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Pharm Cardio
Pharm: Cardiology
| Question | Answer |
|---|---|
| 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
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