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152 Cards in this Set
- Front
- Back
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1st line therapy for HTN in pregnancy…
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Hydralazine + methyldopa (a2 agonist)
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MOA of hydralazine… SEs…
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Incr cGMP thus relaxing arterioles and decr afterload. SEs: reflex tachycardia making contraindicated in angina/CAD), fluid retention, N/HA, angina. Lupus like syndrome
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SEs of minoxidil…
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Hypertrichosis, pericardial effusion, reflex tachycardia, Na retention, angina
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Patient takes hydralazine and their heart starts to race, what do you give them..
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Beta blocker
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HTN drugs that can cause angina…
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Hydralazine and minoxidil (due to reflex tachycardia)
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Uses of Ca channel blockers…
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HTN, angina, nodal (SVT) arrythmias (not nifedipine), Raynaud’s
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SEs of Ca channel blockers…
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Cardio depression, AV block, periph edema, flushing, dizziness, constipation
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How does incr NO (via nitroglycerin and hydralazine) cause smooth muscle relaxation…
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Incr cGMP blocks MLCK which causes smooth muscle relaxation
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Tx of renal problems in malignant HTN…
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Fenoldopam (D1 agonist)
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Determinants of myocardial oxygen consumption (MVO2) and what decr each of them…
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EDV (nitrates), BP (nitrates/betablockers), Contractility (beta blockers), HR (beta blockers and bb + nitrates), ejection time (nitrates- decr preload).
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Effect of nitrates on HR and contractility…
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Increase in both (reflex tachycardia)
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Drugs contraindicated in angina…
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Hydralazine, minoxidil, Pindolol and Acebutolol (partial beta agonists)
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Statin effect on LDL, HDL, & TGs… SEs…
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Big decr in LDL, slight incr HDL, slight decr in TGs. Causes hepatotoxicity, rhabdomyolysis
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Niacin effect on LDL, HDL, & TGs… SEs…
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Decr in LDL, big incr in HDL, decr in TGs. Causes flushing (tx w/ asprin), hyperglycemia, hyperuricemia
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Bile acid resins (chol, col) effect on LDL, HDL, & TGs… SEs…
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Decr LDL, slightly increases HDLs and TGs. Causes decr fat soluble vitamin absorption, cholesterol gall stones
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Ezetimibe (chol reabsorp blocker) effect on LDL, HDL, & TGs… SEs…
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Decr LDL, no effect on others. Causes incr LFTs
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Fibrates effect on LDL, HDL, & TGs… SEs…
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Decr LDL, incr HDL, but large incr in HDL. Causes myositis, hepatoxic, gall stones
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MOA of niacin lipid tx…
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Inhibits secretion of VLDLs from liver
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MOA of gemfibrozil and other fibrates…
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Upregulate LPL
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Half life of digoxin… how excreted…
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40 hr half life, urinary excretion
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1st line therapy for HTN in pregnancy…
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Hydralazine + methyldopa (a2 agonist)
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Uses of digoxin…
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CHF (incr contractility) and a-fib (dec condxn thru AV node, suppression of SA node thru vagal stimulation)
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MOA of hydralazine… SEs…
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Incr cGMP thus relaxing arterioles and decr afterload. SEs: reflex tachycardia making contraindicated in angina/CAD), fluid retention, N/HA, angina. Lupus like syndrome
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SEs of digoxin…
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Cholinergic (N/V/D, blurry yellow vision), incr PR (AV decr), decr QT (incr contrxn), T-wave inversion, arrhythmia, hyperK
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SEs of minoxidil…
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Hypertrichosis, pericardial effusion, reflex tachycardia, Na retention, angina
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Things that worsen digoxin toxicity…
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Renal failure (decr excretion), hypoK (allows digoxin to bind to K site), quinidine (displaces from albumin and tissue binding sites), activates estrogen receptors causing gynecomastia
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Patient takes hydralazine and their heart starts to race, what do you give them..
