Pharmacology-- Cardiology Flashcards Preview

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Flashcards in Pharmacology-- Cardiology Deck (46):
1

Digoxin

Dec. AV nodal conduction. Inhibits Na/K ATPase= inc. Ca concentration in heart cells = inc. contraction force
Tx: CHF and atrial flutter. Negative inotropic
Decreased K+ levels cause digoxin toxicity (tx w Digoxin immune Fab

2

Diltiazem

Non-DHP Calcium channel blocker
Tx: black men
Tx: AV nodal re-entrance

3

Quinidine

Blockfast inward Na current (INa). -- use dep block
Dec. AV nodal conduciton. Cinchonism (quinine OD, bc quinine stereoisomer). Anticholinergic= aggravates MG. Hypotension= alpha block

4

Verapamil

L-type Ca channel blocker
Dec AV nodal conduction, Dec BP. Negative inotrope= no CHF use
Inc O2 supply via dec. vasospasm. Tx: Prinzmetal's angina

5

Propranolol

Nonselective beta blocker
Dec AV nodal conduction, dec BP Negative inotrope (B block). Aggravates asthma and DM via B2 block.
Blocks reflex tachy but causes excess bray= Inc diastole time= Inc EDV

6

Diazoxide

Balanced vasodilator-- K-channel activator, leads to muscle relaxation

7

Nitroprusside

Balanced vasodilator. Unloads heart. Inc. cyanide= pre-tx w/ thiosulfate.
Tx: acute HTN crisis, dyspnea

8

Reserpine

Tx: severe and resistant HTN
Depletes Ca, See suffy nose. Not for pt.s w peptic ulcers
Mech: irreversibly blocks the vesicular monoamine transporter (VMAT).[4] This normally transports free Ne, 5HT, DA from the cytoplasm of the presynaptic nerve terminal into storage vesicles for subsequent release

9

Dobutamine

Primary mech: direct B1 stim. At high doses Beta2 offsets alpha1= beta1. Inc CO w/o systemic vascular resistance

10

Dopamine

At low doses: tx of shock = dilates renal and mesenteric arteries= maintain urine output

11

Esmolol

short acting beta antagonist

12

Captopril

ACE inhibitor. Balanced vasodilator. Tx: outpatient CHF. Dry cough (bradykinen excess induced)

13

Quinidine - mech

Class Ia anti-arrhythmic. Moderate Na channel block

14

Digoxin toxicity

Fatal ventricular arrhythmias w/ severe AV block
Tx w digoxin immune Fab (Digibind)

15

Lidocaine

ClassIB anti-arrhythmic. Normalizes conduction. Tx: inital MI to control arrhythmias

16

Flecanide

Class IC anti-arrhythmic (Na). Marked conduction slowing

17

Amiodarone

Long t1/2. Need potent doses to obtain desired level for action. Side effeects: blue skin, ocular deposits, pulm. fibrosis

18

NE

Inc AV nodal conduction via B1.
Metoprolol is B1 blocker

19

ACh

Dec. AV nodal conduction via M receptor.
Atropine is a muscarinic antagonist

20

Atenolol

selective beta1 receptor antagonist
Controls catecholamine induced arrhythmias

21

Bretylium

Class III anti-arrhythmic, blocks K channels
Tx: Malignant ventricular arrhythmias but cause catecholamine release that can aggravate arrhythmias briefly

22

Nimodipine

DHP-Ca channel blocker, selective for cerebral vasculature
Tx: acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm

23

Atropine

Competitive Ach Musc receptor antagonist (thus blocks PS action)
Dec excess vagal tone as seen in sinus bradycardia

24

Nitrates

Decrease preload= Venous pooling, Dec MVO2=reflex tachy, Inc ventricular work= dec O2 demand

25

Aspirin

Prevents arterial platelet adhesion (NOT DVT thrombi) . Irreversibly inactivates COX= Dec. platelet production of Txa 2, a potent vasoconstrictor

26

Warfarin

Decreases vit-K dep. gamma-carboxylation of clotting factors= anticoagulation state

27

Heparin

Activates Antithrombin III
--Only IV

28

tPA

Binds to fibrin clots and activates plasminogen on the spot. Short t1/2, given IV. Dose not discriminate between fibrin-ased clots= bleeding/stroke risk

29

Streptokinase

Binds and activates plasminogen (fibrinolytic). Used for some MI and PE
Bacteria derived so allergy risk high. Can see excess bleeding in pt.s post-op

30

Urokinase

aka uPA. Plasminogen activator (fibrinolytic) Human source. Can see excess bleeding in pt.s post-op bc of inc plasmin

31

Colestipol

Bile acid sequestrant. Interrupt bile acid reabsorption= Big inc in LDL uptake. Cholestyramine has same MOA

32

Lovastatin

(a statin) HMG-coA reducatase inhibitor.Leads to inc. LDL-receptor synth. Provastatin/mevastatin have same MOA

33

Losartan

Angiotensin II receptor antagonist. Decresease aldosterone, inc renin 2-3x.
Similar effects to ACE inhibition but no cough side effects

34

Diazoxide

Tx insulinomas. Only dilates arterial smooth muscle, not venous

35

Clonidine

Central alpha2 adrenergic agonist. Dec TPR via dec. sympathetic effects

36

Methyldopa

Central alpha2 receptor iagonist.
??? Positive Coombs--> hemolytic anemia

37

Quinidine Pre-tx

Atrial arrhythmia pretx w a drug that will dec ventricular response such as: digozxin, beta blocker, Ca channel blocker

38

Class II--??

Beta blocker dec. risk for reinfarction & sudden death following MI

39

"Gray man"

Amiodarone side effect--- class III antiarrhythmic--- skin discolors w extended use, see it in fair skinned ppl more

40

Beperidil

Ca channel blocker. Limited clinical use due to Torsades de Pointes

41

ACEIs

Vasodilate renal efferents > renal afferents. Dec. GFR and filtration pressure. Thus dec. Diabetic renal failure progression

42

Adenosine

Adenosine receptor blocked by methylxanthines (e.g. theophyline). Favored for tx of reentrant supra ventricular tachy

43

Enoxaparin

Low molec weight heparin (LMWH)= oral anticoagulant

44

Isoproterenol

Inc HR and Dec MAP

45

Variant angina

Prinzmetal...use Ca Channel receptor blocker like Nifedipine to dec. spasm

46

Contraindicated in CHF

Beta receptor antagonists. Don't want to dec. heart's contractility.