Pharm Final

Front 1

what is the pathway of normal heart impulse

Back 1

SA node (pacemaker) to atrium to AV node to ventricles

Front 2

what are 2 different ways to get an arrhythmia

Back 2

altered pacemaker
altered pathway

Front 3

describe the typical action potential of heart muscle

Back 3

resting potential of -90mv
Na+ influx
Ca++ influx (causes muscle contraction)
K+ efflux

Front 4

what is the best treatment for arrhythmias

Back 4

no treatment at all (if patient is otherwise healthy)

Front 5

what are the 4 non-drug treatments for arrhythmias

Back 5

pacemakers
cardioversion (electric shock)
implantation of automatic defibrillators
surgical removal of ectopic foci

Front 6

describe the different classes of drugs for treating arrhythmias

Back 6

class 1: local anesthetics that decrease Na+ influx; greater effect on ectopic foci
1A: lengthen AP and slow depolarization
1B: lidocaine
class 2: inhibit effect of epi on heart (slow HR); DOC for atrial fib
class 3: K+ channel blockers (for atrial fib)
class 4: Ca++ channel blockers (for supraventricular atrial fib; used for all except ventricular arrhythmias)

Front 7

what are the class 1A anti-arrhythmia drugs

Back 7

"PDQ" like "pretty damn quick"
procanamide
disopramide
quinidine

Front 8

class 1B anti-arrhythmias

Back 8

lidocaine

Front 9

class 2 anti-arrhythmias

Back 9

propanolol
metaprolol

Front 10

class 3 anti-arrhythmias

Back 10

sotalol
amiodarone

Front 11

class 4 anti-arrhythmias

Back 11

verapamil
dilteazan
nifedipine
adenosine

Front 12

how do the class 1A anti-arr work

Back 12

lengthen AP and slow depolarization
they decrease sodium influx

Front 13

what is quinidine used for

Back 13

all arrhytmias (atrial and ventricular)

Front 14

side effects of quinidine

Back 14

cns effects
tinnitus
altered color vision

Front 15

what is procanamide used for

Back 15

all tachycardias

Front 16

what is the difference between procaine and procanamide

Back 16

procanamide is an analog of procaine
procanamide lasts longer and does NOT enter the CNS
has lupus like side effects in slow acetylators

Front 17

what is the drug of choice for ventricular tachycardia

Back 17

lidocaine

Front 18

what type of arrythmias is disopyramide used for

Back 18

ventricular

Front 19

which anti-arrhytmia drug is like atropine

Back 19

disopyramide

Front 20

how is lidocaine given

Back 20

IV b/c of first pass effect
it is class 1B anti-arrhythmia drug

Front 21

what is a general way to remember class 2 anti-arrhyth drugs

Back 21

they are beta blockers
propanolol blocks beta 1 and beta 2
metaprolol blocks just beta 1

Front 22

which anti-arrhytmia drug acts like all 4 classes of the drugs and thus has many side effects

Back 22

amiodarone (class 3)...classified as a K+ channel blocker though

Front 23

what are the many side effects of amiodarone

Back 23

it is a class 3 anti-arrhythmia drug
blocks K+ channels
corneal deposits
optic nerve damage (optic neuritis)
pulmonary fibrosis
skin deposits (b/c it contains iodine and leaves blue/gray color)
altered thyroid gland fxn b/c it contains iodine

Front 24

which anti-arrythmia drug contains iodine

Back 24

amiodarone
corneal deposits
skin deposits
altered thyroid gland

Front 25

which 3 anti-arrhythmia drugs cause vasodilation

Back 25

verapamil
dilteazan
nifedipine

all are class 4 (calcium channel blockers)

Front 26

which anti-arrhythmia drug is given IV and decreases firing rate of the AV node

Back 26

adenosine

Front 27

what does adenosine do

Back 27

decreases firing rate of AV node
given IV

Front 28

what clotting factors require Vitamin K

Back 28

7,9,10, prothrombin, protein C

so all these are inhibited by coumadin

Front 29

what does activated protein C do

Back 29

degrades Va and VIIa and degrades clots

Front 30

what does factor Xa do

Back 30

catalyzes the reaction of prothrombin to thrombin

Front 31

how do you pronounce luncheon

Back 31

ask jonas.... its french

Front 32

difference between white thrombi and red thrombi ?

