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Pharmacology Flashcards

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1
Q

What are common nicotinic antagonists used for intubation

A

Rocuronium
Succinylcholine

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2
Q

What are some potential side effects of succinylcholine

A

Malignant hyperthermia
hyperkalemia

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3
Q

which pressor can be used when minimal effect on vasculature is required

A

Dobutamine

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4
Q

Which beta blockers are non-selective beta antagonists

A

Propranolol
Nadolol
Pindolol
Timolol

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5
Q

Which beta blockers are B1 selective

A

Metoprolol
Atenolol
esmolol
Acebutolol
dobutamine

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6
Q

Which beta blockers cover alpha 1, B1, B2

A

Carvedilol
Labetalol
isoproterenol

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7
Q

What is a benefit to using labetalol to lower BP

A

It causes less tachycardia
*good for hypertensive emergencies

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8
Q

When is Esmolol used

A

For SVT management

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9
Q

When do you get the most cardioselective benefit from atenolol/metoprolol

A

At low doses

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10
Q

What are alpha 1 receptors responsible for and where are they found

A

Vasoconstriction (Increase peripheral resistance)
increase BP
mydriasis

blood vessels and smooth muscle

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11
Q

What are Alpha 2 receptors responsible for and where are they found

A

Inhibits NE release
Inhibits insulin release

brain and periphery

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12
Q

What are B1 receptors responsible for and where are they found

A

increasing inotropy and chronotropy

renin release from the kidneys

found on heart and kidneys

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13
Q

What are B2 receptors responsible for and where are they found

A

Vasodilation
Bronchodilation
Increase glucagon release

smooth muscle and airway

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14
Q

When is Pindolol beneficial

A

Managing HTN in someone with bradycardia

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15
Q

Are anti-platelet medications better for the arterial or venous system

A

Arterial

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16
Q

What are the different groups of antiplatelet medications

A

P2Y12
other
GP2B/3A

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17
Q

Which antiplatelets are P2Y12 inhibitor

A

Clopidogrel
Ticagrelor
Prasugrel

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18
Q

How do the GP2B/3A medications work and what are they

A

Prevent platelet aggregation via fibrinogen

Abciximab
Tirofiban
Eptifibatide

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19
Q

What medications fall under the “other” category for antiplatelets and how do they work

A

ASA (prevents TXA activation)
Cilostazol
Dipyramidole

*prevents breakdown of cAMP = decrease Ca2+

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20
Q

What are the different groups of anticoagulants

A

Vitamin K antagonist
Direct thrombin inhibitors
Indirect thrombin inhibitors
Xa inhibitors

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21
Q

Which mediations are vitamin K antagonists

A

Warfarin

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22
Q

Which anticoagulants are direct thrombin inhibitors and when are they used

A

Dabigatran
Argatroban (inhibits factor 2)

