CV

Question 1

Nitroglycerin

Answer 1

Nitrates

Question 2

Isosorbide mononitrate

Answer 2

Nitrates

Question 3

Nitrates MOA

Answer 3

work directly on vascular smooth muscle

Question 4

Nitrates AE

Answer 4

reflex tachycardia, dizziness, OH, weakness

Question 5

Nitrates Common Routes

Answer 5

IV, sublingual, topical

Question 6

Nitrates Other drug care

Answer 6

“limit light exposure
short shelf life
tingling sensation as drug dissolves
1st dose 1-2 min, 2nd dose 5mins, 3rd in 15mins”

Question 7

Aspirin

Answer 7

NSAID that works as a Antiplatelet

Question 8

Clopidogrel (Plavix)

Answer 8

Antiplatelet

Question 9

Antiplatelet MOA

Answer 9

ADP receptor inhibitor which decreases platelet aggregation (will last 7-10 days)

Question 10

Antiplatelet AE

Answer 10

BLEED

Question 11

Aspirin MOA

Answer 11

inhibs COX 1 and COX 2 -> Inhib platelet aggregation (low doses COX 1 specific)

Question 12

Aspirin AE

Answer 12

GI, kidney, Heart?

Question 13

Antiplatelet Other

Answer 13

“CYP2C19 to activate (metabolism)

decreased efficacy in some genetic variations (asain and african american)”

Question 14

Rivaroxaban (Xarelto)

Answer 14

Anticoagulant (factor Xa)

Question 15

Apixaban (Eliquis)

Answer 15

Anticoagulant (factor Xa)

Question 16

anticoagulant (Factor Xa) MOA

Answer 16

SELECTIVELY and REVERSIBLY binds to FXa –> stops further coagulation cascade

Question 17

Rivaroxaban AE

Answer 17

More GI BLEED (beers list)

Question 18

Apixaban AE

Answer 18

Lowest Bleed risk

Question 19

Rivaroxaban Other

Answer 19

MUST BE TAKEN WITH FOOD (HIGH FAT)

Question 20

Factor Xa reversal agent

Answer 20

reversal agent andexanet alfa,

Question 21

Enoxaparin (Lovenox)

Answer 21

LMWH Anticoagulant

Question 22

Warfarin

Answer 22

Anticoagulant

Question 23

Haparin

Answer 23

ANticoagulant

Question 24

Heparin MOA

Answer 24

potentiates action of antithrombin which prevents fibrinogen to fibrin

Question 25

Heparin AE

Answer 25

Heparin induced thrombocytopenia (HIT)

Question 26

Heparin reversal agent

Answer 26

reversal agent: protamine sulfate

Question 27

Lovenox MOA

Answer 27

Like heparin, potentiates action of antithrombin but has a greater effect on inhib FXa (prefered over heparin)

Question 28

Lovenox reversal agent

Answer 28

reversal angent: Andexanet alfa (andexxa)

Question 29

Antithrombotics types

Answer 29

Antiplatelet Anticoagulant Fibrinolytics

Question 30

Antithrombotics | PT concerns

Answer 30

``` "FALLS Contradicted PT treatment Haparin - LAB VALUES (aPTT) Warfarin - LAB VALUES (INR) LMWH dont need to" ```

Question 31

Warfarin MOA

Answer 31

converts inactive vit K to active vit K, depletes vit k stores, inhibts synth of factors VII, IX, X, and II (REVERSAL AGENT VIT K)

Question 32

Warfarin AE

Answer 32

Intercranial bleed, DDIs

Question 33

Warfarin other

Answer 33

FOOD INTERACTIONS, "3 to 5 days to take effect NTI requires frequent monitoring of INR Metabolized by CYP2C9

Question 34

Atorvastatin (lipitor)

Answer 34

HMG CoA Reductase inhibs (statins)

Question 35

Rosuvastatin (crestor)

Answer 35

HMG CoA Reductase inhibs (statins) | less likely myalgia

Question 36

simvastatin

Answer 36

HMG CoA Reductase inhibs (statins)

Question 37

pravastatin

Answer 37

HMG CoA Reductase inhibs (statins) | less likely Myalgia

Question 38

HMG CoA Reductase inhibs MOA

Answer 38

block HMG-CoA Reductase= blocks cholesterol synthesis

Question 39

HMG CoA Reductase inhibs AE

Answer 39

"MYALGIA (less likely with pravastatin and rosuvastatin) myopathy, rhabdo dyspepsia, headache, increased liver enzyme function, tendinopothy"

Question 40

HMG CoA Reductase inhibs PT

Answer 40

"Mytositis and myalgia persistent muscle effects Rhabdo"

Question 41

HMG CoA Reductase inhibs Other

Answer 41

"increased myopathy with fibrates (DDI) 1ST line for atherosclerosis then go to ezetimibe" Grapefruit Juice

Question 42

Amiodarona used for

Answer 42

Used for ventricular arrhythmias

Question 43

Amiodarona MOA

Answer 43

prolong duration of the action potential by blocking K, Na, and Ca channels

Question 44

Amiodarona AE

Answer 44

pulmonary fibrosis, GI problems, Thyroid dysfuction, blurred vision, ataxia, dizziness, liver tox, neuropathy, CV (bradycardia, heart block), bluish discoloration on exposed areas

Question 45

Amiodarona Other

Answer 45

Long half life 50 days

Question 46

Sacubitril/valsartan (Entrsto)

Answer 46

ARNI

Question 47

Digoxin

Answer 47

ARNI

Question 48

Sacubitril/valsartan (Entresto) MOA

Answer 48

"Valsartan MOA: previously discussed to↓ VASOCONSTR aldosterone release, also ↓ CATECHOLAMINE RELEASE Sacubitril MOA: inhibits neprilysin enzyme (which typically breaks down peptides) = ↑natriuretic peptides = ↑ vasodilation, diuresis, natriuresis, GFR "

Question 49

ARNI AE

Answer 49

SAME AS THE ARBs BUT HIGHER RISK OF ANGIODEMA

Question 50

ARNI Other

Answer 50

reduces mortality even more than ACEi (only ernesto)

Question 51

Digoxin MOA

Answer 51

inhib Na/K ATPase in myocardial cells = increases Na = increase Ca = Increased contractility