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73 Cards in this Set

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(2) diuretics used for HTN


what do both lower as an AE?
Thiazides

Loops


both lower K+
Vasodilator used for severe HTN and CHF

AE?
Hydralazine


AE: SLE-like effects
Vasodilator used for emergency HTN situations

AE?
Nitroprusside


AE: converts to cyanide
Anti-HTN, anti-anginal and anti-arrhythmic class that works by reducing heart contractility

(2) AE
Calcium channel blockers


AE: Cardiac depression; Edema
which of the calcium channel blockers most specific for:

Vascular Smooth Muscle
Nifedipine
which of the calcium channel blockers most specific for:

Heart muscle
Verapamil
Drug for angina that also is effective against pulmonary edema
Nitroglycerine
what are the (5)* determinants of myocardial oxygen consumption?
BEECH:

BP,
Ejection time,
EDV,
Contractility,
HR
BEECH
Drug used for CHF and A-fib can cause arrthymias

what are the ECG changes?
(3)
Digoxin

ECG:
Inc PR
Dec QT
T-wave inversion
MOA of digoxin

(2) AE?
Inhibit Na/K pump to indirectly inhibit Na/Ca antiport, causing Ca increase inside cell

AE:
Yellow vision; Arrhythmias
(4)* class IA antiarrhythmics
Queen Amy Proclaims Diso's PYRAMID:

Quinidine,
Amiodarone,
Procainamide,
Disopyramide
Queen Amy Proclaims Diso's PYRAMID
MOA of class IA Na-channel blockers

what type of arrhythmias is it good for?
Inc action potential duration by Inc QRS (QT interval)

Use: Ventricular Arrhythmia
how do the Na-channel blockers affect HR, CO, BP and SV?
Dec HR -> Dec CO -> Dec BP -> Inc SV
(more time to fill)
AE for Quinidine
Cinchonism:

HA, Tinnitus, thrombocytopenia, Torsades de Pointes
why are Procainamide and Disopyamide successful at slowing the QT interval?
both are Amides, which are metabolized in the liver giving NH4 that can be converted to GLU -> GABA
AE for Procainamide
SLE-like effects
DOC for V-Tach
Lidocaine

(b/c it affects ischemic tissues and works quickly; IV only)
what is the class and drug that is the last resort (V-fib) as a
Na-channel blocker?

when is it contra-indicated?
Class IC: Flecainide


CI:
post-MI (leads to heart stopping)
Na-channel blocker class/drug that decreases Action Potential time
Class IB: Lidocaine
(3) drugs that can block both Na and Ca channels

what Dx are they good for?
Procainamide,

Phenytoin,

Quinidine

use: Wolf Parkinson White
Class II antiarrhythmics class and MOA
Beta-blockers

MOA:
Dec cAMP and Ca currents ->
Dec slope of phase 4 and Inc PR interval
(3) AE of Beta-blockers
blocking betas make me SICk:

Sedation,

Impotence,

CV effects (bradycardia, CHF)
blocking betas make me SICk
B-blocker:

Longest acting
Propranolol
B-blocker:

Shortest acting
Esmolol
B-blocker:

also blocks Alpha-receptors
(for Pheos and HTN crisis)
(2)
Labetalol


Carvedilol
B-blocker:

for Miosis
Timolol
B-blocker:

also blocks K+ channels
Sotalol
B-blocker:

good for patient w/ DM, asthmatics, MI and elderly
Atenolol
(3)* drugs in Class III anti-arrhythmics
BiAS to K-channel blockers:

Bretylium,

Amiodarone,

Sotalol
BiAS to K-channel blockers
MOA of K-channel blockers
Inc AP by Inc QT interval
AE of Amiodarone
(4)
Amy aught to run PFTs, LFTs and TFTs or you'll be BLUE:

Pulmonary fibrosis,
Hepatotoxicity,
Hyper/Hypothyroidism (contains iodine),
turns skin Blue
Amy aught to run PFTs, LFTs and TFTs or you'll be BLUE
Class of choice for Atrial arrhythmias

MOA
Ca-Channel blockers;

For AV nodal cells, Inc ST segment and Inc PR interval
DOC for Digitalis-induced arrthymias
Phenytoin
drug that inhibits VLDL production, Dec TG and Dec HDL breakdown

AE?
Niacin


AE: Flushing
class that increases the production of lipoprotein lipase to
Inc breakdown of TG

(2) AE?
Fibrates

"-FIBR-" (Gemfibrozil, Fenofibrate)

