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Pharmacology > PLE: Pharma Cardio > Flashcards

PLE: Pharma Cardio Flashcards

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1
Q

Class of Digoxin

A

Cardiac glycoside - positive intoropic drug

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2
Q

MOA of Digoxin

A

Na/K/ATPase inhibition to increase intracellular calcium

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3
Q

Side effect of digoxin

A

Blurry, yellow visual changes

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4
Q

Drugs which reduce digoxin clearance (5)

A 
Quinidine
Amiodarone
Cyclosporine
DIltiazem
Verapamil
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5
Q

Drugs with Narrow Therapeutic Index mnemonics

A

WALA na Cyang Papa! VasTeD na!

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6
Q

Drugs with narrow therapeutic index

A 
warfarin
aminoglycoside
lithium
amphotericin B
carbamazepine
phenobarbital
phenytoin
vancomycin
theophylline
digoxin
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7
Q

Drug of choice for digitalis toxicity

A

lidocaine

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8
Q

1st line therapy for systolic and diastolic failure

A

diuretics

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9
Q

1st line drugs for chronic heart failure

A

angiotensin antagonists

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10
Q

MOA of phosphodiesterase inhibitors (inamrinone, milrinone)

A

increase in cAMP

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11
Q

Drugs that have shown improvement in survival of HF

A

ACE inhibitors
Beta blockers
Aldosterone antagonists

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12
Q

a drug that inhibits the enzyme neprilysin, which is responsible for degrading ANP and BNP

A

sacubitril

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13
Q

Singh-Vaughan Williams classification of anti-arrhythmics

A

Class 1: sodium channel blockers
Class 2: beta adreneceptor blockers
Class 3: potassium channel blockers
Class 4: calcium channel blockers

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14
Q

Class 1 sodium channel blockers block which phase of AP?

A

Phase 0

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15
Q

Group 1A anti arrhythmics effect on AP

A

PROLONG the AP

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16
Q

Group 1B anti arrhythmics effect on AP

A

SHORTEN the AP

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17
Q

Group 1C anti arrhthmics effect on AP

A

none

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18
Q

Group 1A antiarrhythmics

A

Disopyramide, procainamide, quinidine

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19
Q

side effect of procainamide

A

lupus-like syndrome

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20
Q

side effect of disopyramide

A

marked anti-muscarinic effects

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21
Q

sides effect of quinidine

A

cinchonism, autoimmune reactions

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22
Q

symptoms of cinchonism

A

headache
dizziness
tinnitus

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23
Q

antidote for cinchonism and other 1A antiarrhythmics

A

sodium lactate

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24
Q

Class 1B antiarrhythmics (4)

