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USMLE

CV Pharm 3

QuestionAnswer
sotalol toxicity torsades, excessive beta-block
ibutilide toxicity torsades
bretylium toxicity new arrhythmias, hypotension
amiodorone toxicity hypothyrodism/hyperthyrodism, pulmonary fibrosis, hepatic toxicity, corneal deposits, skin deposits (photodermatitis), neurologic defects, constipation, bradycardia, heart block, chf
what 3 tests to do before using amiodarone? PFT, LFT, TFT
name 2 class IV antiarrhytmics verapamil, diltiazem
mechanism for class IV antiarrhythmics blocks Ca channels; affect AV nodal cells, decrease conduction velocity, incrase ERP, increase PR.
what are class IV antiarrhythmics used for prevent nodal arryhtmias (SVT)
what are 4 general side effects for class IV constipation, flushing, edema, cv (chf, av block, sinus node depression)
bepridil toxicity torsades
adenosine function hyperpolarizes cells by facilitating K movement out of cells. drug of choice in diagnosing/abolishing AV nodal arryhtmias
potassium function depress ectopic pacemaker, esp in dig toxicity
magnesium function torsades and dig toxicity use
what are the adverse effects of nifedipine and verapamil? (5) dizziness, flushing, nausea (verapamil also has constipation and AV block)
adverse effects of Diazoxide? hypoglycemia - reduces insulin release
what is the first-line treatment of hypertension in pregnancy? hydralazine with methyldopa
what is the mechanism of minoxidil? K channel opener --> hyperpolarizes and relaxes vascular smooth muscle
what is the toxicity of minoxidil? hypertrichosis, pericardial effusion
what is the treatment for malignant hypertension? nitroprusside, fenoldopam and diazoxide
what is the mechanism of action of fenoldopam? Dopoamine D1 receptor agonist --> relaxes renal vascular smooth muscle
what is the mechanism of diazoxide? K channel opener --> hyperpolarizes and relaxes vascular smooth muscle
what are the HMG-CoA reductase inhibitors? lovastatin, pravastatin, simvastatin, atorvastatin
What effects do the statins have on LDL, HDL and TGs? greatly decreases LDL, increases HDL and decreases TGs
what is the mechanism of action of the Statins? inhibit cholesterol precursor, mevalonate
side effects of statins? reversible increase in LFTs and myositis
What effect does Niacin have on LDL, HDL and TGs? decreases LDL, increases HDL, lesser decrease in TGs
what is the mechanism of action of niacin? inhibits lipolysis in adipose tissue; reduces hepatic VLDL secretion into circulation
what effect do the Bile acid resins have on LDL, HDL, and TGs? decrease LDL, slight increase in HDL, slight increase in TGs
what are the bile acid resins? cholestyramine, colestipol
what is the mechanism of action of cholestyramine and colestipol? prevent intestinal reabsorption of bile acids; liver must use cholesterol to make more
what are side effects of cholestyramine and colestipol? bad taste, causes GI discomfort, decreased absorption of fat-soluble vitamins
What effect does ezetimibe have on LDL, HDL and TGs? decreases LDL; no effect on others
what is the mechanism of action of ezetimibe? prevents cholesterol reabsorption at small intestine brush border
What are the Fibrates? gemfibrozil, clofibrate, bezafibrate, fenofibrate
what effect do the fibrates have on LDL, HDL and TGs? mainly decrease TGs, lesser decrease LDL and increase HDL
what is the mechanism of action of the fibrates? upregulate LPL --> increase TG clearance
what are the side effects of fibrates? myositis, and increase in LFTs
what Beta blockers are contraindicated in angina and why? labetalol, pindolol and acebutolol, due to partial agonist effects
Created by: Asclepius
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