity * Reye syndrome in children with viral infection * Metabolic acidosis-respiratory alkalosis
101
What is the mechanism of action of Alteplase?
Aids in conversion of plasminogen to plasmin
102
What are the key indications for Alteplase?
* Early myocardial infarction * Ischemic stroke * Pulmonary embolism
103
What are the key toxicities associated with Alteplase?
Bleeding
104
What is the mechanism of action of Digoxin-Immune Fab?
Binds excess digoxin or digitoxin
105
What is a key indication for Digoxin-Immune Fab?
Digoxin toxicity
106
What are the key indications for Albumin?
Blood volume expander, acts as an oncotic agent
107
What are the key toxicities associated with Albumin?
* Hypovolemia * Subacute bacterial peritonitis * Cirrhosis * Heart failure * Edema
108
What is the mechanism of action of Digoxin-Immune Fab?
Binds excess digoxin or digitoxin ## Footnote Used primarily to treat digoxin toxicity.
109
What is the key indication for using Digoxin-Immune Fab?
Digoxin toxicity ## Footnote Specifically for patients with elevated levels of digoxin.
110
What is a key toxicity associated with Digoxin-Immune Fab?
Heart failure exacerbation
111
What is the mechanism of action of Albumin?
Acts as an oncotic agent and binds to various substances in the blood ## Footnote Includes bilirubin and drugs.
112
What are the key indications for Albumin?
Hypovolemia, subacute bacterial peritonitis, cirrhosis, heart failure, edema
113
Fill in the blank: Digoxin-Immune Fab is used to treat _______.
Digoxin toxicity
114
Fill in the blank: Albumin acts as a _______ agent.
oncotic
115
True or False: Albumin is used to treat heart failure.
True
116
What effect does Albumin have on blood volume?
Expands blood volume
117
What is the mechanism of action of Lidocaine?
Na+ channel blockage preferentially binds to Na+ channels in the deactivated state ## Footnote Used primarily for acute ventricular arrhythmia
118
What is a key indication for using Lidocaine?
Acute ventricular arrhythmia secondary to: * myocardial infarction * digitalis toxicity * cardiac manipulation (i.e., catheterization, surgery) ## Footnote Important for treating arrhythmias in various cardiac situations
119
What are the key toxicities associated with Lidocaine?
Cardiotoxicity: * arrhythmia * bradycardia Neurotoxicity: * excitation/depression ## Footnote These toxicities can lead to serious complications
120
What is the mechanism of action of Procainamide?
Na+ channel blockage preferentially binds to Na+ channels in the deactivated state ## Footnote Similar to Lidocaine in its action
121
What is a key indication for using Procainamide?
Ventricular arrhythmia and supraventricular arrhythmia ## Footnote Effective in treating various types of arrhythmias
122
What is a key toxicity associated with Procainamide?
SLE-like syndrome: increased incidence in slow acetylators ## Footnote This can lead to autoimmune-like symptoms
123
What is the mechanism of action of Quinidine?
Na+ channel blockage preferentially binds to Na+ channels in the activated state ## Footnote Distinct from Lidocaine and Procainamide in its binding state
124
What is a key indication for using Quinidine?
Ventricular arrhythmia/tachycardia and atrial fibrillation/flutter ## Footnote Used in more complex arrhythmias
125
What are the key toxicities associated with Quinidine?
Cinchonism and ↑ QT interval ## Footnote Cinchonism includes symptoms like tinnitus and headache
126
What is the mechanism of action of Amiodarone?
K+, Ca2+, and Na+ channel blocker: broad-spectrum anti-arrhythmic ## Footnote Amiodarone acts on multiple ion channels, making it effective for various arrhythmias.
127
What is a key indication for Amiodarone?
Most types of arrhythmias: secondary due to broad mechanism of action ## Footnote Amiodarone is used for a wide range of arrhythmias due to its diverse action.
128
What are the key toxicities associated with Amiodarone?
* Pulmonary fibrosis * Hyper- or hypothyroidism * Blue pigment of the skin ('smurf skin') * Corneal deposits * Hepatotoxic * Photophobia ## Footnote These toxicities highlight the importance of monitoring patients on Amiodarone.