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Beta blocker
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Class IA effect on ventricular AP…
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Incr AP duration, incr ERP, decr slope of phase 0. also incr slope of phase 4 depolarization in pacemaker cells
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HTN drugs that can cause angina…
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Hydralazine and minoxidil (due to reflex tachycardia)
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Class IA antiarrythmics affect which arrhythmias…
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Atrial and ventricular, especially reentrant and ectopic supraventricular and V-tachycardia
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Uses of Ca channel blockers…
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HTN, angina, nodal (SVT) arrythmias (not nifedipine), Raynaud’s
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Toxicity of quinidine…
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HA, tinnitus, thrombocytopenia, torsades de pointes
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SEs of Ca channel blockers…
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Cardio depression, AV block, periph edema, flushing, dizziness, constipation
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Class IB antiarrythmics…
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Lidocaine, Mexiletine, Tocainide, maybe phenytoin
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How does incr NO (via nitroglycerin and hydralazine) cause smooth muscle relaxation…
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Incr cGMP blocks MLCK which causes smooth muscle relaxation
|
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Class IB effects on action potential and in what cases do you give them and when not…
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Decr AP. Good for post-MI ventricular arrythmias and digitalis toxicity. Since they don’t slow condxn, not useful for AV or atrial dysrhythmias
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Tx of renal problems in malignant HTN…
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Fenoldopam (D1 agonist)
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In what cases are IC antiarrythmics contraindicated…
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Post-MI and in patients with structural abnormalities
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Determinants of myocardial oxygen consumption (MVO2) and what decr each of them…
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EDV (nitrates), BP (nitrates/betablockers), Contractility (beta blockers), HR (beta blockers and bb + nitrates), ejection time (nitrates- decr preload).
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Class IC antiarrythmics and uses…
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Flecanide, encainide, propafenone. V-tachycardia and especially v-tachy that goes to v-fib. Last resort drugs
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Effect of nitrates on HR and contractility…
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Increase in both (reflex tachycardia)
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Short acting beta blocker used for supraventricular arrythmias…
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Esmolol
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Drugs contraindicated in angina…
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Hydralazine, minoxidil, Pindolol and Acebutolol (partial beta agonists)
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Effects of beta blockers on action potential…
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AV node sensitive, incr PR interval
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Statin effect on LDL, HDL, & TGs… SEs…
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Big decr in LDL, slight incr HDL, slight decr in TGs. Causes hepatotoxicity, rhabdomyolysis
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SEs of beta blockers used for arrythmias…
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Impotence, asthma exacerbation, bradycardia, AV block, CHF, sedation, sleep changes, mask signs of hypoglycemia, dyslipidemia (metoprolol)
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Niacin effect on LDL, HDL, & TGs… SEs…
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Decr in LDL, big incr in HDL, decr in TGs. Causes flushing (tx w/ asprin), hyperglycemia, hyperuricemia
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Class III antiarrythmics…
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Sotalol, ibutilide, bretylium, dofetilide, amiodarone
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Bile acid resins (chol, col) effect on LDL, HDL, & TGs… SEs…
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Decr LDL, slightly increases HDLs and TGs. Causes decr fat soluble vitamin absorption, cholesterol gall stones
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Class III antiarrythmics effect on AP…
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Like class IA: Incr AP duration, incr ERP, incr QT
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Ezetimibe (chol reabsorp blocker) effect on LDL, HDL, & TGs… SEs…
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Decr LDL, no effect on others. Causes incr LFTs
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Sotolol SEs…
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Excessive beta block, torsades (effects of class II and III)
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Fibrates effect on LDL, HDL, & TGs… SEs…
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Decr LDL, incr HDL, but large incr in HDL. Causes myositis, hepatoxic, gall stones
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Amiodarone SEs…
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PF, hepatotoxic, thyroid probs, CORNEAL deposits, blue/grey skin, neuro defects, constipation, bradycardia/heart block/CHF
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MOA of niacin lipid tx…
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Inhibits secretion of VLDLs from liver
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Amiodarone has class I, II, III, and IV effects, why…
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Alterns the lipid membrane
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MOA of gemfibrozil and other fibrates…
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Upregulate LPL
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Class IV antiarrythmic effect on AP…
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Ca channel blockers. Decr condxn velocity causing incr ERP, incr PR.
