Pharmacology

Question 0

Ronalazine

Answer 0

Increase QT but prevents afib and Vtach

Question 1

Nitrates

Answer 1

Forms NO with increase guanylate cyclase
Venodilation
Smooth muscle relaxation
Does not need intact endothelium

Question 2

Cogent trial

Answer 2

No difference in event rates with plavix even when you add omeprazole

Question 3

Plavix

Answer 3

Incomplete  blockade of p2y12 receptor
85% inactive
 98%  reversibly bound to plasma
Anti platelet effect 2 hours after loading dose
Need to be metabolized to be active

Question 4

Prasugrel

Answer 4

Avoid in TIA age>75

Weight <70ibs

Question 5

Ticagrelor

Answer 5

Use only 100mg Asa
Shorter acting reversible
Don’t use in liver failure
Asthma like reaction

Question 6

Abcixab

Answer 6

Severe thrombocytopenia
Don’t start in the ER
Only for pci use

Question 7

Eptifibatide

Answer 7

Safe non imminogenic

Question 8

Strptokinase

Answer 8

Highly antigenic

Question 9

tPA non antigenic

Specific boy more bleeding

Answer 9

TNK longer half life

Question 10

Dabigatran

Answer 10

Reversible thrombin inhibitor
Kidney
Amiodarone increase the dose by 50%

Question 11

Riveroxaban

Answer 11

Take with food
Reversible Xa
Do not use in renal failure 
Dialysible
Don't use with statins, ketoconazol

Question 12

Apixaban

Answer 12

Use in RF

Aristotle study

Question 13

Procan

Answer 13

Lupus
Don’t use in RF and CHF
Agranulocytosis

Question 14

Disopyrimide

Answer 14

Works in HOCM

Can work in sinus Brady

Question 15

Lidocaine

Answer 15

Dizziness seizures

CHF and hepatic

Question 16

Flecanide

Answer 16

Depresses rapid upstroke of AP, slows conduction
Negative ionotropic
Donot use in ischemic heart disease
Worsens arrhythmias in 5-25%

Question 17

Propafenone

Answer 17

Negative ionotropy 
Some beta blockade 
Worsens CHF 
Bronchospasm 
Pro arrhythmic in 5%
Very effective in PVC therapy

Question 18

Sotolol

Answer 18

Do not use in RF prolongs QT torsades

CHF

Question 19

Defetolide

Answer 19

Class 3 prolongs repolarization 
Terminates afib flutter 
Safe in CHF and mi 
Torsades 
Keep in the hospital fir 3 days
DC if QTc>500
Cyp3A4 verapamil statin dabi erythromycin

Question 20

Amio

Answer 20

Guide lines do not ask for pfts
3-4% thyroid
Every one have corneal deposits has no significance
?optic neuritis German study think it’s coincidence

Question 21

Thiazides

Answer 21

Ca excretion to prevent calcium stones
Increase sodi excretion followed by potassium secretion
Works on pct

Question 22

Thiazides

Answer 22

Metolazone 10x more potent than hctz

Chlorthalidone long half life and constant effect on pct
2x more effective than thiazides
Both cause hypokalemia

Question 23

Thiazides

Answer 23

Hupokakemia
Torsades
Can usually use in sulfa allergy

Question 24

Loop diuretic

Answer 24

Ethacrynic acid no sulfa Each molecule controls 4 molecules of water Butemide torsemide liver excretion More bio available Use if lasix fails and in right heart failure

Question 25

Side effects of loop diuretics

Answer 25

Abnormal lips Hyper glycemic Ototoxic ethacrynic acid

Question 26

Spiranolactone

Answer 26

Gyneconastia RF Starting dose shoukd be 50mg to be effective Use loop or metolazone

Question 27

Beta blockers mi

Answer 27

No iv

Question 28

Highest B1 blocker

Answer 28

Nebivolol which also releases NO Next is bisoprolol Metoprolol causes vasoconstriction by switching to alpha

Question 29

CHF

Answer 29

Do not use Pindalol Or acebutalol both + ISA

Question 30

CHF and dibutamine

Answer 30

Comet study Coreg.markedly reduces dibutamine response Lopressor only slightly inhibitory Coreg less well tolerated in asthma

Question 31

Acei

Answer 31

``` Ccb induced edema Cough 8-20% Angio edema more in blacks Elevated Cr. Need salt and volume control Works better with diuretics RF in Hypovolemia CHF bilateral Renal stenosis ```

Question 32

Acei cough

Answer 32

Bradykinin and substance p

Question 33

Ace escape

Answer 33

Increase AT2

Question 34

CCB

Answer 34

Effective in blacks DM elderly Reduces stroke risk BP lowering with NSAIDs and salt

Question 35

Alpha blocker

Answer 35

Ortho static hypotension | Worsening of The CHF

Question 36

Pregnancy

Answer 36

No Lipitor

Question 37

Statins

Answer 37

Hepatic 2% | Myositis >10x 0.4%

Question 38

Bile acids

Answer 38

Reduce the absorption but liver increase the production

Question 39

Zetia

Answer 39

Decrease cholesterol absorption and works repeatedly | No increSe in TG

Question 40

Niacin

Answer 40

You need shorter acting niacin | Liver need niacin free time

Question 41

Pregnancy

Answer 41

Gemfibrozil is ok not metformin of fenofibrate

Question 42

Dig CHF

Answer 42

Reduced hospitalization not mortality

Question 43

Aha guide lines

Answer 43

``` 30% cal from fat 55% from carb 15% from protein Less than 10% from sat fat Less than 300 mg cholesterol per day ```

Question 44

``` Fish oil ALA Anti arrhythmic Anti thrombotic Increase NO Reduce atherosclerosis ```

Answer 44

Use post mi