129
What is the mechanism of action of Bretylium?
Unknown ## Footnote The exact mechanism by which Bretylium works is not fully understood.
130
What is a key indication for Bretylium?
Ventricular arrhythmia resistant to typical antiarrhythmic therapy: considered last-resort ## Footnote Bretylium is used when other treatments fail.
131
What are the key toxicities associated with Bretylium?
* Orthostatic hypotension * Nausea * Vomiting ## Footnote These side effects necessitate careful monitoring during treatment.
132
What is the mechanism of action of Sotalol?
β-blocker; K+ channel blocker ## Footnote Sotalol combines two mechanisms for its antiarrhythmic effects.
133
What are the key indications for Sotalol?
* Ventricular arrhythmia * Atrial fibrillation/flutter ## Footnote Sotalol is used for both ventricular and atrial arrhythmias.
134
What are the key toxicities associated with Sotalol?
* Torsades de pointes * β-blockade ## Footnote These toxicities require monitoring of heart rhythm and blood pressure.
135
What type of drug are Amlodipine, Nicardipine, and Nifedipine?
Ca2+ channel blockers preferentially in vasculature ## Footnote These drugs primarily target vascular smooth muscle.
136
What is a key indication for using Amlodipine?
Angina ## Footnote Amlodipine is also indicated for hypertension.
137
What are some common toxicities associated with Amlodipine, Nicardipine, and Nifedipine?
* Peripheral edema * Pulmonary edema * Flushing/dizziness * Reflex tachycardia ## Footnote These side effects result from their action on vascular smooth muscle.
138
What is the mechanism of action for Diltiazem and Verapamil?
Ca2+ channel blockers preferentially in vasculature ## Footnote They also act on cardiac tissues.
139
What is a key indication for using Diltiazem?
Supraventricular tachycardia ## Footnote Diltiazem is also used for angina and hypertension.
140
What are some common toxicities associated with Diltiazem and Verapamil?
* Cardiac depression * Constipation ## Footnote These side effects can occur due to their effects on cardiac function.
141
Fill in the blank: Amlodipine is indicated for _______.
Angina
142
True or False: Amlodipine can cause gingival hyperplasia.
True
143
Fill in the blank: Diltiazem is used to treat _______.
Supraventricular tachycardia
144
What is the mechanism of action of Adenosine?
Adenosine receptor agonist: ↓ cAMP via Gi
145
What is a key indication for the use of Adenosine?
AV nodal arrhythmia, Paroxysmal supraventricular tachycardias
146
What are the key toxicities associated with Adenosine?
Impending doom, Vasodilation, Dyspnea secondary to bronchoconstriction
147
What type of drug is Atropine?
Muscarinic antagonist
148
What are the key indications for Atropine?
Inhibit secretions, Sinus bradycardia, AV block, Adjuvant with anticholinesterase
149
What are the toxic effects of Atropine?
Antimuscarinic/cholinergic effects
150
What is the mechanism of action of Digoxin?
Cardiac Na+/K+ ATPase inhibitor
151
What are the key indications for Digoxin?
Heart failure, Atrial fibrillation
152
What are the toxicities associated with Digoxin?
Arrhythmia, Nausea, Vomiting, Diarrhea, Blurry yellow vision
153
What is the mechanism of action of Epinephrine?
β- and α-agonist: β > α
154
What are the key indications for Epinephrine?
Anaphylactic reactions, Hypotension
155
What are the secondary effects of Epinephrine?
Secondary to β- and α-adrenergic receptor effects
156
What is the mechanism of action of Ibutilide?
K+ channel blocker
157
What are the key indications for Ibutilide?
Atrial fibrillation/flutter, Torsades de pointes
158
What is the mechanism of action of Isoproterenol?
β-agonist
159
What are the indications for Isoproterenol?
Heart block, Bradyarrhythmias, Bronchospasm
160
What are the toxicities associated with Isoproterenol?
Arrhythmias, Angina, Flushing
161
What is the mechanism of action of Magnesium sulfate?