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Half life of digoxin… how excreted…
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40 hr half life, urinary excretion
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SEs of class IV antiarrythmics…
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Flushing, Edema, Constipation, CHF/AV block
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Uses of digoxin…
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CHF (incr contractility) and a-fib (dec condxn thru AV node, suppression of SA node thru vagal stimulation)
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MOA of adenosine…
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Incr K out of cells thus hyperpolarizing them and decr Ca influx
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SEs of digoxin…
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Cholinergic (N/V/D, blurry yellow vision), incr PR (AV decr), decr QT (incr contrxn), T-wave inversion, arrhythmia, hyperK
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SEs of adenosine…
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Flushing, hypotsn, chest pain. Effects blocked by TheO
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Things that worsen digoxin toxicity…
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Renal failure (decr excretion), hypoK (allows digoxin to bind to K site), quinidine (displaces from albumin and tissue binding sites), activates estrogen receptors causing gynecomastia
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In what antiarrythmic situation would one administer Mg…
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Torsade de pointes or digoxin toxicity
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Class IA effect on ventricular AP…
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Incr AP duration, incr ERP, decr slope of phase 0. also incr slope of phase 4 depolarization in pacemaker cells
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Which drugs decr aqueous humor synthesis and how…
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Epinephrine and brimonidine (both alpha agonists that probably vasoconstrict decr blood flow)
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Class IA antiarrythmics affect which arrhythmias…
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Atrial and ventricular, especially reentrant and ectopic supraventricular and V-tachycardia
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Which drugs decr aqueous humor secretion (not necessarily synthesis) in glaucoma…
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Beta blockers (timolol, betaxolol, carteolol), acetazolamide
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Toxicity of quinidine…
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HA, tinnitus, thrombocytopenia, torsades de pointes
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Which drugs incr outflow of aqueous humor in glaucoma…
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Directly: pilocarpine, carbachol; Indirectly: physostigmine, echothiophate. These open meshwork to free up canal of schlem. Latanoprost (a PGF2 agonist) also increases aqueous humor outflow
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Class IB antiarrythmics…
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Lidocaine, Mexiletine, Tocainide, maybe phenytoin
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Side effects seen in glaucoma drugs…
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Epinephrine bad for closed angle and can cause mydriasis and stinging. Muscarinic agonists can cause miosis. Latanoprost can darken the iris
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Class IB effects on action potential and in what cases do you give them and when not…
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Decr AP. Good for post-MI ventricular arrythmias and digitalis toxicity. Since they don’t slow condxn, not useful for AV or atrial dysrhythmias
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How do opioids effect synaptic transmission…
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Open K channels, close Ca channels and decr synaptic transmission. They also inhibit the release of Ach, NE, Ser, glutamate, and sub P
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In what cases are IC antiarrythmics contraindicated…
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Post-MI and in patients with structural abnormalities
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To what side effects of opioids does tolerance not develop…
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Constipation and miosis
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Class IC antiarrythmics and uses…
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Flecanide, encainide, propafenone. V-tachycardia and especially v-tachy that goes to v-fib. Last resort drugs
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Butorphanol MOA, use, and SEs…
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Partial agonist at mu receptors, agonist at kappa receptors (much like pentazocine). Used for pain, especially when trying to avoid resp depression (has less). SE: causes withdrawal if on full opioid agonist
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Short acting beta blocker used for supraventricular arrythmias…
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Esmolol
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Tramadol MOA… SE…
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Weak opioid agonist, inhibits Ser and NE reuptake. Causes opioid like SEs and decreases seizure threshold
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Effects of beta blockers on action potential…
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AV node sensitive, incr PR interval
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1st line tx for Tonic clonic seizures…
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Valproic acid, Carbamazapine, Phenytoin
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SEs of beta blockers used for arrythmias…
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Impotence, asthma exacerbation, bradycardia, AV block, CHF, sedation, sleep changes, mask signs of hypoglycemia, dyslipidemia (metoprolol)
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Prophylaxis for GTC seizures…
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Phenytoin
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Class III antiarrythmics…
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Sotalol, ibutilide, bretylium, dofetilide, amiodarone
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1st line tx for seizures in pregnant women and in children…
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Phenobarbitol
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Class III antiarrythmics effect on AP…
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Like class IA: Incr AP duration, incr ERP, incr QT
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Epilepsy drugs that work thru Na channel inactivation..
