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Pharm 1 Liner- Cardiovascular Flashcards

(97 cards)

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1
Q

3 side effects of ACE inhibitors

A

Dry cough, hyperkalemia, angioedema

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2
Q

Inactivated by angiotensin converting enzyme, contributes to dry cough and angioedema

A

Bradykinin

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3
Q

ACE inhibitor is drug of choice for

A

Hypertension with diabetic nephropathy because it can decrease the intraglomerular pressure and slow GBM thickening

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4
Q

Ace inhibitors are contraindicated in

A

Pregnancy, hyperkalemia, bilateral renal artery stenosis

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5
Q

Mechanism of action of losartan and valsartan

A

Block angiotensin II type 1 receptor

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6
Q

Side effect associated with ACE inhibitors but not angiotensin receptor blockers

A

Dry cough

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7
Q

Calcium channel blockers with predominant effect on arteriole dilation

A

Nifedipine, amlodipine, nimodipine (dihydropyridines)

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8
Q

Calcium channel blockers with predominant effect on heart

A

Verapamil and diltiazem

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9
Q

Side effects of calcium channel blockers

A

Constipation, peripheral edema, cardiac depression, AV block, gingival hyperplasia

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10
Q

Alpha 2 agonist used in pregnant women with hypertension

A

Methyldopa

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11
Q

Side effects of methyldopa

A

Positive Coombs hemolytic anemia, SLE-like syndrome, CNS depression

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12
Q

Methyldopa is contraindicated in

A

Geriatrics due to its CNS (depression) effects

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13
Q

Side effect of clonidine

A

Rebound hypertension, bradycardia, sedation, dry mouth

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14
Q

Direct vasodilator of arteriolar smooth muscle by increasing cGMP and inhibit IP3-induced calcium release from the SR

A

Hydralazine

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15
Q

Side effect of hydralazine

A

Lupus-like syndrome

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16
Q

Arterial vasodilator that works by opening K channels

A

Minoxidil

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17
Q

Side effect of minoxidil

A

Hyertrichosis

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18
Q

MAO and effect of nitric oxide

A

Increase NO leads to increased cGMP which leads to vascular smooth muscle relaxation

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19
Q

IV nitrate used in hypertensive crisis

A

Nitroprusside

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20
Q

What does nitroprusside dilate

A

Veins and arteries

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21
Q

Side effect of nitroprusside

A

Cyanide poisoning

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22
Q

Mechanism of action of sildenafil

A

Inhibits phosphodiesterase 5, enhancing effects of nitric oxide, activated increase in cGMP

