Pharm Cardio

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Author:
nicstrain
ID:
12602
Filename:
Pharm Cardio
Updated:
2010-04-05 22:40:59
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USMLE
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Description:
Cardiology Drugs
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  1. Digoxin
    • Decrease AV nodal conduction
    • Inhibit Na/K/ATPase
    • Increase Ca conc in heart cells = increase in contraction force
    • Tx CHF and Atrial Flutter - inotropic - decreases K levels = dig Toxicity
  2. Diltiazem
    • Tx Black men
    • Tx AV nodal re entrance
  3. Quinidine
    • Decrease AV nodal conduction. Cinchonism
    • Anticholinergic = aggravate MG
    • Hypotension = alpha block

    Class Ia anti-arrhythmic - moderate Na channel block
  4. Quinidine pre tx
    Atrial arrhythmia pre tx w/ drug that will decrease ventricular responses: Dig, Beta (-), Ca Ch (-)
  5. Verampil
    • Decrease AV nodal conduction. Decrease BP
    • Negative inotrope = no CHF use

    • Increase O2 supply via decrease in vasospasm
    • Tx Prinzmetal's variant angina
  6. Propranolol
    • Decrease AV nodal conduction. Decrease BP
    • Negative inotrope (= beta block)
    • Aggravates asthma and DM via the beta 2 block

    Blocks reflex tachy but causes excess brady = increase distole time = increased EDV
  7. Diazoxide
    balanced vasodilator
  8. Nitroprusside
    • Balanced vasodilator. Unloads heart
    • Increases cyanide = pre tx w/thiosulfate
    • Tx - acute HTN crisis
  9. Reserpine
    Tx severe resistant HTN. Depletes Ca, see stuffy nose. No to pts w/ peptic ulcers
  10. Dobutamine
    High doses beta 2 (+) offset alpha1 = beta1 increase CO w/o systemic vascular resistance
  11. Dopamine
    At low doses tx shock = dilates renal and mesenteric aa = maintain urine output
  12. Esmolol
    Short acting beta (-)
  13. Captopril
    • Balanced vasodilator
    • Tx output CHF, see dry cough (bradykinin induced)
  14. Dig Toxicity
    Fatal ventricular arrhythmia's w/ severe AV block
  15. Lidocaine
    • Class Ib anti-arrhythmic. Normalizes conduction
    • Tx initial MI = control arrhythmia
  16. Flecanide
    Class Ic anti-arrhythmic. Marked conduction slowing
  17. Amiodarone
    • Long t 1/2 = need potent doses to obtain desired levels for action
    • See blue skin, ocular deposits, pulmonary finrosis
  18. NE
    • Increase AV node conduction via beta 1
    • Metoprolol (-) beta 1
  19. Ach
    • Decrease AV node conduction via M receptor
    • Atropine (-) M-r
  20. Atenolol
    Controls catecholamine induced arrhythmia
  21. Brethylium
    Tx Malignant Ventricular Arrhythmia but causes passing catecholamine release that can aggravate arrhythmia briefly
  22. Nimodipine
    Tx Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm
  23. Atropine
    decreases excess vagal tone as seen in Sinus Bradycardia
  24. Nitrates
    Decrease preload = venous pooling. Decrease MVO2 = reflex tachy. increase ventricular work = decrease O2 demand
  25. Aspirin
    Prevents arterial platelets adhesion (not DVT thrombi). Inactivates COX = decrease platelet production of TxA2, a potent vasoconstrictor
  26. Warfarin
    (-) Vit K dependent gamma carboxylation of clotting factors = anticoagulation state
  27. Heparin
    Dependent on antithrombin III activation
  28. TPA
    • Binds to fibrin clots and activates plasminogen on the spot, Short t 1/2, give IV
    • Does not discriminate b/t fibrin-based clots = bleeding and stroke complications
  29. Streptokinase
    From bacteria = allergies arise. Can see excess bleeding in post-op pts
  30. Urokinase
    Human source, increase plasmin. Can see excess bleeding in post-op pts
  31. Colestipol
    • Bile acid sequestrates. Interrupt bile acid reabsorption = increased LDL uptake
    • Cholestyramine has same MOA
  32. Lovastatin
    • HMGCoA reductase (-) = increase LDL-r synthesis.
    • Pravastatin / Mevastatin same MOA
  33. Losartin
    • Decreased aldosterone
    • Increased Renin 2-3x's
  34. Diazoxide
    • Tx insulinomas
    • Not balanced vasodilator = only dilates arterial SM
  35. Clonidine
    Central alpha2 (+). Decreases TPR via decreased sympathetic effect
  36. Methyldopa
    Central alpha2 (+). (++) Coombs = Hemolytic anemia

    DOC for pregnancy induced HTN
  37. Phenytoin
    Class Ib reverse mild AV block due to digtoxin toxicity
  38. Procainamine
    Class Ia - SLE liek syndrome
  39. Indopamide
    Only thiazide that will have no effect on cholesterol
  40. Thiazides
    Older black men w/ HTN due to Increased Renin
  41. Beta (-)
    Young white men w/o asthma (causes bronchospasm)
  42. ACEIs
    • (-) change AI --> AII. (-) Bradykinin inactivation
    • Captropil / Enalapril
    • Causes renal failure = use w/ caution in elderly

    • Vasodilate renal efferents > than afferent : decrease GFR and Filtration pressure
    • Decrease diabetic renal failure progression
  43. Epi
    • Increase contraction rate & force via Beta1
    • Increase systolic but decrease in diastolic BP
    • Decreased in peripheral resistance via beta2 vasodilation
  44. Norepi
    • Increase HR and systolic and diastolic BP
    • Increase peripheral blood vessel resistance
  45. Class II
    Beta (-), decrease risk of reinfarction and sudden death following MI
  46. "Grey Man"
    Amiodarone: class III anti-arrhythmia
  47. Beperidil
    Ca Ch (-). Limited clinical use due to Torsades de Pointes
  48. Adenosine
    • Its receptor is blocked by Methylxanthines (Theophyline)
    • Favored for tx of Reentrant Spura Ventricular Tachycardia
  49. Enoxaparin
    Low molecular weight heparin = Oral anticoagulant
  50. Isoproterenol
    Increased HR and decreased MAP
  51. Variant angina
    Use Ca Ch (-) (Nifedipine)
  52. Contraindicated in CHF
    Beta(-) = you don't want to decrease heart's pumping strength

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