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Phenytoin, carbamazapine, Lamotrigene, Valproic acid and topiramate (also incr GABA)
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Sotolol SEs…
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Excessive beta block, torsades (effects of class II and III)
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MOA of gabapentin…
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GABA analog but also inhbitits HMA Ca channels
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Amiodarone SEs…
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PF, hepatotoxic, thyroid probs, CORNEAL deposits, blue/grey skin, neuro defects, constipation, bradycardia/heart block/CHF
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MOA of ethosuxamide…
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Blocks T-type Ca channels in thalamus
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Amiodarone has class I, II, III, and IV effects, why…
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Alterns the lipid membrane
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MOA of tiagabine…
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Inhibits GABA reuptake
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Class IV antiarrythmic effect on AP…
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Ca channel blockers. Decr condxn velocity causing incr ERP, incr PR.
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MOA of vigabatrin…
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Irreversibly inhibits GABA transaminase thus incr GABA
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SEs of class IV antiarrythmics…
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Flushing, Edema, Constipation, CHF/AV block
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SEs of carbamazapine…
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(DAN Teratan)Dipolopia, Ataxia, Nystagmus, Teratogen, agranulocytosis and aplastic anemia, liver toxicity, p450 indxn, SIADH, SJ syn
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MOA of adenosine…
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Incr K out of cells thus hyperpolarizing them and decr Ca influx
|
|
|
SEs of ethosuxamide…
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GI distress, fatigue, HA, uriticaria, SJ
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SEs of adenosine…
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Flushing, hypotsn, chest pain. Effects blocked by TheO
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SEs of phenytoin…
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Like carbamazapine (DAN Teratan): Diplopia, Ataxia, Nystagmus, Teratogen, indxn of p450. Also, megaloblastic anemia, SLE-like, gumar hyperplasia, hirsuitism
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In what antiarrythmic situation would one administer Mg…
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Torsade de pointes or digoxin toxicity
|
|
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SEs of topiramate…
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Sedation, mental dulling, kidney stones, wt loss
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Which drugs decr aqueous humor synthesis and how…
|
Epinephrine and brimonidine (both alpha agonists that probably vasoconstrict decr blood flow)
|
|
|
Which epilepsy drug blocks voltage-gated Na channels…
|
Lamotrigen
|
|
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Which drugs decr aqueous humor secretion (not necessarily synthesis) in glaucoma…
|
Beta blockers (timolol, betaxolol, carteolol), acetazolamide
|
|
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Benzo effect on REM sleep…
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Decrease
|
|
|
Which drugs incr outflow of aqueous humor in glaucoma…
|
Directly: pilocarpine, carbachol; Indirectly: physostigmine, echothiophate. These open meshwork to free up canal of schlem. Latanoprost (a PGF2 agonist) also increases aqueous humor outflow
|
|
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If a patient has night terrors and sleep walking, what drug might you give them…
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Benzo
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Side effects seen in glaucoma drugs…
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Epinephrine bad for closed angle and can cause mydriasis and stinging. Muscarinic agonists can cause miosis. Latanoprost can darken the iris
|
|
|
Amine form and passage into the brain via BBB…
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Pass BBB in unchanged form and then bind to ion channel in brain in changed form
|
|
|
How do opioids effect synaptic transmission…
|
Open K channels, close Ca channels and decr synaptic transmission. They also inhibit the release of Ach, NE, Ser, glutamate, and sub P
|
|
|
Which inhaled anesthetic is not a risk for malignant hyperthermia…
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Nitrous oxide
|
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To what side effects of opioids does tolerance not develop…
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Constipation and miosis
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MOA of bromocriptine… pergolide…
|
Both are ergot alkaloids that are agonists of dopamine receptors (used for Parkinsons)
|
|
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Butorphanol MOA, use, and SEs…
|
Partial agonist at mu receptors, agonist at kappa receptors (much like pentazocine). Used for pain, especially when trying to avoid resp depression (has less). SE: causes withdrawal if on full opioid agonist
|
|
|
MOA of pramipexole and ropinrole…
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D2 receptor agonists, they are non-ergots
|
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Tramadol MOA… SE…
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Weak opioid agonist, inhibits Ser and NE reuptake. Causes opioid like SEs and decreases seizure threshold
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Benztropine used to treat what aspects of Parkinsons…
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Improves tremor and rigidity but does little to effect bradykinesia
|
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1st line tx for Tonic clonic seizures…
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Valproic acid, Carbamazapine, Phenytoin
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|
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Selegine effects on DA, NE, and Ser…
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Increases DA most since MOA-B selectively metabolizes DA more then NE and Ser
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Prophylaxis for GTC seizures…
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Phenytoin
|
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SEs of L-dopa…
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Arrythmias from peripheral conversion to DA, dyskinesia following administration and akinesia in between doses
|
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1st line tx for seizures in pregnant women and in children…
|
Phenobarbitol
|
|
|
Memantine MOA and SEs…
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NMDA receptor antagonist used for Alzheimers. Helps prevent excitotoxicity caused by incr Ca. SEs: dizziness, confusn, hallucinations
|
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Epilepsy drugs that work thru Na channel inactivation..