Effect on Ca2+ and K+ fluxes
162
What are the key indications for Magnesium sulfate?
Torsades de pointes, Digitalis-induced arrhythmia
163
What are the toxic effects of Magnesium sulfate?
Cardiac arrest, ↓ Deep tendon reflexes
164
What is the mechanism of action of Atenolol?
β-blocker, β1 > β2
165
What are the key indications for Atenolol?
Hypertension, Angina, Post-MI secondary prevention
166
What are the key toxicities associated with Atenolol?
Bradycardia, Heart failure, AV block
167
What is the mechanism of action of Esmolol?
β-blocker, β1 > β2
168
What is the key indication for Esmolol?
Supraventricular tachycardia
169
What are the key toxicities associated with Esmolol?
Cardiac arrest, Bradycardia, Hypotension
170
What is the mechanism of action of Metoprolol?
β-blocker, β1 > β2
171
What are the key indications for Metoprolol?
Hypertension, Angina, Acute myocardial infarction in hemodynamically stable patients, ↓ Morbidity and mortality in heart failure
172
What are the key toxicities associated with Metoprolol?
Hypotension, Bradycardia, AV block, Dyslipidemia
173
What is the mechanism of action of Carteolol?
β-blocker
174
What are the key indications for Carteolol?
Open-angle glaucoma, Intraocular hypertension
175
What are the key toxicities associated with Carteolol?
Conjunctival hyperemia
176
What is the mechanism of action of Propranolol?
β-blocker, β1 = β2
177
What are the key indications for Propranolol?
Hypertension, Angina, Essential tremor, Migraine prophylaxis, Thyrotoxicosis, Supraventricular arrhythmias, also ventricular tachycardias
178
What are the key toxicities associated with Propranolol?
Bradycardia, AV block, COPD and asthma exacerbation, Vasospasm exacerbation in Prinzmetal angina
179
What is the mechanism of action of Sotalol?
β-blocker, K+ channel blocker
180
What are the key indications for Sotalol?
Ventricular arrhythmia, Atrial fibrillation/flutter
181
What are the key toxicities associated with Sotalol?
Torsades de pointes, β-blockade
182
What is the mechanism of action of Carvedilol?
α- and β-blocker
183
What are the key indications for Carvedilol?
Congestive heart failure, Hypertension, Antiarrhythmic
184
What are the key toxicities associated with Carvedilol?
Hypotension, Cardiovascular effects: bradycardia, etc.
185
What is the mechanism of action of Labetolol?
α- and β-blocker
186
What are the key indications for Labetolol?
Hypertension, Hypertensive emergencies such as in pregnancy
187
What are the key toxicities associated with Labetolol?
Orthostatic hypotension
188
What are Angiotensin II Antagonists also known as?
Angiotensin receptor blockers (ARBs) ## Footnote ARBs are a class of medications that inhibit the action of angiotensin II.
189
Name three examples of Angiotensin II Antagonists.
* Losartan * Candesartan * Valsartan ## Footnote These medications are commonly used to treat various cardiovascular conditions.
190
What is the key indication for Angiotensin II Antagonists?
* Hypertension * Heart failure * Diabetic kidney disease ## Footnote These conditions are commonly treated with ARBs to manage blood pressure and protect kidney function.
191
What is a potential toxicity associated with Angiotensin II Antagonists?
* Hyperkalemia * Teratogen * ↓ Glomerular filtration rate (GFR) * Hypotension ## Footnote These toxicities can arise from the use of ARBs and require monitoring.
192
True or False: Angiotensin II Antagonists can cause hypotension.
True ## Footnote Hypotension is a known side effect of ARBs due to their blood pressure-lowering effects.
193
What is the mechanism of action for Clonidine?
α2-agonist ## Footnote Clonidine primarily works by stimulating alpha-2 adrenergic receptors in the brain.
194
List the key indications for Clonidine.
* Hypertension * Attention deficit hyperactive disorder (ADHD) * Tourette syndrome * Opioid withdrawal ## Footnote Clonidine is used in various conditions, including management of ADHD and withdrawal symptoms.
195
What are the key toxicities associated with Clonidine?
