3-1: Pharm Reinforcement

Front 1

Zofenopril

Back 1

-pril
RamiPRIL

ACE-inhibitor; prevents AgI-->AgII

AE: Dry cough, angioedema, low BP

Front 2

Valsartan

Back 2

-sartan: CandeSARTAN, LoSARTAN

ACE-inhibitor Alternative

Ag II Receptor Antagonist; decreases symp output to induce vasodilation, natriuresis

AE: No cough, angioedema, DO NOT USE IN PREGNANCY

Front 3

Furosemide

Back 3

-emide, -anide: Bumetanide, Torsemide

Loop Diuretic, more potent than thiazides, SHORTER acting

Potential for hypokalemia

Front 4

Metolazone

Back 4

Thiazide; such as HCTZ

Sustained action, vascular dilation after long term use

Front 5

Spironolactone

Back 5

Aldosterone Antagonist; such as Eplerenone

POTASSIUM SPARING DIURETIC Antognizes aldosterone receptor in MYOCARDIUM, arterial walls, kidneys

Front 6

Amrinone

Back 6

-rinone; Milrinone

Phosphodiesterase inhibitor

Positive inotropic effect, vasodilator

Front 7

Gemfibrozil

Back 7

-fibr-; fibrate
fenoFIBRate, fenoFIBRIC acid

Decreases TG by up-regulating lipoprotein lipase; don't use w/statin

Front 8

Colestipol

Back 8

Cole-: Bile Acid Resin

Prevents intestinal absorption of bile acids (req'd for cholesterol synthesis)--dec'd LDL

AE: Diarrhea

No effect on hepatic cholesterol

Front 9

Ezetimibe

Back 9

Inhibits intest absorption of cholesterol to lower LDL

AE: Diarrhea

No effect on hepatic cholesterol

Front 10

Niacin

Back 10

Inhibits lipolysis in adipose tissue, reduces hepatic VLDL

AE: Flushing

Front 11

Quinidine

Back 11

Class IA Antiarrhythmic: Na+ blocker; Inc AP Pd, Inc Ref Pd

Use for atrial/ventricular arrhythmias

Disopyramide
Quinidine--torsades, cinchonism (ringing, blurred vision, delirium)
Procainamide--lupus (reversible)

Front 12

Tocainide

Back 12

Class IB Antiarrhythmic: Na+ blocker, Dec AP Pd

Acute ventricular arrhythmias, esp post-MI, digoxin-induced

Lidocaine
Tocainide
Mexiletine
PHENYTOIN

ALL HAVE CNS EFFECTS

Front 13

Propafenone

Back 13

Class IC Antiarrhythmic: Na+ blocker, no effect on AP pd

Vtachs that progress to vfib: LAST RESORT

Felacainide
Propafenone

CAREFUL THESE ARE PROARRHYTHMICS, no use in prior heart dz

Front 14

Atenolol

Back 14

Selective beta-1 block in heart/vasc SM

IMPOTENCE, brady

Don't stop abruptly

Front 15

Which beta-blockers decrease mortality in heart failure?

Back 15

BMC
Bisoprolol
Metoprolol Succinate
Carvedilol

Front 16

Propranolol

Back 16

Non-selective beta-blocker: blocks b-1, b-2

Dizziness, sleep disturbances

Inc'd airward resistance, don't use in asthmatics

Front 17

Which beta-blockers also vasodilate?

Back 17

Carvedilol
Lobetalol

Both block alpha-1 in addition to beta-1/2

Front 18

Bretylisum

Back 18

SIBA
Class III AntiArrhythmic: K+ block

Sotalol- torsades; beta-blocking activity
Ibutylide- torsades
Bretylium- new arrhythm
Amiodarone-least torsades, Pulm, Hep, Thyroid fx; class I-IV activity

Front 19

Nifedipine

Back 19

-dipine: DH Ca2+ blocker


Binds and blocks L-type Ca2+ at vascular smooth muscle; vasodilation

AE: Peripheral edema

Front 20

Verapamil

Back 20

NON-DH Ca2+ blocker
Diltiazem--weaker inotropic effect

Blocks L-type Ca2+ at vasc SM AND at SA/AV node

AE: Peripheral Edema, AV block, brady, CHF

Front 21

Adenosine

Back 21

Slow AV node conduction, inhibits re-entry

Use to dx SVT
Short acting, low tox

Front 22

Magnesium

Back 22

Tx Torsades, digoxin-toxicity

Front 23

Digoxin

Back 23

Cardiac Glycoside

Inhibits Na/K ATPase, causes VAGAL stimulation

Use: CHF (inc'd contractility), AFib (dec conduction at AV/SA)

Toxicity if hypokalemic

Front 24

Isosorbide Dinitrate

Back 24

Nitrate:
NTG, Isosorbide MN

Release NO, inc cGMP-->VEIN DILATION, muscle relax; reduces PRELOAD

Flushing

Contraind w/PDE-5

Front 25

Hydralazine

Back 25

Peripheral ARTERIOLAR dilation via inc'd cGMP, reduces AFTERLOAD

Reserve for severe HTN, CHF

AE: Reflex Tach, Lupus

Contraind'd in angina, CAD

Front 26

Ranolazine

Back 26

Unk Mech

Chronic angina

Prolonged AT-->Torsades

Front 27

ASA

Back 27

Inhibits COX1/2

Analgesia, Anti-platelet (MI/TIA/Thrombotic prophylaxis)

AE: Ulcers, bleeds, ringing in ears

Front 28

Clopiodgrel

Back 28

Thienopyridine
Prasugrel

Acute coronary syndrome, cath lab, thrombo prophylaxis

Block ADP receptors to prevent GIIb/IIIa expression; thus inhibit platelet aggregation

AE: Bleeds

Front 29

Ticlopidine

Back 29

Thienopyridine
Inhibits platelet agg by blocking ADP receptors (prevents GIIb/IIIa expression)

Acute coronary syndrome, cath lab, thrombo prophylaxis
AE: Neutropenia

Front 30

Heparin

Back 30

Activates ANTITHROMBIN
Requires Factor III

ACS (NSTEMI), Afib, DVT/PE, CABG, CathLab

Monitored by PT
rapid anticoag
Okay in pregnancy

Front 31

Warfarin

Back 31

Interferes with synthesis of Vit K--II, VII, IX, X

Monitor by PTT
PO

2-3 days to work, not okay in pregnancy
Treat tox w/vit K and plasma

Front 32

Tirofiban

Back 32

GPIIb/IIIa Antagonist (prevents fibrinogen binding)

ACS, MI, Cathlab

FIBan: bleed, brady, dizzy (no to ASA allergy)
MAB: hypotn
FIBat: hypotn, bleed

Front 33

Lepirudin

Back 33

Direct Thrombin Inhibitor: -irubin

Binds and inhibits thrombin

Use for HIT, Thromboembolism, DVT, CathLab; NO ANTIDOE (heparin has protaline)

Front 34

Argatroban

Back 34

Direct Thrombin inhibitor
Along with Dabigatran

Binds and inhibits thrombin

Use for HIT, Thromboembolism, DVT, CathLab; NO ANTIDOE (heparin has protaline)

Front 35

Ardeparin

Back 35

Low molecular weight heparin

Inhibits thrombin, XA

DVT, CathLab, N/STEMI

Front 36

Epoxide Reductase is affiliated with _______.

Back 36

Vitamin K; inhibited by warfarin