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23
Q

Drugs used in management of exertional angina

A

Nitrates, calcium channel blockers, beta blockers

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24
Q

Aspirin reduces mortality in unstable angina by

A

Inhibiting platelet aggregation

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25
Mechanism of action of organic nitrates
Requires enzymatic release of NO, relaxes vascular smooth muscle of veins
26
Nitrate free intervals are needed due to
Pharmacological tolerance
27
Side effects of nitrates
Reflex tachycardia, hypotension, flushing, throbbing headache due to meningeal artery dilation
28
Indication for digoxin
Atrial fibrillation and CHF
29
Digoxin toxicity can be precipitated by
Hypokalemia
30
PDE3 inhibitors indicated for acute CHF; long term use is associated with increased mortality
Amrinone and milrinone
31
Side effect of amrinone and milrinone
Thrombocytopenia
32
Agent used in acutely decompensated CHF resembling natriuretic peptide
Nesiritide
33
Mechanism of action of class 1 antiarrythmics
Sodium channel blockers
34
Mechanism of action of class 2 antiarrythmics
Beta blockers
35
Mechanism of action of class 3 antiarrthmics
Potassium channel blockers
36
Mechanism of action of class 4 antiarrythmics
Calcium channel blockers
37
Limiting side effect of class 1a and III antiarrythmics
Prolongs QT interval
38
Most common side effects of quinidine that limits its use
Cinchonism
39
Major drug interaction with quinidine
Increased concentration of digoxin
40
Side effect of procainamide
Systemic lupus like syndrome
41
Disopyramide is contraindicated for
Obstructive uropathy, glaucoma, heart failure
42
Class of drug is selective for ischemic heart tissue
Class 1B (lidocaine, mexiletine)
43
Used as last line antiarrythmics agents due to pro arrhythmic property; strongest sodium channel blocker
Class 1C (flecainide, propafenone)
44
Anti-arrhythmic agents that decrease mortality
Beta blockers
45
Used intravenously for acute tachycardia during and post surgery
Esmolol
46
Drug of choice for management of acute ventricular tachycardia
Amiodarone
47
Antiarrythmics effect in most types of earth is
Amiodarone
48
Class 3 antiarrythmics that exhibits properties of all 4 classes
Amiodarone
49
New non-iodinated amiodarone analogue
Dronedarone
50
Side effects of amiodarone
Thyroid dysfunction, corneal deposits, liver damage and pulmonary fibrosis
51
Antiarrythmics that exhibits class 2 and 3 properties
Sotalol
52
Side effect of sotalol
Prolongs QT interval
53
Life threatening cardiac event that prolong QT leads to
Torsades de pointes
54
Drug of choice for narrow complex PSVT
Adenosine
55
Mechanism of action of adenosine
Activates G-protein coupled K+ channels in atrium, SA and AV node
56
Anti arrhythmic with less than 10 second duration of action
Adenosine
57
Drug of choice for early depolarizations
Magnesium sulfate
58
Drug is 2nd line choice for chronic stable angina that modifies myocardial metabolism
Ranolazine
59
Mechanism of action of ranolazine
Blocks the late inward sodium current in ventricular myocardial cells' reduces diastolic wall tension and oxygen consumption
60
Mechanism of action of statins
Inhibits HMG CoA reductase
61
HMG CoA reductase inhibitors are contraindicated in
Pregnancy
62
2 side effects of HMG CoA reductase inhibitors
Rhabdomyolysis and hepatotoxicity
63
2 parameters to obtain before initiation of statins
LFTs, creatine kinase
64
How grapefruit Juice increases statin effect
Inhibit CYP450 3A4
65
Concurrent use of fibrates and statins increases risk of
Rhabdomyolysis
66
Class of agents for cholestyramine, colestipol, colesevalem
Bile acid binding resins
67
Major nutritional side effect of bile acid binding resins
Impair absorption of fat soluble vitamins
68
Fibrates increase activity of
Lipoprotein lipase
69
Fibrates bind and activate a nuclear receptor to upregulate lipoprotein lipase, downregulate hepatic apolipoprotein CIII and increase hepatic fatty acid oxidation in hepatocytes
PPARalpha
70
Side effect of fenofibrate and gemfibrozil
Cholesterol-gallstone formation
71
Mechanism of action involves indirect reduction of liver triglyceride synthesis
Niacin, fibrates
72
Side effect of niacin
Cutaneous flushing
73
Cutaneous flush due to niacin can be reduced by pretreatment with
NSAIDs
74
Inhibits intestinal cholesterol absorption by inhibitin NPC1L1protein
Ezetimibe
75
Mechanism of action of aspirin
Irreversibly blocks COX1 and COX2 via acetylation
76
Agent used to treat MI and to reduce incidence of subsequent MI
Aspirin
77
Side effect of aspirin
GI bleeding
78
Antiplatelet drug reserved for patients allergic to aspirin
Ticlopidine
79
Side effect of ticlopidine
Neutropenia and agranulocytosis
80
Inhibit platelet aggregation by irreversibly blocks ADP (P2Y12) receptor; effective in preventing TIA
Clopidogrel and ticlopidine
81
Phosphodiesterase III inhibitor that increases cAMP and inihibits platelet aggregation indicated for intermittent claudication, coronary vasodilation and prevention of stroke
Dipyridamole, cilostazol
82
Block glycoprotein IIb,IIIa involved in platelet cross linking
Abciximab, tirofiban, and eptifibatide
83
Vitamin K dependent anticoagulant with zero order kinetics of elimination
Warfarin (PT)
84
Route of admin of warfarin
Oral
85
Contraindications of warfarin
Pregnancy
86
Anticoagulant of choice when pregnant
Heparin
87
Heparin (PTT) increases activity of
Antithrombin 3
88
Routes of administration of heparin
IV and SC
89
Side effect of both warfarin and heparin
Bleeding
90
2 anticoagulant used for prophylaxis and treatment of thrombosis in patients with HIT
Bivalirudin, argatroban
91
Mechanism of action of bivalirudin and argatroban
Bind to thrombin active site and inhibit thrombin directly
92
Thrombolytic used for acute MI and ischemic (non-hemorrhagic) cerebral vascular accident (stroke
Altephase
93
Mechanism of action of thrombolytics
Lyse thrombi by catalyzing the formation of plasmin which cleaves fibrin
94
Side defect of tissue plasminogen activators
Cerebral hemorrhage
95
Indications for thrombolytics
pulmonary embolism, severe DVT
96
Thrombolytic that can cause allergic reaction and non selective systemic fibrolysis
Streptokinase
97
Oral agents that inhibit factor Xa
Apixaban, rivaroxaban

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