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PCOL Cumulative Final > First Semester Test 2 CCB/ARB/Cardiac > Flashcards

First Semester Test 2 CCB/ARB/Cardiac Flashcards

1
Q

CCB Chart

A
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2
Q

Calcium Channel Blockers (CCBs) - Non-Dihydropyridines (Non-DHPs)

A

Verapamil - ADRs: Constipation, arrythmias, HA, Dizzyness, Peripheral Edema, AV block, Hypotension, Sinus Bradycardia​​

Diltiazem - ADRs: Above + Rhinitis

Actions: Peripheral & Coronary Vasodilation, negative inotrope/chronotrope/dromotrope, regulate O2 supply /demand

Use: AFIB/Flutter, Paroxysmal Supraventricular tachycardia, HTN (DHP preferred), Myocardial ischemia/angina

Class 4 Antiarrythmic

VD the Non-DHP CCB

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3
Q

CCBs - Dihydropyridines (DHPs)

A

Amy - Amlodipine

Needs - Nifedipine

No - Nicardipine

Friends - Felodipine

In - Isradipine

Niche - Nimodipine

Novels - Nisoldipine

Cleveland - Clevidipine

Dipine, Dipine, Calceeem!

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4
Q

CCB - DHP - Specs/Actions/ADRs

A

Actions: Peripheral Vasodilation

Specifics: HTN, Myocardial Ischemia (Non-DHP preferred), Helps, with O2 supply but not demand

ADRs: Peripheral Edema, Flushing, Palpations, Reflex tachycardia, Hypotension, Dizziness, Fatigue, Exacerbation of Angina, Precipitating Arrhythmias

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5
Q

AADs - Class 1 Sodium Channel blockers - 1A

A

Double - Disopyramide - Negative inotrope

Quarter - Quinidine - Antimalerial also

Pounder - Procainamide - Cleared renally, most used

Actions: Increased duration of refractory period, slows conduction rate, treat Atrial & ventricular arrhythmias

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6
Q

AADs - Class 1 Sodium Channel blockers - 1A ADRs

A

Disopyramide - Anticholinergic effects, exacerbate HF, increase Digoxin tox (negative inotrope)

Quinidine - Vertigo, Tinnitus, GI disturbances, Hemolytic Anemia, Hepatitis (not used anymore)

Procainamide - Hypotension, Lupus-like syndrome, agranulocytosis (need good renal)

All can cause new Arrhythmias

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7
Q

AADs - Class 1 Sodium Channel blockers - 1B

A

Lettuce - Lidocaine - IV or IM, Acute Ventricular arrhythmias

Mayo - Mexiletine - PO, Long Duration

Actions: Ventricular arrhythmias, slows conduction rate

ADRs: CNS toxicity (Paresthesia, Confusion, Seizures, Tremor, GI upset)

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8
Q

AADs - Class 1 Sodium Channel blockers - 1C

A

Pickles - Propafenone - Mild Beta Blocking

Fries - Flecainide - Eliminated via kidney & liver

Actions: Slows conduction rate

ADRs: Conduction abnormalites, HF exacerbation, Metalic Taste, Constipation

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9
Q

AADs - Class 2 (Beta Blockers)

A

Esmolol - Acute Arrhythmias

Actions: Heart Rate Control

ADRs: Bronchospasm, AV block, Exercise intolerance, Cardiac Depression, Hypotension, Sexual Dysfunction

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10
Q

AADs - Class 3 (Potassium Channel Blockers) Agents/Actions

A

SADDI

Sotalol - V. Arrhythmia, AFIB, Renal Clear, Blocks K &B (weakly)

Amiodarone - Wide Use, Class 1,2,& 4 electrophysiological properties, Many DDIs

Dofetilide - Treatment/prophylaxis of AFIB, Must start inpatient

Dronedarone - Also blocks Ca/Na, strong CYP3A4 interactions

Ibutilide - Acute AFIB, Blocks K/Na/B

Actions: Delay repolarization, Increase action potential & refractory period, Used for Atrial and Ventricular arrhythmias

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11
Q

AADs - Class 3 (Potassium Channel Blockers) ADRs/DDIs

A

Sotalol:

ADRs: Torsades de Pointes, Cardiac Depression, Bradycardia, Bronchospasm

DDIs: No significant DDIs

Amiodarone:

ADRs: Pulmonary Fibrosis, Hepatic dysfunction, Grey-Blue skin, Corneal Deposits, Hyper/hypothyroidism

DDIs: Many

Dofetilide:

ADRs: Torsades de Pointes, Pro-arrhythmia

DDIs: HCTZ & Verapamil

Dronedarone:

ADRs: GI intolerance

DDIs: Strong CYP3A4 interactions

Ibutilide:

ADRs: Torsades de Pointes

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12
Q

AAds - Class 4 (Non-DHP CCB)

A

Verapamil : DDI with Digoxin, Dofetilide, Simvastatin, and Lovastatin

Diltiazem : IV or PO

Not preferred for Rate Control, Use for PTs with restrictive airway disease

Actions: Slows conduction in AV node, Increase Refractory period

ADRs: Constipation (more w/verapamil), Hypotension, Heart Block, Exacerbation of HF

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13
Q

Renin, Angiotensin, Aldosterone, System (RAAS) - Angiotensin Converting Enzyme (ACE) Inhibitors

