Cardiovascular Pharm

Front 1

What are 6 side effects of thiazide diuretics?

Back 1

1) hypokalemia
2) hypercalcemia
3) hyperglycemia
4) hyperuricemia
5) hyperlipidemia
6) lassitude

Front 2

What are 4 adverse effects of loop diuretics?

Back 2

1) ototoxicity (with aminoglycosides)
2) K+ wasting
3) metabolic alkalosis
4) hypotension

Front 3

What are 3 side effects of clonidine?

Back 3

1) severe rebound HTN
2) dry mouth
3) sedation

Front 4

What are 2 side effects of methyldopa?

Back 4

1) + Coombs test
2) sedation

Front 5

What are 4 side effects of hexamethonium?

Back 5

1) severe orthostatic hypotension
2) blurry vision
3) constipation
4) sexual dysfunction

Front 6

What are 4 side effects of reserpine?

Back 6

1) sedation
2) DEPRESSION!
3) nasal stuffiness
4) diarrhea

Front 7

What are 3 side effects of guanethidine?

Back 7

1) orthostatic and exercise hypotension
2) sexual dysfunction
3) diarrhea

Front 8

What are 3 side effects of prazosin?

Back 8

1) 1st dose hypotension
2) dizzy
3) HA

Front 9

What are 4 side effects of beta blockers?

Back 9

1) asthma (B2 block)
2) impotence
3) bradycardia/CHF/AV block
4) sedation/sleep alterations

Front 10

Which vasodilator causes lupus-like syndrome, reflex tachycardia, and salt retention?

Back 10

hydralazine - give with beta blocker and diuretic!

Front 11

Which vasodilator causes hypertrichosis, pericardial effusion, reflex tachycardia, and salt retention?

Back 11

minoxidil - use with beta blocker and diuretic!

Front 12

What are side effects of calcium channel blockers?

Back 12

dizziness, flushing, nausea, constipation (verapamil)

Front 13

What is a side effect of nitroprusside?

Back 13

cyanide release

Front 14

What are side effects of ACE inhibitors? (CAPTOPRIL + 1 more)

Back 14

Cough, Angioedema, Proteinuria, Taste change, hypOtension, Pregancy problem, Rash, Increased renin, Lower AII, hyperkalemia

Front 15

What is Losartan? Side effects?

Back 15

AII receptor blocker - fetal renal toxicity, hyperkalemia

Front 16

How does hydralazine work?

Back 16

increases cGMP --> smooth muscle relaxation (arterioles)

Front 17

How do calcium channel blockers work?

Back 17

block L-type Ca channels of cardiac and SM --> reduce muscle contractility

Front 18

Which calcium channel blocker has greatest effects on vascular smooth muscle?

Back 18

nifedipine

Front 19

Which calcium channel blocker has greatest effects on heart muscle?

Back 19

verapamil

Front 20

What are Ca channel blockers used for?

Back 20

HTN, angina, arrhythmia (except nifedipine)

Front 21

How do nitroglycerin and isosorbide dinitrite work?

Back 21

release NO in smooth muscle, causing inc. cGMP, relaxation, venous dilation

Front 22

How could you reduce myocardial O2 consumption?

Back 22

1) lower EDV
2) lower BP
3) lower contractility
4) lower HR
5) lower ejection time

Front 23

Nifedipine : ?
Verapamil : ?

Back 23

nitrates
beta blockers

Front 24

What cardiac drug can cause the following changes on EKG: inc. PR, dec. QT, scooped ST segment, T wave inversion

Back 24

digoxin

Front 25

A patient you know to be taking medications for his CHF comes in complaining of nausea and diarrhea as well as "everything looks yellow." What is he on?

Back 25

digoxin (also worry about arrhythmia when on Dig)

Front 26

What can make toxicities of digoxin worse? (3)

Back 26

- hypokalemia
- renal insufficiency
- quinidine

Front 27

What are antidotes for digoxin toxicity?

Back 27

- lidocaine
- slowly normalize K+
- cardiac pacer
- anti-dig Fab fragments

Front 28

In general, how to the Class 1 antiarrhythmics work?

Back 28

They bind specifically to depolarized cells and block Na channels, decreasing slope of Phase 4 depolarization and increasing the threshold for firing.

Front 29

What are the 4 Class 1a antiarrhythmics?

Back 29

quinidine, procainamide, amiodarone, disopyramide

Front 30

The Class 1a drugs INCREASE 3 things that affect atrial and ventricular arrhythmias:

Back 30

- axn potential duration
- QT interval
- refractory period

Front 31

What are toxicities of quinidine?

Back 31

- cinchonism (HA, tinnitus)
- thrombocytopenia
- torsades de pointes (due to prolonged QT)

Front 32

What are toxicities of procainamide?

Back 32

reversible lupus-like syndrome (part of "HIPP")

Front 33

What are 3 Class 1b antiarrhythmics?

Back 33

lidocaine, tocainide, mexiletine

Front 34

How do the Class 1b drugs work?

Back 34

decrease axn potential duration - affect ischemic or depolarized Purkinje & ventricular tissue only (so is good for dig-induced ventricular arrhythmia)

Front 35

What are toxicities of Class 1b drugs?

Back 35

local anesthetic, CNS stimulation/depression, cardiovascular depression

Front 36

What are the 3 Class 1c drugs?

Back 36

flecainide, encainide, propafenone

Front 37

When would you use a Class 1c drug? When are they contraindicated?

Back 37

Useful in v-tachs that progress to v-fib, and in intractable SVT (last resort). Contraindicated in post-MI because can induce arrhythmia.

Front 38

What are the Class 2 antiarrhythmics? ("PEMAT")

Back 38

beta-blockers! propranolol, esmolol, metoprolol, atenolol, timolol

Front 39

How do beta blockers work as antiarrhythmics?

Back 39

decrease cAMP, decrease Ca currents, suppress abnormal pacemakers (like AV node) by decreasing slope of Phase 4 depolarization

Front 40

If you decrease the slope of Phase 4 depolarization, how is that shown on EKG?

Back 40

lengthen PR interval (slowed atrial depolarization)

Front 41

What are toxicities of beta-blockers? (laundry list...I think I have another card asking the same thing, but oh well, answer me again!)

Back 41

- impotence
- worsen asthma
- bradycardia, AV block, CHF
- sedation, sleep alterations
- MASK signs of HYPOGLYCEMIA

Front 42

What are the Class 3 antiarrhythmics? (4)

Back 42

K+ channel blockers: sotalol, ibutilide, bretylium, amiodarone

Front 43

How do K+ channel blockers help in arrhythmia?

Back 43

increase axn potential duration (repolarization phase) and refractory period (used when other drugs fail)

Front 44

What are the main toxicities of amiodarone?

Back 44

- pulmonary fibrosis
- hepatotoxicity
- hypo-/hyperthyroidism
(other tox: neurologic, bradycardia, heart block, CHF, constipation, corneal deposits, photodermatitis)

Front 45

What are the Class 4 antiarrhythmics? (2)

Back 45

Ca channel blockers: verapamil, diltiazem

Front 46

What type of cells do verapamil and diltiazem affect?

Back 46

AV nodal cells - good for nodal arrhythmias like SVT

Front 47

What are toxicities of Ca channel blockers?

Back 47

constipation, flushing, edema, AV block, torsades de pointes

Front 48

What is adenosine good for?

Back 48

drug of choice in Dx and abolishing AV node arrhythmia

Front 49

How is K+ an antiarrhythmic?

Back 49

depresses ectopic pacemakers, esp. in Dig-toxicity