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Pharm Cardio

Pharm: Cardiology

QuestionAnswer
Class Ia anti-arrhythmics affect what channels? what phase of AP? Na+ channel, phase 0 of AP
What are the 2 Ia drugs Quinidine, Procainamide
How is Quinidine pro arrhythmic causes vasodilation-->reflex tachycardia (Vtach)
Why does Quindine cause cinchonism (and what exactly is tha?) causes cinchonism b/c of a1 and M block. Cinchonism= GI probs, tinnitus, doplopia, CNS probs
Ia drugs work on what state of activation of channel? activated state (state dependent)
Which anti arrhythmic requires previous digitalization Quinidine
impt feature of procainamide SLE syndrome in slow acetylators (hematotoxicity)
Ib drugs block what channels Na+ INACTIVATED channels.
Ib drugs cause AP prolongation or shortening? shortening
What are the 3 Ib drugs Lidocaine, Mixelitine, trocainide
Use of Ib drugs post-MI, post heart surgery
class Ic agent? Flecainide
what does flecainde(Ic) do to AP duration no affect
What is the anti-arrhythmic action of beta blockers (what cells do they act on) slow down SA, AV nodes
which B blockers are used for anti-arrhythmia Porpranolol (non selective), acebutolol and esmolol (cardio selective)
B blocker Tx for acute SVT Esmolol
What are the K+ blocker anti arrhythmics Amiadarone, Sotalol
Which phase do K+ blockers work on Phase 3
Amiodarone has short or long half life? t1/2= 80d!! extremely long. b/c inc protein binding==>large Vd
common s/e's of amiodarone pulm fibrosis, smurf skin, hepatotox, thyroid fxn
which class of anti arrhythmics are ideal for SVT II and IV (bc they slow down the nodal transmission) and Adenosine (DOC!!!)
Of the CCBs (verapamil, diltiazem, nifedipine) which are used for anti arrhythmic fxn? verap, diltiaz
Mech of axn of verap + diltiaz prolong phase 0 of Nodal potential
common s/e of verapamil constipation. also AV block (esp w/ B blockers or digoxin)
How does adenosine work Gi coupled..decr cAMP..DOC for SVTs
t1/2 of adenosine? 10seconds! used for emergency
which anti arrhythmics cause torsades? Ia and III (K+ channel blockers)
Tx for torsades? Mg2+
Drug for managing HTN in pregnancy? methyldopa (stays protein bound)
Which HTN drugs cause orthostatic HTN and CNS depression? SANS drugs (clonidine and methyldope--->a2 agonists)
methyldopa causes which lab test to be positive? coombs test
HTN drug that causes suicidal tendency reserpine (vesicle blocker)...due to decreased DA and 5HT
a1 blockers (prazocin, etc) are effective in HTN and what other comorbidity BPH
What s/e is inconvenient of a1 blockers urinary incontinence
are a1 blockers good or bad for lipid profile GOOD.
mechanism of B blocker efficacy in HTN? decrease Renin.
s/e of B blocker HTN Tx sexual dysfxn, raised lipids
DOC for HTN emergency? Nitroprusside
Vasodilator that causes SLE like syndrome? Hydralazine
Vasodilator class other than nitric oxide drugs? K+ openers (minoxidil and diazoxide)
minoxidil is used for what aesthetic purpose? baldness (rogaine)
what HTN meds cause gingival hyperplasia? Nitroprusside (+ phenytoin, cyclosporine)
mechanism of renal failure in ACEi usage? renal ARTERY stenosis
Bosentan Mech of Axn? lowers HTN via endothelin receptor agonist.
how does Digoxin raise Ca2+ levels in myocyte? replaces K+ in Na/K pump, causing raised Na, which blocks Na/Ca exchange.
B1 receptors increase inotropy how? incr cAMP cause protein kinase A to activate Ca2= channels to allow more Ca2+ into cell
Inamrinone, Milrinone mech of axn? PDE inhibitors, raise cAMP, protein Kinase A activates Ca2+ channels
alternative affects of digoxin? blocks Na/K in neurons, leading to SANS activation of myocyte (B1 affect) and PANS activations of SA node/ AV node.
uses of digoxin CHF, SVT (PANS affect)
sensory s/e of digoxin? visual halos
which types of diuretics are bad to give w/ digoxin? K+ wasting b/c it enhances digoxin activity
how to treat WPW? Quinidine w/o digitalization
what is Nesiritide? rh BNP
nitrates act on what vessels? large veins
what amino acid does NO come from L-Arginine
NO-->cGMP-->???--->??? protein kinase--->phosphatase--->deactivates myosin light chain
best drug for vasospastic angina? nifedipine
c/i for vasospastic angina? B blockers
types of diuretics at each location: PCT, TAL, DCT, CD PCT: osmotic+CA inh. TAL: loop diuretic. DCT: thiazide. CD:K+ sparing, aldosterone antagonists.
which are the potassium sparing diuretics? spironolactone, amiloride, triamterene
why are osmotic diuretics beneficial w/ statins? statins cause rhabdomyolsis, osmotic diuretics clear it out
what happens to pH of urine/blood with CA inhibitors urine= increased pH (causes stones) blood= lowers pH (used for met alkalosis)
name 2 CA inh acetozolamide, dorzolamide
uses of CA inh met alkalosis, pulm edema, glaucoma
mechanism of action of CA inh? CA inhibition = lower H+ leves in cell= lower Na+/H+ exchange on cell membrane
name loop diuretics furosemide, ethacrynic acid
what ions are lost with loop diuretics? Na+ (duh), K+, Cl-, Mg2+, Ca2+
which loop diuretic DOESNT cause sulfa allerg ethacrynic acid
s/e of loops ototoxicity (ethacrynic), hyperuricemic gout
effect of thiazides on Ca2+ in blood Ca2+ goes up! b/c less Na+ in cell means Na+/Ca2+ antiporter can work even more
what pt's should never recieve thiazides? diabetics
name a thiazide other than hydrochlorothiazide indapamide
sprinolactone has what affect on sexual KKs causes anti-androgenic affects (loss of body hair, etc)
mech of axn of spironolactone blocks androgen receptor
which antihyperlipidemic drug causes raised triglycerides (and VLDL) cholestyramine and colestipol (bile acid sequestrants)
which antihyperlipidemic causes aspirin-allergy like Sx (flushing, rashes, etc) Niacin
Gemfibrozil stimulates which enzyme? has what affect on serum lipids? stimulates LPL. causes triglycerides to drop
which antihyperlipidemics cause rhabdomyolysis? statins + gemfibrozil
this antihyperlipidemic has no affect on triglyceride levels niacin
which antihyperlipidemics black cholesterol from exiting cells to form VLDL? statin + niacin
mech of axn of exetimibe prevents intestinal absorption of cholesterol (lowers LDL) given w/ statins only.
Created by: jsad