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Cardio Exam 2 > Drug review > Flashcards

Flashcards in Drug review Deck (59):
1

Epinephrine mech?

activate a1, a2, B1, B2, B3 [B2 > a1]

2

Epinephrine effect on:
HR
SBP
DBP
MAP
TPR

in low dose vs normal dose

Low dose → decrease diastolic and mean BP
o Increase HR/SBP/slightly MAP and decrease TPR/DBP

Normal dose
o Increase all HR/SBP/DBP/MAP/TPR

3

Norepinephrine mech?

activates a1, a2, B1 [NOT B2]

4

Norepinephrine effect on:
HR
SBP
DBP
MAP
TPR

increase DBP/MAP/SBP/TPR; decrease HR
o Strong baroreceptor decreases HR
o Increases BP more than Epi due to lack of B2

5

Use of norepinephrine?

cardiogenic shock, septic/hypovolemic shock

6

adverse of norepi?

severe hypertension

7

Isoproterenol mech?

activates B1/B2/B3 [not As]

B agonist

8

Isoproterenol effect on:
HR
SBP
DBP
MAP
TPR

decrease DBP/MAP/TPR; increase SBP slightly/HR
o Biggest increase HR b/c direct same direction as reflex

9

Dobutamine mech?

selective B1 agonist

10

Dobutamine effect?

increase HR and contractility

11

Dopamine mech?

low dose = D1
moderate = D1 + B1
high = D1 + B1 + a1

12

Dopamine effect at low, medium high dose?

low = more renal flow + urine output, decrease BP a little
moderate = decrease BP a little, increase HR/CO, no change in TPR
high = increase BP, a1 effect outweighs D1 effect

13

Fenoldopam mech?

selective D1 agonist

14

Fenoldopam effect?

decrease BP --> used to treat severe HTN

15

Albuterol Mech?

selective B2 agonist

16

Albuterol effect?

vasodilate + bronchodilate + increase HR

17

Side effects/adverse of albuterol?

tachycardia, N/V, hypokalemia, hypotension

18

Phenylephrine mech?

a agonist, slightly selective for a1

19

Clonidine mech?

a2 agonist = sympatholytic adrenergic agonist

20

What is action of tyramine?

NE releaser = indirect sympathomimetic

in aged cheese/meat/fish/wine

avoid with MAO inhibitor

21

What is mech of propanolol?

non-selective B blocker
also a class II anti-arrhythmic

22

What is use of B blockers?

- angina, SVT, slowing ventricular rate during AFib/flutter
- HTN
- MI

23

What is mech of nadolol?

non-selective B blocker

24

What is mech of metoprolol?

selective B1 blocker

25

What is mech of atenolol?

selective B1 blocker

26

What is mech of bisoprolol?

selective B1 blocker

27

What is mech of action of pindol?

partial B1/B2 agonist

- in absence of normal physiologic agonist it is an agonist
when high sympathetic drive --> its a beta antagonist

28

What is black box warning with B blockers?

don't withdraw quickly b/c upregulated B receptors cause unsafe increase in HR and contractility

29

What B blocker does not have black box warning?

pindol

30

WHat is mech carvedilol?

antagonist at B1, B2
partial antagonist at a1

31

What is effect of carvedilol?

vasodilate, inhibits cardiac remodeling

use in HF

32

What is mech of labetalol?

antagonist at B1/a1
partial agonist at B2 with ISA activity [aka antagonist when high intrinsic sympathetic activity]

33

What is mech of phentolamine?

competitive a antagonist

34

What is effect of phentolamine?

decrease BP due to a1 blockade

35

What is mech of acetylcholine?

full agonist at M and N receptors
higher affinity for M than N

36

What is effect of ACh with small vs large dose?

small = quick drop in BP, reflex tachycardia
big = direct effect on SA node --> drop in BP + bradycardia

37

What is mech of bethanechol?

M agonist

38

What is mech of nicotine?

N agonist --> at ganglia activates sympathetic/parasympathetic branches whichever is dominant for the most part

39

What is effect of nicotine?

- increase BP
- increase HR [in part due to Epi released from adrenal]

at high dose --> ANS activation then depolarizing blockade

40

What is mech of neostigmine? does it cross BBB?

AChe inhibitor

does not cross BBB

41

What is mech of physostigmine? does it cross bbb?

AChe Inhibitor

crosses BBB

42

What is mech of donepezil?

AChe inhibitor, relatively selective for brain ACh

43

What is mech of rivastigmine?

AChe inhibitor, relatively selective for brain ACh

44

What is mech of galantamine?

AChe inhibitor

45

What is use of donepezil/rivastigmine/galantamine?

used to treat dementia

46

What is mech of atropine?

M receptor antagonist

47

What is mech of scopalamine?

M receptor antagonist

48

What is mech of ipratroprium?

competitive non-selective muscarinic antagonist

inhalational only

49

What is use of ipratroprium?

acute asthma exacerbation
bronchospasm w/ COPD

50

What type of drug is quinidine?

class 1A

51

What type of drug is lidocaine?

class iB

52

What type of drug is flecainide?

class 1C

53

What type of drug is amiodarone?

class 3

54

What type of drug is sotolol?

class 3

55

What type of drug is dilitiazem?

class 4

56

What type of drug is procainamide?

class 1A

57

What type of drug is propafenone?

class 1C

58

What type of drug is dofetilide?

class 3

59

What type of drug is verapamil?

class 4