Fa Cardio Drugs

Front 1

drug class that prevents renin release

Back 1

Beta blockers

Front 2

drug class that blocks renin actions

Back 2

ACE-inhibitors

Front 3

drug class that blocks the increase in preload with angiotensin II

Back 3

diuretics

Front 4

drug class that blocks the increase in afterload with angiotensin II

Back 4

vasodilators

Front 5

class and adverse side effects of this antihypertensive drug: hydrochlorothiazide

Back 5

diuretic- hypokalemia, mild hyperlipidemia, hyperuricemia, lassitude, hypercalcemia, hyperglycemia

Front 6

class andadverse side effects of this antihypertensive drug: loop diuretics

Back 6

diuretic- potassium wasting, metabolic alkalosis, hypotension, ototoxicity

Front 7

class andadverse side effects of this antihypertensive drug: clonidine

Back 7

sympathoplegics- dry mouth, sedation, severe rebound HTN

Front 8

class andadverse side effects of this antihypertensive drug: methyldopa

Back 8

sympathoplegics- sedation, + coombs test

Front 9

class andadverse side effects of this antihypertensive drug: hexamethonium

Back 9

sympathoplegics- severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction

Front 10

class andadverse side effects of this antihypertensive drug: reserpine

Back 10

sympathoplegics- sedation, depression, nasal stuffiness, diarrhea

Front 11

class andadverse side effects of this antihypertensive drug: guanethidine

Back 11

sympathoplegics- ortho/exercise hypotension, sexual dysfunction, headache

Front 12

class andadverse side effects of this antihypertensive drug: prazosin

Back 12

sympathoplegics- 1st dose ortho hypotension, dizziness, headache

Front 13

class andadverse side effects of this antihypertensive drug: beta blockers

Back 13

sympathoplegics- impotence, asthma, CV effects, CNS effects

Front 14

class andadverse side effects of this antihypertensive drug: hydralazine

Back 14

vasodilators- N, headache, lupus-like syndrome, reflex tachy, angina, salt retention

Front 15

class andadverse side effects of this antihypertensive drug: minoxidil

Back 15

vasodilators- hypertrichosis, pericardial effusion, reflex tachy, angina, salt retention

Front 16

class andadverse side effects of this antihypertensive drug: nifedipine, verapamil

Back 16

vasodilators- dizziness, flushing, nausea, constipation (verapamil), AV block (verapamil)

Front 17

class andadverse side effects of this antihypertensive drug: nitroprusside

Back 17

vasodilators- dcyanide toxicity (releases CN)

Front 18

class andadverse side effects of this antihypertensive drug: diazoxide

Back 18

vasodilators- hyperglycemia (reduces insulin releas, hypotension)

Front 19

class andadverse side effects of this antihypertensive drug: captopril, enalapril, fosinopril

Back 19

ACE-inhibitors- hyperkalemia, cough, angioedema, taste changes, hypotension, pregnancy problems (fetal renal damage), rash, increase renin

Front 20

class andadverse side effects of this antihypertensive drug: losartan

Back 20

fetal renal toxicity, hyperkalemia

Front 21

MOA and AE's for hydralazine

Back 21

increase cGMP--> smooth muscle relaxation---> vasodilates arterioles> veins--> decreases afterload Aes- compensatory tachy, fluid retention, lupus-like syndrome

Front 22

MOA and AE's for minoxidil

Back 22

K+ channel opener--> hyperpolarizes and relaxes vascular smooth muscle AE's = hypertrichosis, pericardial effusion

Front 23

MOA and AE's for calcium channel blockers as antihypertensive

Back 23

block voltage-dependant L-type channels of cardiac and smooth muscle --> reduce muscle contractility. AE's = cardiac depression, peripheral edema, flushing, dizziness, and constipation

Front 24

MOA and AE's for nitroglycerin, isosorbide dinitrate

Back 24

vasodilate by releasing NO in smooth muscle, causing increase in cGMP and smooth muscle relaxation- dilates veins>>>arterioles decreases preload. AE's tachycardia, hypotension, flushing, headache. "Monday disease"

