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Cardiology- pharm

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drnieves's version from 2017-06-20 01:30

Section

Question Answer
Ca Ch blockersDihydropyridines and non-dihydropyridines
DehydropyridinesOn SM. Amlodipine, clevidipine, nicardipine, nifedipine,
Non dehydropyridinesAct on heart. Diltiazem, verapamil.
Ca ch blockers MOABlock L type Ca ch= decrease contractility.
Vascular SMAmlodipine= nifedipine> diltiazem> verapamil
Heartverapamil> diltiazem> amlodipine= nifedipine
Dihydropyridine (except nimodipine) usesHTN, angina, Raynaud
NimodipineSubarachnoid hemorrhage (no cerebral vasospasm)
Clevidipine911 HTN
Non dihydropyridineHTN, angina, afib/flutter
HMG CoA reducatse I (statins)Decrease LDL, increase HDL, decrease TAG
Statins MOACant convert HMG-CoA to mevalonate. Decrease mortality in CAD.
Statins ADRHepatotoxicity, myopathy (when vibrates + niacin). Acute RF with macrolides.
Bile acid resinsCholestyramine, colestipol, colesevelam
Bile acid resins Decrease LDL, poor raise in HDL and TAG
Prevent bile acid reabsorption; liver must use cholesterol to make moreBile acid resins MOA
Bile acid rains ADRGI upset, decrease absorption of other dugs and fat soluble vit.
EzetimibeDecrease LDL. Prevent cholesterol in SI brush border
Ezetimibe ADRDiarrhea, LFTs increase.
Fibratesgemfibrozil, clofibrate, bezafibrate, fenofibrate
Fibrates MOAMinor decrease in LDL, minor increase in HDL, super decrease in TAG. Upregulate LPL so there is an increase TG Cl. Activates PPAR-a to induce LDL synthesis.
Fibrates ADRMyopathy, cholesterol gallstones.
Niacin (B3)Decrease LDL, increase HDL, decrease TG.
Niacin MOAInhibits lipolysis (hormone sensitive lipase) in adipose tissue; reduces hepatic VLDL synthesis
Niacin ADRRed, flushed face. Hyperglycemia, hyperuricemia.
Class 3Amoidarone, Ibutilide, Dofetilide, Sotalol
Class 3 MOAIncrease AP duration, increase in rep, increase QT interval.
Afib, atrial flutter, vtacClass 3 use
Sotaloltorsades de pointes, excessive B blockade.
Ibutilidetorsades
Amiodaronepulmonary fibrosis, hepatotoxicity, hypo/hyerthyroidism, acts as happen, near sx, constipation, bradycardia, heart block, HF)
Arteriolar vasodilatorsHydralazine, monoxidil. Lower BP by reducing systemic vascular R. Effect limited by subsequent stimulation of baro R with resulting reflex sympathetic activation- Na and fluid retention.
DigoxinDirect inhibitor of Na/K pump, indirect of Na/Ca pump, increase Ca, increased inotropy.
Stimulates vagus, decrease HRDigoxin
Digoxin useHF, afib
Factors that predispose toxicity with digoxinRF, hypokalemia, verapamil, amiodarone, quinidine,
Digoxin antidoteNormalize K, cardiac pacer, anti digoxin Fab fragments, Mg.
memorize
n:m
Question Answer
AdenosineIncreased outflow of K.= hyperpolarizing the cell and decrease Ica.
DOC for supraventricular tachycardia. super short actingAdenosine
Effect blunted by theophylline and caffeineAdenosine
Adenosine ADRflushing, hypotension, chest pain, sense of impending doom, bronchospasm.
MgTorsades de points and digoxin toxicity.
memorize

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