* Depression of the CNS * Respiratory depression * Bradycardia * Hypotension * Miosis ## Footnote The toxic effects can lead to severe complications if not monitored.
196
What is the mechanism of action for Doxazosin and Terazosin?
α1-blocker ## Footnote These medications block alpha-1 adrenergic receptors, leading to vasodilation.
197
List the key indications for Doxazosin and Terazosin.
* Hypertension * Benign prostatic hyperplasia symptoms ## Footnote These drugs are often prescribed for hypertension and urinary issues related to prostate enlargement.
198
What is a key toxicity associated with Doxazosin and Terazosin?
* Orthostatic hypotension * Urinary incontinence ## Footnote Patients may experience dizziness upon standing due to blood pressure changes.
199
What is the mechanism of action for Amrinone and Milrinone?
Phosphodiesterase (PDE) inhibitor
200
What is the key indication for Amrinone and Milrinone?
Heart failure
201
What is a key toxicity associated with Amrinone and Milrinone?
Arrhythmia
202
What type of agonist is Dobutamine?
β- and α-agonist
203
What are the key indications for Dobutamine?
Heart failure, Tachyarrhythmia, Hypertension
204
What is a key toxicity associated with Dobutamine?
Tachyarrhythmia
205
What are the mechanisms of action for Dopamine?
Dopamine, β- and α-agonist
206
What is the key indication for Dopamine?
Low cardiac output/poor perfusion
207
What is a key toxicity associated with Dopamine?
Arrhythmia, Angina
208
What is the mechanism of action for Epinephrine?
β- and α-agonist
209
What are the key indications for Epinephrine?
Type I hypersensitivity reactions, Hypotension secondary to septic shock, Cardiac arrest
210
What are the key toxicities associated with Epinephrine?
Angina, Arrhythmia, Anxiety, Respiratory difficulties
211
What is the mechanism of action for Norepinephrine?
β- and α-agonist
212
What is the key indication for Norepinephrine?
Hypotension, Cardiac arrest, Septic shock
213
What are the key toxicities associated with Norepinephrine?
Hypertension, Bradycardia, Arrhythmia, Anxiety, Dyspnea
214
What is the mechanism of action for Phenylephrine?
α-agonist
215
What is a key indication for Phenylephrine?
Hypotension, Decongestant
216
What are the key toxicities associated with Phenylephrine?
Hypertension, Reflex bradycardia, Anxiety, Pulmonary edema
217
Fill in the blank: Dobutamine is a _______ agonist.
[β- and α-]
218
True or False: Norepinephrine can cause bradycardia.
True
219
What is the mechanism of action of Hydralazine?
↑ cGMP, leading to smooth muscle relaxation ## Footnote Used primarily for severe hypertension and heart failure.
220
What are the key indications for using Nitroprusside?
Severe hypertension Decompensated heart failure ## Footnote It works by increasing cGMP.
221
What is a potential toxicity associated with Nitroprusside?
Hypotension Cyanide toxicity (potential) ## Footnote Careful monitoring is required due to the risk of cyanide toxicity.
222
What is the primary mechanism of action for Minoxidil?
Arteriolar vasodilator, opens K+ channels ## Footnote Also indicated for androgenetic alopecia.
223
What are the key indications for Minoxidil?
Severe hypertension Androgenetic alopecia ## Footnote It can cause tachycardia and salt and water retention.
224
What are the side effects of Minoxidil?
Tachycardia Salt and water retention Hirsutism ## Footnote These effects are due to its vasodilatory action.
225
What is the mechanism of action of Diazoxide?
Opens K+ channels in smooth muscle ## Footnote It is used for severe hypertension and hypoglycemia in insulin-secreting tumors.
226
What are the key indications for Diazoxide?
Severe hypertension Hypoglycemia in the setting of insulin-secreting tumors ## Footnote It can cause hypotension and hyperglycemia.
227
What are the potential toxicities associated with Diazoxide?
Hypotension Hyperglycemia ## Footnote Monitoring is essential due to the risks involved.
228
What is the mechanism of action for Acetazolamide?