Front 25

3 drugs for malignant HTN treatment:

Back 25

nitroprusside (NO cGMP), fenoldapam (D1 agonist relaxes renal smooth muscle), diazoxide(K+ channel opener- hyperpolarizes and relaxes smooth muscle)

Front 26

goal of antianginal therapy:

Back 26

reduce myocardial O2 consumption via decreaseing one of the following: EDV, BP, HR, contractility, ejection time

Front 27

of the Ca+ channel blockers, which ones work more at vascular smooth muscle vs heart

Back 27

vascular smooth muscle- nifedipine>diltiazam>verapamil heart verapamil>diltiazam>nifedipine

Front 28

as an antianginal agent, nitrates primarily work to affect _____

Back 28

preload- thereby reducing EDV, BP, ejection time, and MVO2 consumption

Front 29

as an antianginal agent, beta blockers primarily work to affect _____

Back 29

afterload- thereby reducing BP, contractility, HR, and MVO2

Front 30

combined effect of nitrates and beta blockers on EDV, BP, HR, contractility, ejection time, MVO2:

Back 30

no effect or decreased EDV, decreased BP, decreased HR, little or no effect on contractility, little or no effect ejection time, big decrease in MVO2 consumption!!!! Yeah!!!!

Front 31

best drug at lowering LDL

Back 31

statins- HMG-CoA reductase inhibitors

Front 32

Side effects of statins

Back 32

expensive, reversible increase in LFTs, myositis

Front 33

MOA of niacin as a lipid lowering agent

Back 33

inhibits lipolysis in adipose tissue; reduces hepatic VLDL secretion into circulation

Front 34

what do you coadminister with niacin to reduce side effect?

Back 34

ASA- reduces facial flushing

Front 35

MOA of cholestyramine, colestipol

Back 35

(bile acid resins) prevent intestinal reabsorption of bile acids- liver must use cholesterol to make more

Front 36

Adverse effects of cholestryamine, colestipol

Back 36

bile acid resins tast like- well, yeah- GI discomofrt, decreased absoprtion of fat soluble vitamins

Front 37

ezetimibe MOA

Back 37

prevents cholesterol reabsortion at small intestine brush border- only effects LDL

Front 38

gemfibrozil, clofibrate, bezafibrate, fenofibrate MOA

Back 38

upregulate Liproprotein lipase LPL to induce TG clearance- good at lowering triglycerides

Front 39

gemfibrozil, clofibrate, bezafibrate, fenofibrate side effects

Back 39

myositis, increas LFTs

Front 40

MOA of cardiac glycosides

Back 40

digoxin- direct inhibitor of Na/K/ATPase leads to indirect inhibition of Na/Ca+ exchanger/intipor--> increase inctracellular Ca = positive inotropy

Front 41

uses of digoxin

Back 41

CHF (increases contractility), atrial fib- decreases conduction at AV node and depression of SA node)

Front 42

ECG side effects of digoxin

Back 42

increase PR interval, decreased QT interval, scooping of ST segment, T-wave inversion

Front 43

non ECG side effects of digoxin

Back 43

increased parasympathetic activity: N, V, D, blurry yellow vision. Arrythmia. Toxicities increased by renal failure, hypokalemia potentiates effects, and quinidine (decreases clearance, displaces from tissue binding sites)

Front 44

digoxin OD antidote

Back 44

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

Front 45

class I antiarrhythmics are all ____ channel blockers

Back 45

Na+

Front 46

common MOA of all Class I antiarrhythmics

Back 46

Na+ channel blockers- slow/block conduction. Decrease the slope of phase 4 depolarization and increase the threshold for firing in abnormal pacemaker cells. (state dependent)

Front 47

what are the class IA antiarrhythmics?

Back 47

Quinidine, Amiodarone (also class III), procainamide, disopyramide Queen Amy Proclaims Diso's Pyramide

Front 48

Class IA antiarrhythmics ___ AP duration, ____ effective refractory period, and ___ QT interval

Back 48

increase, increase, increase

Front 49

which class IA antiarrhythmic has a reversible SLE-like side effect?

