HF

Question 1

HF + fluid retention first line drug?

Answer 1

first Loop D. - Furosemide then ACEi or ARB

Question 2

HF + no fluid retention TOC?

Answer 2

First ARNi + ARB
then beta-blockers

Question 3

DOC emergency HTN pregnancy

Answer 3

First Labetalol then Methyl-dopa then Hydralazine

Question 4

If after ARNi and ARB, Beta blockers also fail in HF, what’s the next step?

Answer 4

Mineralocorticoid Receptor blocker - Spironolactone (alternate)
SGLT2i - Gliflozins - antidiabetic
Vericiguat - Guanyl cyclase

Question 5

Last choice drugs in HF?

Answer 5

Ivabradine (HR>70)
Digoxin (symptomatic)
Both used for persistent symptoms

Question 6

Best drugs for chronic HF?

Answer 6

ARNI

Question 7

Which anti-diabetic drug is used for HF?

Answer 7

Gliflozins

Question 8

Drugs that relieve congestion in HF?

Answer 8

Diuretics (loop) - Furosemide
Natriuretic - Nesiritide

Question 9

Drugs that Increase pumping action in HF pts?

Answer 9

Dopamine and Dobutamine
Ionotropic agents

Question 10

ARNI is?

Answer 10

ARB + Neprilysin inhibitor
(it’s an enzyme that breaks ANP AND BNP, but if they don’t break ANP BNP increase which show diuretic effect)

Question 11

Drugs that inhibit remodeling and increase survival in HF pts?

Answer 11

Beta blockers
ARB
ACEi
Pot sparing diuretics/aldosterone antagonist
SGLT-2 inhibitors - Gliflozin
Hydralazine + Nitrate
Ivabradine

Question 12

Action of Hydralazine + Nitrate?

Answer 12

Hydralazine is Atrial dilator
Nitrate is Venous dilator

Question 13

Ivabradine specifications and use?

Answer 13

Causes bradycardia (use in HR>70) after beta blocker use
in HF pts

Question 14

Which drug uses funny channel inhibition for its function?

Answer 14

Ivabradine

Question 15

Luminous phenomenon is S/E of which drug?

Answer 15

Ivabradine

Question 16

–pril which drugs?

Answer 16

ACEi

Question 17

Example of ARBs used in ARNI-HF drug therapy?

Answer 17

Valsartan + Sacubitril

Question 18

beta-1 agonist used in shock + oliguria?

Answer 18

Dopamine

Question 19

beta-1 agonist used in acute pump failure?

Answer 19

Dobutamine

Question 20

beta-1 agonist used in cardiogenic shock?

Answer 20

Nor-adrenaline

Question 21

DOC digitalis drugs toxicity? (Digoxin and Digitoxin)

Answer 21

Lidocaine/Lignocaine

Question 22

DOC severe digitalis drugs toxicity?

Answer 22

Digibind
KCl last option

Question 23

Which drugs are indicated to be used in severe and refractory CHF?

Answer 23

PDE-3 inhibitors = increase C-AMP = dilates blood vessels (ionodilators)
eg:
Amrinone
Milrinone
Levosimendan - Ca sensitizer

Question 24

Which PDE inhibitor drug used in CHF is Ca sensitizer?

Answer 24

Levosimendan

Question 25

Which is the newer drug for CHF?

Answer 25

Omecamtiv - myosin activator

Question 26

Digoxin MOA?

Answer 26

Na-K-ATPase inhibitor (increase contractility - positive ionotrope) + Vago-mimetic (decrease HR - negative chronotropic)

Question 27

Why is Digoxin used for CHF?

Answer 27

Because it increases contractility and its positive ionotrope

Question 28

Why is Digoxin used for SVT?

Answer 28

Because it decreases HR and is negative chronotrope

Question 29

3 drugs for SVT?

Answer 29

Beta blocker CCB Digoxin

Question 30

SVT + HF DOC?

Answer 30

Digoxin

Question 31

Which site in myocardial cell digoxin bind to?

Answer 31

K (less K means more digoxin binding)

Question 32

Highest risk caused by Digoxin?

Answer 32

Arrythmia (MC ventricular) Yellow vision - Xanthopsia

Question 33

Which arrythmia is NOT caused by Digoxin?

Answer 33

Atrial flutter

Question 34

Which arrythmia caused by digoxin is most characteristic?

Answer 34

SVT with AV block

Question 35

Name drugs that increase digitalis toxicity?

Answer 35

Verapamil Diltiazem Quinidine

Question 36

Name drugs that decrease digitalis toxicity?

Answer 36

Antacids Sucralfate

Question 37

DOC WPW syndrome?

Answer 37

Flecainide/Procainamide

Question 38

DOC HOCM (hypertropic obstructive cardiomyopathy)?

Answer 38

Negative ionotrops = beta blockers

Question 39

C/I Digoxin

Answer 39

WPW Syndrome Hypokalemia - will cause digoxin toxicity HOCM Partial AV block MI high output heart failure

Question 40

Which drug group is not safe to be given with Digoxin?

Answer 40

Diuretics

Question 41

PSVT DOC

Answer 41

Adenosine

Question 42

DOC Sinus bradycardia, mobitz type 1and first degree heart block

Answer 42

Atropine

Question 43

TOC mobitz type 2 and complete heart block?

Answer 43

Pacemaker

Question 44

Best anticonvulsant in Eclampsia

Answer 44

Mg

Question 45

Best antihypertesive in Eclampsia

Answer 45

Labetalol

Question 46

First sign of Mg toxicity?

Answer 46

Loss of deep tendon reflex

Question 47

DOC Mg and Ca toxicity

Answer 47

Calcium gluconate 10-10-10 rule

Question 48

Drug used for stress ECHO

Answer 48

Dobutamine

Question 49

DOC classical angina

Answer 49

Beta blockers

Question 50

Best antihypertesive in IHD

Answer 50

Beta-blockers

Question 51

Best drug for prinzmetal vasospastic angina and peripheral vascular disease?

Answer 51

CCBs (dipines) - vasodilation needed

Question 52

Which drugs are good in angina + diabetes?

Answer 52

FS Oxidase inhibitor - Ranolazine & Trimetazidine Better Hb1Ac control

Question 53

DOC acute IHD attack

Answer 53

Nitroglycerine

Question 54

Drugs with high first pass, metabolism

Answer 54

Nitrates Propranolol Lignocaine

Question 55

Nitrates given by sublingual route are?

Answer 55

GTN and IDN (Sorbitrate - jeeb me rakho)

Question 56

In which spasms/colic patients Nitrates are not effective?

Answer 56

Renal

Question 57

Monday headaches address caused by?

Answer 57

Nitrates tolerance holidays