Carbonic anhydrase inhibitor ## Footnote Used for conditions like edema, mountain sickness, glaucoma, and idiopathic intracranial hypertension.
229
What is a key indication for the use of Acetazolamide?
Edema Mountain sickness Glaucoma Idiopathic intracranial hypertension (pseudotumor cerebri) ## Footnote Acetazolamide has multiple indications including the management of mountain sickness.
230
What is a key toxicity associated with Acetazolamide?
Metabolic acidosis Hyperammonemia Paresthesias Sulfa allergy ## Footnote These toxicities can occur with the use of Acetazolamide.
231
What is the mechanism of action for Loop Diuretics?
Inhibit Na+/K+/2Cl− transporter of thick ascending limb of loop of Henle ## Footnote This mechanism is crucial for their action in lowering blood pressure and reducing edema.
232
List three key indications for Loop Diuretics.
* Hypertension * Edema due to heart failure * Edema due to liver failure * Edema due to nephrotic syndrome * Hypercalcemia ## Footnote Loop diuretics are used in various conditions related to fluid overload.
233
What is a key toxicity associated with Loop Diuretics?
Ototoxicity Metabolic hypokalemic alkalosis Hypovolemia Sulfa allergy Interstitial nephritis Gout ## Footnote These adverse effects are important to monitor during treatment.
234
What decreases the efficacy of Loop Diuretics?
Use with NSAIDs ## Footnote The interaction between Loop Diuretics and NSAIDs can lead to reduced effectiveness.
235
What is the mechanism of action for Thiazide Diuretics?
NaCl reabsorption inhibitor in distal convoluted tubule ## Footnote This mechanism helps to control blood pressure and manage fluid retention.
236
List two key indications for Thiazide Diuretics.
* Heart failure * Edema * Nephrogenic diabetes insipidus * Calcium nephrolithiasis ## Footnote Thiazide diuretics are commonly used in cardiovascular and renal conditions.
237
What is a key toxicity associated with Thiazide Diuretics?
Sulfa allergy Hypokalemia Hyper-uricemia Hyperglycemia Hypercalcemia Hyperlipidemia Metabolic alkalosis ## Footnote These toxicities can significantly impact patient management.
238
What is the mechanism of action for Amiloride?
ENaC epithelial channel blocker in cortical collecting ducts ## Footnote This mechanism is crucial for potassium-sparing effects.
239
List two key indications for Amiloride.
* Heart failure * Hyperaldosteronism * Nephrogenic diabetes insipidus * States of K+ depletion (i.e., use of thiazides) ## Footnote Amiloride is particularly useful in conditions leading to potassium loss.
240
What is a key toxicity associated with Amiloride?
Hyperkalemia ## Footnote Hyperkalemia is a significant risk, especially in patients with renal impairment.
241
What is the mechanism of action for Spironolactone?
Aldosterone receptor blocker in cortical collecting ducts (in their cytoplasm) ## Footnote This action helps manage conditions related to excess aldosterone.
242
List two key indications for Spironolactone.
* Heart failure * Hyperaldosteronism * Hepatic ascites ## Footnote Spironolactone is often used in heart failure and conditions with fluid overload.
243
What is a key toxicity associated with Spironolactone?
Hyperkalemia Gynecomastia ## Footnote These side effects can affect patient compliance and treatment outcomes.
244
What are HMG-CoA Reductase Inhibitors commonly known as?
Statins ## Footnote Statins are a class of drugs used to lower cholesterol levels.
245
What is the mechanism of action for Atorvastatin?
HMG-CoA reductase inhibitor ## Footnote This mechanism reduces cholesterol production in the liver.
246
What is the key indication for using Atorvastatin?
Vascular disease secondary to atherosclerosis ## Footnote Atorvastatin is primarily prescribed to reduce the risk of cardiovascular events.
247
What are the key toxicities associated with HMG-CoA Reductase Inhibitors?
* Myopathy * Hepatotoxicity * Potential for teratogenicity ## Footnote These side effects can vary in severity and impact patient safety.
248
Which HMG-CoA Reductase Inhibitor is contraindicated in pregnancy?
All statins ## Footnote Statins are known to have teratogenic effects.