Back 32

arterial (white)
venous (red) origin

Front 33

what is a thrombus

Back 33

a clot that adheres to a vessel wall

Front 34

what type of thrombi would most likely have fibrin and platelets, and is associated with atherosclerotic plaque

Back 34

white thrombi

Front 35

embolus

Back 35

a piece of a thrombus that breaks off and can potentially plug a downstream vessel

Front 36

where is heparin stored

Back 36

mast cells

Front 37

what enzyme does heparin activate

Back 37

lipoprotein lipase

Front 38

2 ways heparin works

Back 38

either directly inhibiting thrombin
or
inhibiting Xa, which is needed to facilitate prothrombin --> thrombin

Front 39

what do you treat a heparin overdose with

Back 39

protamine sulfate

Front 40

how does synthetic heparin (fondaparinux) work

Back 40

ONLY on Xa

Front 41

fodaparinux

Back 41

synthetic heparin

only acts on Xa

Front 42

decreases number of platelets

Back 42

anagrelide

Front 43

ADP receptor blockers anticoagulants

Back 43

"clopid"/"grel"

ticlopidine
clopidogrel
prasugrel

Front 44

mechanism of action of aspirin for anticoagulats

Back 44

inhibits ENZYME (COX) which decreases amout of TXA2

Front 45

fibrinogen receptor blockers (GP IIB/IIIA blockers) for anticoag.

Back 45

abciximab
tirofiban
eptifibatide

Front 46

phosphodiesterase inhibitors for anticoag. and mech of action

Back 46

cilostazol
dipyridamole

inhibit ENZYME (PDE) which causes increased cAMP which inhibits platelet aggregation

Front 47

which things dissolve fibrin clots

Back 47

streptokinase/urokinase
TPA
drotrecogin alfa (activated protein C)

Front 48

what are the hemostatic agents (cause platelet aggregation and possibly clotting)

Back 48

"A.T.E. A."...."i ATE A clot"

aminocaproic acid
tranexamic acid
estrogen
astringents

Front 49

which drugs are calcium chelators (inhibit calcium)

Back 49

EDTA
citric acid

Front 50

compare heparin, low molec. wt. heparins, and fondaparinux

Back 50

heparin: inhibits thrombin and Xa by activating AT3 (also activates lipoprotein lipase)
low mol. wt. hep's (parins): inhibit Xa (also thromin a little)
fondaparinux: inhibits ONLY Xa

Front 51

mechanism of action of heparin

Back 51

activates AT3 which will inhibit thrombin and Xa
activates lipoprotein lipase which will break down FA's in blood

Front 52

what do you take if you overdose on heparin

Back 52

protamine sulfate

Front 53

what are the leech drugs and how do they work

Back 53

leeches are "rude" and say "arg"
"irudin"s
argatroban (used to treat HIT)
inhibit thrombin

Front 54

which drugs can inhibit thrombin

Back 54

heparin
low mol.wt. heparins (parins)
leech drugs (irudins and argatroban)

Front 55

which drug is activated protein c

Back 55

drotrecogin alfa

Front 56

mechanism of action of drotrecogin alfa

Back 56

(it is activated protein C) so protein C degrades Va and VIIIa and dissolves clots

Front 57

coumadin is an analog of what

Back 57

vitamin K (so it inhibits the action of real vitamin K which inhibits 7,9,10, PT)

Front 58

mechanism of action of coumadin

Back 58

it is an analog of vitamin K so it inhibits the action of real vitamin K which inhibits 7,9,10, PT

Front 59

side effects of heparin

Back 59

bleeding
osteoporosis with long term use
thrombocytopenia (HIT)

Front 60

heparin is a ______ drug

Back 60

natural drug...extracted from dead cow/pig

Front 61

which drug is used to treat heparin induced thrombocytopenia (HIT)

Back 61

argatroban (leech drug that inhibits thrombin)

Front 62

which drug is used to treat disseminated intravascular coagulation (DIC)

Back 62

drotrecogin alfa

Front 63

which anticoagulant is pregnancy category X

Back 63

coumadin

Front 64

what do you do if you overdose on coumadin

Back 64

take vitamin K

Front 65

in what type of people will coumadin not work so well

Back 65

vegans or people who eat a lot of food with vitamin K in it

Front 66

side effects of ticlopidine, clopidogrel, and prasugrel

Back 66

(the ADP receptor blockers)
decrease WBC's: neutropenia, agranulocytosis, thrombocytopenia

Front 67

side effects of fibrinogen receptor blockers

Back 67

thrombocytopenia
decrease platelet aggregation
white thrombi (arterial)

Front 68

which drug is a monoclonal antibody

Back 68

abciximab

any drug that has "mab" is a monoclonal antibody

Front 69

Who's the world's greatest athlete?

Back 69

The guy who finishes first and third in a masturbation contest.

Front 70

What is the difference between a woman and a washing machine?

Back 70

You can put your load in a washing machine and it won't call you a week later.

Front 71

What is the cheapest meat?

Back 71

Deer balls, they're under a buck.

Front 72

What is the difference between a clever midget and a venereal disease?

Back 72

One is a cunning runt, and the other is a running cunt

Front 73

What do you do when your dishwasher stops working?

Back 73

Yell at her.

Front 74

What's the difference between a priest and pimples?

Back 74

Pimples don't come on your face until you're 13.