A

LIDOCAINE, mexiletine, phenytoin, tocainide

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25
Why are Class 1B best for post MI?
selectively affect ischemic or depolarized Purkinje and ventricular tissue
26
Drugs that can cause AGRANULOCYTOSIS mnemonics
CCCAPPIT Me
27
Drugs that can cause AGRANULOCYTOSIS
``` Clozapine Co trimoxazole Colchicine Aminopyrine Phenylbutazine PTU Indomethacin Tocainide Methimazole ```
28
MOA of Class 1C antiarrhythmics
Depress sodium current, seen in ECG as increased QRS duration
29
Class 1C antiarrhythmics (3)
FLECAINIDE, propafenone, encainide, moricizine
30
Use of Class 1C antiarrhythmics
refractory arrhythmias
31
Class 2 antiarrhythmics MOA
reduction in cAMP - reduction in sodium and calcium currents
32
Effect of class 2 antiarrhythmics
Prolonged PR interval, AV node sensitive | Act on phase 4
33
only beta blocker classified under class III
sotalol
34
MOA of class 3 antiarrhythmics
Act on phase 3 Blockade of Ik potassium channels responsible for the repolarization Result to increase in ERP - reduced ability of heart to respond to rapid tachycardias
35
ECG morphology of class 3 aniarrhthymics
increased QT interval
36
Class 3 antiarrhythmics
dofetilide, ibutilide, AMIODARONE< dronedarone, VERNAKALANT
37
Side effects / amiodarone toxicity (6)
``` corneal and skin deposits paresthesia pulmonary fibrosis thyroid dysfunction tremors ```
38
Class 4 antiarrhythmics
verapamil | diltiazem
39
MOA of class 4 antiarrhythmics
Block voltage-gated L-type calcium channels
40
SE of verapamil
gingival hyperplasia
41
SE of diltiazem
Raynauds phenomenon
42
When should you not use class 4 antiarrhythmics
vtachs
43
ECG change of class 1A (procainamide)
Prolonged AP Prolonged PR and QT interval Prolonged QRS duration
44
ECG change of class 1B (lidocaine)
Shortened AP | NO effect on normal cells
45
ECG change of class 1C (flecainide)
NO effect on AP | Prolonged QRS duration
46
ECG change of class 2 (propanolol)
no effect on AP | prolonged PR interval
47
ECG change of class 3 (dofetilide)
prolonged AP | prolonged QT interval
48
ECG change of class 4 (verapamil)
no effect on AP | prolonged PR interval
49
DOC for paroxysmal SVT
adenosine
50
MOA of adenosine
Activation of the inward rectifier K + current (hyperpolarization) Inhibition of Ca 2+ current (suppression of calcium dependent AP)
51
Drugs that modify salt excretion
``` Carbonic anhydrase inhibitors (PCT) Loop diuretics (TAL) Thiazides (DCT) Potassium sparing diuretics (CCT) Osmotic diuretics ```
52
Drugs that modify water excretion
Osmotic diuretics ADH agonists ADH antagonists
53
Site of uric acid transport
PCT
54
3 MOA of acetazolamide
in PCT reduced aqueous humor metabolic acidosis to increase respiration
55
uses of acetazolamide
glaucoma, mountain sickness, edema with alkalosis
56
SE of acetazolamide in cirrhotics
hepatic encephalopathy
57
Causes of HAGMA
``` MUDPILES Methanol Uremia DKA Paraldehyde Isoniazid, iron Lactic acid Ethanol, ethylene glycol Salicylates ```
58
Causes of NAGMA
``` HARDUP Hyperalimentation Acetazolamide RTA Diarrhea Ureteral diversion Pancreatic fistula ```
59
Site of calcium and magnesium reabsorption
TAL
60
Decreases the efficacy of loop diuretics
NSAIDs
61
Drug class of dichlorphenamide
carbonic anhydrase inhibitor
62
drug class of bumetanide
loop diuretic
63
drug class of ethacrynic acid
loop diuretic - has no sulfa group
64
MOA of loop diuretics
inhibition if Na/K/2Cl transporter in TAL | causes increased Ca excretion
65
Synergistic ototoxicity with furosemide
aminoglycosides
66
Adverse effects of loop diuretics mnemonic
OH DANG!
67
adverse effects of loop diuretics
``` ototoxicity hypokalemia dehydration allergy to sulfa nephritis gout ```
68
MOA of thiazides
inhibition of Na/Cl transporter in DCT | reduced Ca excretion
69
unusual thiazide diuretics
chlorthalidone indapamide quinethazone
70
side effects of thiazide diuretics
hyperGlycemia hyperLipidemia hyperUricemia hyperCalcemia
71
primary site of urine acidification
cortical collecting duct
72
potassium sparing diuretics
spironolactone triamterene amiloride eplerenone
73
MOA of spironolactone
inhibits aldosterone receptor in CCD
74
SE of aldosterone
gynecomastia BPH hyperchloremic metabolic acidosis
75
MOA of amiloride/triamterene
inhibits ENaC | do not give with potassium supplements
76
drugs that cause gynecomastia
``` spironolactone digoxin cimetidine alcohol ketoconazole ```
77
osmotic diuretics
mannitol glycerin isosorbide urea
78
ADH agonists
vasopressin
79
MOA of ADH agonists
V1 and V2 receptors | activate insertion of aquaporin in collecting tubule
80
factor increased by vasopressin
factor VIII
81
ADH agonist contrainidicated in pregnancy as it can cause contractions
terlipressin
82
ADH antagonists
tolvaptan lixivaptan demeclocycline lithium
83
uses of ADH antagonists
SIADH | hyponatremia
84
AE of rapid correction of hyponatremia
central pontine myelinolysis
85
diuretics that increase urine calcium, causing hypocalcemia
loop diuretics
86
diuretics that decrease urine calcium, causing hypercalcemia
thiazide diuretics
87
diuretics that decrease blood pH (acidemia)
carbonic anhydrase inhibitors (cause HCO3 reabsorption) | K sparing diuretics (aldosterone blockade prevents K and H secretion)
88
diuretics that increase blood pH
loop diuretics | thiazides
89
dual endothelin receptor antagonist used in PAH, teratogenic
bosentan
90
a sympatholytic anti HPN acting on A1 (antagonist) and 5HT1A (agonist); does not elicit reflex tachycardia
uradipil
91
B2 agonist that causes direct relaxation of uterine smooth muscle used for premature labor
isoxuprine

Pharmacology (8 decks)

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