AE: GI upset, gall stones
contraindication of Bile Acid Sequestrants?
High TG levels...BAS Increases TG
DOC in AV nodal arrhythmias
Adenosine
Antiarrhythmic that depresses ectopic pacemakers
(esp digoxin toxicity)
Potassium
(3) First generation H1 blockers
Diphenhydramine (Benadryl),

Chlorpheniramine (Chlor-trimeton),

Promethazine (Phenergan)
First gen H1 for:
resp: "-amine"
GI: "-azine"
Clinical uses (3) and AE (3) of First generation H1 blockers
Uses:

Motion sickness
Allergy (hives, itching, nasal),
Sleep aid

AE:
Sedation,
Antimuscarinic,
Anti-alpha-adrenergic
(3) Second generation H1 blockers

Use?
Loratadine (Claritin),

Fexofenadine (Allegra),

Centirazine (Zyrtec)

Use: Non-drowsy Allergic rhinitis, Hay fever
second gen H2 for allergy:
"-adine" or "-azine"
Name and MOA of a Nasal Decongestant
Pseudoepherine (Sudafed)

Alpha-agonist leading to vasoconstriction
(2) Cough suppressants
Codeine,

Dextromethophan (DM)
Name and MOA of expectorant
Guaifenesin
(Robitussin)


Inc. respiratory secretions and viscosity
Long acting B2-agonist for Asthma Prophylaxis
Salmeterol
Methylxanthine used for Severe asthma

MOA?

(2) AE?
Theophylline

Bronchodilator by Inh Phosphodiesterase and Dec cAMP hydrolysis

AE:
Cardiotoxicity;
Neurotoxicity
Drug and MOA of Mast Cell Stabilizers

Use?
Cromolyn

causes Mast cells not to release histamine

use: Only for Prophylaxis
what is the most potent anti-inflammatory agent that is effective for mild, moderate and severe asthma
(first line for chronic asthma)?

MOA?
Glucocorticosteroids


Inh NF-kB transcription factor that induces TNF-alpha, inhibiting formation of PGE and LTE
(2) Adverse effects of Glucocorticoids?
Oral candidiasis,

bone demineralization
Leukotriene effect modulator that inhibits lipoxygenase and leukotriene formation

AE?
Zileuton


AE: Hepatotoxicity
(2) Leukotriene effect Modulator that binds the leukotriene receptors

Use?
Zafirlukast,

Montelukast


Use: Prophylaxis; mild/moderate asthma
Muscarinic antagonist that prevents bronchoconstriction
Ipratropium
non-specific Beta-agonist that relaxes bronchial smooth muscle

AE?
Isoproterenol


AE: tachycardia
What asthma agents deal with an early response (bronchoconstriction)?
(4)
My BLT:

Muscarinic antagonist,

Beta-agonist,

Leukotriene antagonist,

Theophylline
My BLT
what asthma agents deal w/ mast cells releasing mediators?
(2)
Cromolyn,

Steroids
Ganglionic blocker (rarely used) for the rapid reduction of HTN
Trimethaphan
only drug that reduces morbidity and mortality in heart failure
Spironoloactone
drug given IV for severe acute heart failure
Dobutamine
what anti-HTN drug may ilicit a positive Coombs test and hemolytic anemia?
Methyldopa
DOC for variant angina
Nifedipine
what drug interaction w/ Digoxin increases its toxicity?
Thiazides

(Dec K+ -> Inc Dig toxicity)
Anti-anginal Tx that has AE of severe constipation
Verapamil
(2) AE of Adenosine
Burning sensation in chest,

SOB
(2) AE of Dobutamine
Inc HR and BP
HTN medication that has AE of "Loss of taste"
ACEi
patient treated w/ anti-arrhythmic that causes recurrent attacks of feeling faint and experiencing episodes of loss of consciousness. what drug?
Quinidine
Cardiac AP drug:

affects Phase 4
(3)
Digoxin,

Verapamil
(Ca-channel blockers),

Lidocaine
Cardiac AP drug:

affects Phase 0 to slow conduction and prolong repolarization
IA drugs

(All class I slow conduction, but only IA prolongs repolarization)
Cardiac AP drug:

affects Phase 0 but causes no change in repolarization
Class IC - Flecainide
Cardiac AP drug:

blocks Na, Ca and K channels
Amiodarone
Drug that lowers HTN by inhibiting Peptidyl Dipeptidase
ACEi

(at biochemical level)
drug class for CHF that decreases Preload and BV
ACEi
only Drug class that increases the survival rate in CHF
ACEi