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Flashcards in gold usmle: cardio pharm Deck (58):
1

Digoxin

↓ AV nodal conduction/ inh. Na/K/Atpase = inc. Ca conc. in heart cells = inc. contraction force

2

Diltiazem

Txt black men. Txt AV nodal re entrance

3

Quinidine

↓ AV nodal conduction. Cinchonism. Anticholinergic= aggravate MG. Hypotension= α block

4

Verapamil

↓ AV nodal conduction. ↓ BP. Negative inotrope= no CHF use

5

Propranolol

↓ AV nodal conduction. ↓ BP. Negative inotrope(= β block) Aggravates Asthma and Diabetes Melitus via β2 block.

6

Diazoxide

Balanced vasodilator.

7

Niroprusside

Balanced vasodilator. Unloads heart. ↑s cyanide= pre-txt w/ thiosulfate. Txt Acute HTN’v Crisis

8

Reserpine

Txt severe & resistant HTN. Depletes CA. See stuffy nose. No to pts w/ peptic ulcers.

9

Dobutamine

At high doses β2(+) offsets α1 = β1 ↑ CO w/o systemic vascular resistance

10

Dopamine

At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output

11

Esmolol

Short acting β(-)

12

Captopril

Balanced vasodilator. Txt Outpt. CHF see dry cough(bradykinin induced)

13

Digoxin

Txt CHF & Atrial Flutter - inotropic - ↓ K+ levels= dig. Toxicity

14

Dig. Toxicity

Fatal ventricular arrhythmias w/ sever AV block

15

Quinidine

ClassIa anti arrhythmic. Moderate Na Ch. Block

16

Lidocaine

ClassIb anit arrhythmic. Normalizes conduction. Txt initial MI= control arrhythmias

17

Flecanide

ClassIc anti arrhythmic. Marked conduction slowing

18

Amiodarone

Long t1/2= need potent doses to obtain desired level for action. See blue skin, ocular deposits, Pulmonary Fibrosis.

19

NE

↑ AV nodal conduction via β1. Metoprolol(-) β1

20

Ach

↓ AV nodal conduction via M receptor. Atorpine(-) M-r

21

Atenolol

Controls catecholamine induced arrhythmias

22

Bretylium

Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias
briefly

23

Nimodipine

Txt Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm

24

Atropine

↓ excess vagal tone as seen in Sinus Bradycardia

25

Nitrates

↓ preload= venous pooling. ↓ MVO2= reflex tachy. ↑ ventr work= dec O2 demand

26

Propranolol

Blocks reflex tachy but causes excess brady= ↑ diastole time= ↑ EDV

27

Verapamil

↑ O2 supply via ↓ in vasospasm Txt Prinzmetal’s variant angina

28

Aspirin

Prevents arterial platelet adhesion (not DVThrombi). Inactivates COX= ↓ platelet production of TxA2, a potent
vasoconstictor

29

Warfarin

(-)Vit. K dependent gamma carboxylation of clotting factors= anticoagulation state

30

Heparin

Dependent on Antithrombin III activation

31

TPA

Binds to fibrin clots & activates plasminogen on the spot. Short t1/2, given IV.
32. Does not discriminate b/t fibrin-based clots= bleeding & stroke complications arise

32

Streptokinase

From bacteria= allergies arise. Can see excess bleeding in post-op pts.

33

Urokinase

Human source. ↑ plasmin. Can see excess bleeding in post-op pts.

34

Colestipol

Bile acid sequestrants. Interrupt bile acid reabsorption= ↑↑ LDL uptake. Cholestyramine same MOA.

35

Lovastatin

HMGCoA reductase(-)= ↑ LDL-r synthesis. Pravastatin/ Mevastatin same MOA.

36

Losartan

↓ Aldosterone. ↑ Renin 2-3x’s

37

Diazoxide

Txt insulinomas. Not balanced vasodilator= onlt dilates arterial smooth muscle

38

Clonidine

Central α2(+). ↓ TPR via ↓ symapthetic effect

39

Methyldopa

Central α2(+). (++) Coombs= Hemolytic anemia

40

Phenytoin

ClassIb. Reverses mild AV block due to digitoxin toxicity

41

Procainamide

ClassIa. SLE like syndrome.

42

Indopamide

Only Thiazide that will have no effect on cholesterol levels

43

Thiazides

Older black men w/ HTN due to ↑ Renin.

44

β(-)

Young white men w/o asthma (cause bronchospasm)

45

ACEIs

(-) change AI ! AII. (-) Bradykinin inactivation. Captopril/ Enalapril
47. Cause renal failure = use w/ caution in the elderly

46

Epinephrine

↑ contraction rate & force via β1.
49. ↑ systolic but ↓ diastolic BP.
50. ↓ peripheral resistance via β2 vasodilaiton

47

Norepi.

↑ heart rate and ↑ systolic and diastolic BP
52. ↑ peripheral blood vessel resistance

48

Methyldopa

DOC for pregnancy induced HTN

49

Quinidine pre-txt

Atrial arrhythmia pretxt w/ a drug that will ↓ ventricular response: Dig.;β(-); Ca Ch.(-)

50

ClassII

β(-) ↓risk fo reinfarction & sudden death following MI

51

“Gray man”

Amiodarone: ClassIII antiarrhythmia

52

Beperidil

Ca Ch(-). Limited clinical use due to Torsades de Pointes

53

ACEIs

Vasodilate renal efferents > than afferent arterioles: ↓GFR & Filtration pressure
59. ↓ Diabetic renal failure progression

54

Adenosine

Its receptor is blocked by Methylxanthines (ie… Theophyline)
61. Favored for the Txt of Reentrant Supra Ventricular Tachycardia

55

Enoxaparin

Low molecular weight heparin = Oral anticoagulant

56

Isoproterenol

↑HR & ↓MAP

57

Variant angina

Use Ca Ch. (-)r ie… Nifedipine

58

Contraindicated in
CHF

β (-)r = you don’t want to ↓ the heart’s pumping strength