249
What is the mechanism of action for Fenofibrate?
PPAR-α agonist, upregulates lipoprotein lipase ## Footnote This action helps to reduce triglycerides and increase HDL levels.
250
What is the key indication for Fenofibrate?
Hypertriglyceridemia, low HDL cholesterol ## Footnote Fenofibrate is used to manage specific lipid disorders.
251
What are the key toxicities associated with Fenofibrate?
* Myopathy * Gallstones (cholesterol) ## Footnote Patients must be monitored for these potential side effects.
252
What is the mechanism of action for Niacin?
Increases HDL and decreases LDL and triglycerides ## Footnote Niacin is effective in improving overall lipid profiles.
253
What is the key indication for Niacin?
Dyslipidemia ## Footnote Niacin is often used in combination therapy for lipid management.
254
What are the key toxicities associated with Niacin?
* Flushing * Pruritis * Hepatotoxicity * Hyperuricemia * Hyperglycemia ## Footnote Flushing can be alleviated with NSAIDs.
255
True or False: Gemfibrozil is a PPAR-α agonist.
True ## Footnote Gemfibrozil works similarly to Fenofibrate in lipid management.
256
What is the mechanism of action of Abciximab?
GpIIb/IIIa inhibitor ## Footnote Used in unstable angina and prevention of cardiac ischemia in percutaneous coronary intervention.
257
What are the key toxicities associated with Abciximab?
Bleeding, Thrombocytopenia ## Footnote These side effects are important to monitor in patients receiving this medication.
258
What is the key indication for Anagrelide?
Thrombocythemia in myeloproliferative disorders ## Footnote Anagrelide is specifically used to lower platelet counts.
259
What are the side effects of Anagrelide?
Palpitations, Headache, Thrombocytopenia, Bleeding ## Footnote Monitor for these effects during treatment.
260
What is the mechanism of action of Cilostazol?
Phosphodiesterase III inhibitor ## Footnote Cilostazol is used for secondary ischemic stroke prevention and intermittent claudication.
261
List the key toxicities of Cilostazol.
Headache, Flushing, Hypotension ## Footnote These side effects can impact patient compliance.
262
What is the main action of Aspirin?
Irreversible COX inhibitor that impairs TXA2 synthesis ## Footnote Aspirin is widely used for treatment and prevention of arterial thrombosis.
263
What are the key toxicities associated with Aspirin?
Tinnitus, Gastrointestinal toxicity, Renal toxicity, Reye syndrome, Metabolic acidosis-respiratory alkalosis ## Footnote Reye syndrome is a serious condition that can occur in children with viral infections.
264
What is the mechanism of action of Ticlopidine and Clopidogrel?
ADP-receptor antagonist ## Footnote This action impairs the expression of GpIIb/IIIa receptors.
265
What are the key indications for Ticlopidine and Clopidogrel?
Acute coronary syndrome, Prevention of cardiac ischemia, Treatment and prevention of arterial thrombosis ## Footnote These medications are crucial in managing cardiovascular events.
266
What is a potential toxicity of Ticlopidine?
Leukopenia ## Footnote This side effect requires monitoring of blood counts.
267
What is the mechanism of action of Alteplase, Streptokinase, and Urokinase?
Aids in conversion of plasminogen to plasmin ## Footnote These agents are used in thrombolytic therapy.
268
What are the key indications for thrombolytics like Alteplase?
Early myocardial infarction, Ischemic stroke, Pulmonary embolism ## Footnote Timely administration is critical for effectiveness.
269
What is a common toxicity of thrombolytics?
Bleeding ## Footnote Careful patient selection is essential to minimize this risk.
270
What is the action of Digoxin-Immune Fab?
Binds excess digoxin or digitoxin ## Footnote This is used in cases of digoxin toxicity.
271
What is the indication for Albumin?
Blood volume expander, Antihyperbilirubinemic ## Footnote It binds to various substances in the blood.
272
What are the key toxicities associated with Albumin?
Hypovolemia, Heart failure, Edema ## Footnote Monitoring is necessary to prevent these complications.

Cardiovascular (15 decks)

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