*stroke prevention in those with poor INR control

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23
Q

Which anticoags are indirect thrombin inhibitors

A

Unfractionated heparin (factor 10&2)
LMWH
Enoxaparin

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24
Q

Which 2 class of medications are for AVN blockade

A

Class 2 and 4

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25
What class of drugs are beta blockers
Class 2
26
What class of drugs are Ca2+ channel blockers
4
27
Which classes of cardiac medications are for non-pacemaker blockade
Class 1 and 3
28
What class are sodium channel blockers
1
29
What class are K+ channel blockers
3
30
What are the 2 sub classes of ca2+ channel blockers
Dihydropyridines Non-dihydropyridines
31
What are dihydropyridines
amlodipine felodapine nicardapine nifedipine
32
When are dihydropyridines used
used for lowering BP via vasodilation
33
What are the non-dihydropyridines
Verapamil Diltiazem
34
When are non-dihydropyridines used
Lowers HR and contractility
35
Which patients is digoxin used in
Those with HEFrEF and afib
36
Are beta-blockers or Ca2+ blockers stronger with rate control
Ca2+
37
What is the difference between AVN blockade and blocking non-pacemaker cells
AVN blockade: Rate control Non-pacemaker blockade: Rhythm control
38
Which medications are K+ blockers
Amioderone Sotalol Ibutilide Dofetilide
39
Out of the K+ blockers, what is special about Amioderone and Sotalol
They can be used on ventricular tissue while the rest of the K+ blockers are only useful on atrial tissue
40
What are the sub-classes of Na+ blockers and which drugs fall under each
1a: disopyramide, quinadine, procainamide 1b: Lidocaine 1c: Flecainide, propefanone
41
Which sub-class of Na+ blockers has the most Na+ blockade
1c: Flecanide, propefanone
42
Which patients should flecainide & Propefanone not be used in
CAD HF LVH MI
43
If a patient goes in Vtach post MI, what is the best medication to help
Lidocaine
44
What is typically the first line medication when someone is in Vtach
Amioderone
45
If someone is in Torsades, what is the best first line agent
Magnesium *Can give lidocaine if needed
46
What is the first line anti platelet in someone with unstable angina
Clopidogrel
47
When is Abcixumab used and what are the pharmacokinetics
Those with short term ischemic events s/p ACS and PCI *Peak effect in 30min, our of system in 24 hours
48
Which medications are interchangeable and used in those with a PCI and have an NSTEMI
Tirofiban Eptifibatide
49
Which medications are K+ sparing diuretics
Amiloride Triamterene
50
Which medications are loop diuretics
Furosumide Bumetanide Torsemide
51
Which loop diuretics is most potent
Bumetanide
52
Which patients cannot be given a loop diuretic
Those with a sulfa allergy
53
Which medications are thiazide diuretics
Chlorthalidone hydrochlorothiazide Metolazone
54
When is metolazone utilized
Added to loops in the treatment of edema in the setting of HF
55
Which thiazide diuretic is helpful with diabetes insipidus
HCTZ *But is ineffective in those with renal impairment
56
What are the carbonic anhydrase diuretics
Acetazolamide
57
What is the use of acetazolamide
Altitude sickness respiratory alkalosis: increases tidal volume & CO2 release idiopathic inter cranial hypertension: Decreases CSF production *Can cause metabolic acidosis due to increased bicarb excretion
58
What are Inotropes and when are they used
Medication that effect the strength/force of heart contractions Positive: HF, cariogenic shock, vasoplegia Negative: arrhythmias, chest pain, and HTN
59
What are examples of positive inotropes
digoxin milrinone dobutamine
60
What are examples of negative inotropes
beta blockers Ca2+ blockeres
61
How do positive inotropes work
increase the amount of calcium within the myocardial cells
62
How do negative inotropes work
they will block Ca2+ channels or prevent the release of calcium from the myocardial cells
63
What are the 4 main classes of inotropes
Catecholamines (norepinephrine) PDE 3 inhibitors (milrinone) Digoxin Calcium sensitizer
64
How do catecholamines work
activate beta-1 receptors to increase inotropy
65
How do the PDE3 inhibitors work
increase inotropy secondary to the influx of Ca2+ due to decreased cAMP degradation
66
How does digoxin work
increases intracellular Na2+ with increases the influx of calcium leading to increased inotropy
67
What are some side effects of catecholamines
peripheral ischemia HTN hyperglycemia
68
adverse effects of milrinone
hypotension cardiac ischemia Torsades *caution in those with low GFR
69
Dopamine and dobutamine side effects
severe HTN cardiac ischemia gangrene nausea
70
In hemodynamically unstable patients in the ICU requiring cardioversion, what should be given for sedation
1-2.5mg midazolam or 2-5mg morphine
71
In those undergoing less urgent cardioversion, what should be given for sedation
50-100mg propofol
72
What combo of agents is given for cardiac anesthesia induction
propofol narcotic neuromuscular blocker
73
When is succinylcholine typically used
RSI or those with difficult airways
74
When is the combo of ketamine and a benzodiazepine useful for induction
those with unstable hemodynamics or tamponade
75
What are the common induction agents
thiopental propofol etomidate
76
What are common anxiolytics used during induction
Midazolam Propofol Lorazepam
77
What narcotics are used during induction
Fentanyl sufentanil remifentanil
78
What muscle relaxants are used for induction
Vecuronium Rocuronium succinylcholine
79

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