Back 49

procainamide

Front 50

which class IA antiarrhythmic can produce cinchonism- headache, tinitis; thrombocytopenia, torsades de pointes (increased QT interval)?

Back 50

quinidine

Front 51

what are the class IB antiarrhythmics?

Back 51

Lidocaine, mexiletine, tocainide I'd Buy Lidy's Mexican tacos (phenytoin also fits this)

Front 52

what are the class IC antiarrhythmics?

Back 52

flecainide, encainide, propafenone

Front 53

what are the class II antiarrhythmics?

Back 53

propranolol, esmolol, metoprolol, atenolol, timolol (beta blockers)

Front 54

what are the class III antiarrhythmics?

Back 54

sotalol, ibutilide, bretylium, amiodarone (also class IA)

Front 55

what are the class IV antiarrhythmics?

Back 55

verapamil, diltiazem

Front 56

class IB antiarrhythmics ____ AP duration

Back 56

decrease- affect ischemic or depolarized purkinje and ventricular tissue

Front 57

uses for class IB antiarrhythmics

Back 57

acute ventricular antiarrhythmias -especially post MI- and digitalis induces arrythmias

Front 58

side effects for class IB antiarrhythmics

Back 58

local anesthetic- CNS stimulation/depression, CV depression

Front 59

class IC antiarrhythmics ____ AP duration

Back 59

have no change on

Front 60

class IC antiarrhythmics are used as a last resort in refractory ____ and intractable ____.

Back 60

Vtachs that progress to Vfib, SVT

Front 61

toxicity of class IC antiarrhythmics:

Back 61

proaarhythmic- especially post MI (contracindicated)- significantly prolongs refractory perios in AV node

Front 62

common toxicity for all class I drugs-

Back 62

hyperkalemia

Front 63

MOA for class II antiarrhythmics

Back 63

beta blockers-decrease cAMP leads to decrease Ca++ currents- suppress abnormal pacemakers by decreasing slope phase 4. AV node esp. Increase PR interval.

Front 64

clinical use of class II antiarrhythmics

Back 64

V-tach, SVT, slowing ventricular rate during a-fib and atrial flutter

Front 65

toxicity of class II antiarrhythmics

Back 65

impotence, exacerbation of asthma, bradycardia, AV block, CGF, sedation, sleep alteration. May mask signs of hypoglycemia- metoprolol can cause dysliidemia

Front 66

MOA for class III antiarrhythmics

Back 66

K+ channel blocker increase AP duration, increase ERP- used when other antiarrhythmics fail. Increased QT interval

Front 67

sotalol (class III antiarrhythmic) side effects:

Back 67

torsades de pintes, excessice beta block

Front 68

amiodarone (class IA/III antiarrhythmic)

Back 68

pulmonary fibrosis, conreal deposits, hepatotoxicity, skin deposits in photodermatitis, neuro effects, bradycardia, heart block, CHF, hypothyroidism/hyperthyroidism

Front 69

wolff--parkinson-white syndrome (class III antiarrhythmic)

Back 69

amiodarone

Front 70

what labs need to be checked when on amiodarone?

Back 70

PFTs, LFTs, TFTs (thyroid)

Front 71

MOA of class IV antiarrhythmics

Back 71

Ca ++ channel blockers affect AV nodal cells-- decreasing conduction velocity, increasing ERP, PR interval. Used in prevention of nodal arrythmias

Front 72

AE's of class IV antiarrhythmics

Back 72

constipation, flushing, edema, CHF, AV block, sinus node depression, torsades de pointes (bepridil)

Front 73

MOA of adenosine on heart

Back 73

increase K+ out of cell hyperpolarizes it. Drug of choice in diagnosing/abolishing AV nodal arrhythmias. Very short acting- flushing, hypotension, chest pain

Front 74

Mg++ is effective as an antiarrhythmic in treating ______ and _____ toxicity

Back 74

torsades de pointes, digoxin