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Phenytoin, carbamazapine, Lamotrigene, Valproic acid and topiramate (also incr GABA)
|
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NT levels in Huntington dx and what is used to treat them…
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Incr DA and decreased GABA and Ach. Reserpine and tetrabenzine both decrease DA while haloperidol is used to antagonize the DA receptor
|
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MOA of gabapentin…
|
GABA analog but also inhbitits HMA Ca channels
|
|
|
Sumatriptan use… MOA… SE…
|
Serotonin AGONIST that causes vasoconstrxn thus inhibiting trigem activation and release of vasoactive peptides. Half life is <2hrs. used for migraines and clusters. SEs: coronary vasospasm, tingling
|
|
|
MOA of ethosuxamide…
|
Blocks T-type Ca channels in thalamus
|
|
|
MOA of tiagabine…
|
Inhibits GABA reuptake
|
|
|
MOA of vigabatrin…
|
Irreversibly inhibits GABA transaminase thus incr GABA
|
|
|
SEs of carbamazapine…
|
(DAN Teratan)Dipolopia, Ataxia, Nystagmus, Teratogen, agranulocytosis and aplastic anemia, liver toxicity, p450 indxn, SIADH, SJ syn
|
|
|
SEs of ethosuxamide…
|
GI distress, fatigue, HA, uriticaria, SJ
|
|
|
SEs of phenytoin…
|
Like carbamazapine (DAN Teratan): Diplopia, Ataxia, Nystagmus, Teratogen, indxn of p450. Also, megaloblastic anemia, SLE-like, gumar hyperplasia, hirsuitism
|
|
|
SEs of topiramate…
|
Sedation, mental dulling, kidney stones, wt loss
|
|
|
Which epilepsy drug blocks voltage-gated Na channels…
|
Lamotrigen
|
|
|
Benzo effect on REM sleep…
|
Decrease
|
|
|
If a patient has night terrors and sleep walking, what drug might you give them…
|
Benzo
|
|
|
Amine form and passage into the brain via BBB…
|
Pass BBB in unchanged form and then bind to ion channel in brain in changed form
|
|
|
Which inhaled anesthetic is not a risk for malignant hyperthermia…
|
Nitrous oxide
|
|
|
MOA of bromocriptine… pergolide…
|
Both are ergot alkaloids that are agonists of dopamine receptors (used for Parkinsons)
|
|
|
MOA of pramipexole and ropinrole…
|
D2 receptor agonists, they are non-ergots
|
|
|
Benztropine used to treat what aspects of Parkinsons…
|
Improves tremor and rigidity but does little to effect bradykinesia
|
|
|
Selegine effects on DA, NE, and Ser…
|
Increases DA most since MOA-B selectively metabolizes DA more then NE and Ser
|
|
|
SEs of L-dopa…
|
Arrythmias from peripheral conversion to DA, dyskinesia following administration and akinesia in between doses
|
|
|
Memantine MOA and SEs…
|
NMDA receptor antagonist used for Alzheimers. Helps prevent excitotoxicity caused by incr Ca. SEs: dizziness, confusn, hallucinations
|
|
|
NT levels in Huntington dx and what is used to treat them…
|
Incr DA and decreased GABA and Ach. Reserpine and tetrabenzine both decrease DA while haloperidol is used to antagonize the DA receptor
|
|
|
Sumatriptan use… MOA… SE…
|
Serotonin AGONIST that causes vasoconstrxn thus inhibiting trigem activation and release of vasoactive peptides. Half life is <2hrs. used for migraines and clusters. SEs: coronary vasospasm, tingling
|