A

-Prils

Lisinopril

Enalapril

Quinapril

Captopril

Ramipril

Benazopril

Fosinopril

Moexipril

Perindopril

Trandolapril

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14
Q

RAAS - ACE inhibitors - Use/Actions/ADRs

A

Use: HTN Post MI, Left Vent Systolic Dysfunction/Systolic HF, CKD

Actions:

DEC TPR/BP DEC Na/H20 retention

DEC H20 Ingestion DEC Arterial pressure

INC Compliance of Large Arteries DEC Proteinuria

ADRs: Dry Cough, Hyperkalemia, Acute Renal, Angioedema, Teratogenic. Hypotension

Can cause AKI when starting or changing therapy/dose

Reduced efficacy in African Americans, they have low renin HTN

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15
Q

RAAS - Angiotensin Receptor Blockers (ARBs)

A

-Sartan

Losartan - Lowers uric acid good for Gout

Valsartan

Olmesartan

Irbasartan

Candesartan

Telmisartan

Eprosartan

Azilsarton

Reduced efficacy in African Americans as they have low renin HTN

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16
Q

RAAS - ARBs - Use/Action/ADRs

A

Use: HTN Post MI/Heart Failure, CKD, Intolerance to ACE inhibitors

Actions: Same as ACE inhibitors

DEC TPR/BP DEC Na/H20 retention

DEC H20 Ingestion DEC Arterial pressure

INC Compliance of Large Arteries DEC Proteinuria

ADRs: Hyperkalemia, Acute Renal, Angioedema, Teratogenic, Hypotension

17
Q

RAAS - Angiotensin Receptor - Neprilysin Inhibitor (ARN)

A

Ernesto (sacubitril/valsartan) - CHF with reduced Ejection Factor

Actions: Vasodilation, Natriuresis, ADR effects, Diuresis, Inhibited Pathogenic GF/Fibrosis

18
Q

Diuretics - Loop

A

Fuck - Furosemide

The - Torsemide

Big - Bumetanide

Exam - Ethacrynic Acid (only non-sulfa, only a concern in sulfa anaphylaxis)

Use: HTN, CHF, Pulmonary Edema, Edema, Good in Renal

Actions: Inhibit Na/K/Cl symporter (more ions in lumen), also more Mg and Ca

ADRs: Hypo K/Ca/Mg/Volemia/Tension, Ototoxicity

19
Q

Diuretics - Thiazide

A

How - Hydrochlorothiazide

Can - Chlorthalidone

I - Indapamide

Continue - Chlorothiazide

Memorizing - Metolazone - Ok for CKD

Use: HTN, CHF, Edema

Actions: Inhibit Na/Cl (more Na/Cl in Lumen)

ADRs: Hypo K/Ca/Mg/Glycemia/Volemia/Tension

Sulfa in all, only avoid in anaphylaxis

20
Q

Diuretics - Potassium Sparing

A

Aldosterone Antagonists - Reduce Na/H2O absorption increase K absorption

Spirinolactone

Eplerenone

ADRs: Hyperkalemia, Impotence (steroid related), DDI’s E>>S

Na Channel Blockers - Inc NA in Lumen, Dec K in Lumen

Amiloride

Triamterene

ADRs: Hyperkalemia

SEAT!

21
Q

Cardiac - Nitrates

A

**Isosorbide Mononitrate**

Isosorbide Dinitrate - For Angina

Nitroglycerin/

Actions: Smooth muscle relaxation (Vasodilation), Dec Preload & Afterload

ADRs: HA, Flushing, Rash, Dizziness, Sweating, Hypotension, Reflex Tachy, Methemoglobinemia (Blue dude), PDE-5 interactions

22
Q

Cardiac - PDE-5 Inhibitors

A

**Vardenafil **

Avanafil - Smooth Muscle Relaxation/vasodilation (INC cGMP)

Tadalafil - /

Sildenafil /

Use: ED, BPH, Pulmonary Arterial HTN

ADRs: Nitrate interactions, Blue/Green Halos

VATS -afil

23
Q

Cardiac - Direct Vasodilators

A

Alpha 1 Blockers

CCBs

24
Q

Cardiac - Others

A

Hydralazine - Use for HTN, HF

Actions: Dec BP/Vascular Resistance, Vasodilation of smooth muscle

ADRs: HA, Flushing, Dizziness, Palpations, Angina, Sinus Tach, Hypotension, Peripheral Edema, Fluid Retention

Minoxidil - Use for Severe drug-resistant HTN

Actions: Dec BP/Vascular Resistance, Vasodilation of smooth muscle

ADRs: Hypotension, Sinus Tach, Hypertrichosis, Angina, HA, Peripheral Edema, Fluid Retention

Nitroprusside - Use in Hypertensive emergency, Acute CHF

Actions: Liberate No, Dec Preload & Afterload

ADRs: Hypotension, Methemoglobinemia, Cyanide tox

25
Q

Cardiac - Positive Cardiac Inotropes - Vasopressors

A

Epinephrine

Norepinephrine

Dopamine

Isoproterenol

Dobutamine

26
Q

Cardiac - Positive Cardiac Inotropes - PDE-3 Inhibitor/Cardiac Glycoside

A

Milrinone - Use short term for acute decompensated HF

Actions : INC contraction/cAMP in cardiac tissue

ADRs: Hepatoxicity, HA, Thrombocytopenia, Arrhythmias

Digoxin - Use for CHF, Rate control in AFIB

Actions : INC Contraction/Intracellular Na & Ca

ADRs : Digitalis Tox, Hyperkalemia, AV block, Arrhythmias, EKG change, Xanthopsia (Yellow vision)

PCOL Cumulative Final (14 decks)

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