CVS pharmacology

Question 1

Hypertensives safe in Pregnancy

Answer 1

Methyldopa
Hydralazine
Labetalol
Nifedipine

Question 2

Non-DHP CCBs

Answer 2

Verapamil and Diltiazem
Heart,
Blocks L-type Calcium channels on heart and vascular smooth muscles
Hypertension, angina, atrial fibrillation

Question 3

Dihydropyridine CCBs

Answer 3

Nicardapine, Nimodapine, Amlopodine
peripheral edema, flushing and dizziness

Question 4

Hydralazine

Answer 4

Increases cGMP, smooth muscle relaxation, vasodilator arterioles more then venues, reduces after-load, safe to use during pregnancy, give BB to prevent reflex tachycardia. Fluid retention, Headache, angina, SLE-like syndrome

Question 5

Nitroprusside

Answer 5

NO increases cGMP, via direct release of NO, causes Cyanide toxicity,

Question 6

Nitrates

Answer 6

Nitroglycerine, isosorbide dinitrates, Isosorbide mononitrate
Increases NO in vascular smooth muscles, Vasodilates, Increase in cGMP, dilates veins reduces preload,

Question 7

Nitrates

Answer 7

Reflex tachycardia, Hypotension, Flushing,
Contraindicated in Right ventricular infarction, Methemoglobinemia, hypotension, flushing,
Tachycardia, Dizziness and headache upon re-exposure

Question 8

HMG-CoA reductase inhibitors

Answer 8

Statins, prevent conversion of HMG-CoA to Melvalonate
Melvalonate is converted to Cholesterol,
Hepatotoxicity increased LFTs
Myopathy, Decreased mortality in patients with Coronary artery disease

Question 9

Bile acid resins

Answer 9

Cholestyramine, Colestipol, Colesevelam
Prevents intestinal reabsorption of bile,
GI upset reduced absorption of fat soluble vitamins
Reduced bile acid absorption and increased Bile acid secretion, interrupts enterohepatic circulation
GI upset Fat malabsorption

Question 10

Ezitimibe

Answer 10

Inhibits NPC1L1 receptor, blocks intestinal brush border reabsorption of cholesterol, increased LFTs

Question 11

Fibrates

Answer 11

Gemfibrizol, Bezafibrates Activate LPL
Triglycerides to fatty acids and glycerol
Activates PPAR alpha
Myopathy worsens with co-administration of statins
Cholesterol gallstones, via 7 alpha hydroxyls

Question 12

PCSK9 Inhibitors

Answer 12

Alirocumab, Evolocumab
Inhibits PCSK 9

Question 13

Niacin

Answer 13

Inhibits HSL in adipose tissues
Inhibits hepatic VLDL synthesis
Flushing, hyperglycemia, and hyperuricemia

Question 14

Digoxin

Answer 14

Direct inhibition of Na/K+ ATPase, indirect inhibition of Na/Ca+ exchanger, increases intracellular Calcium.

Question 15

Digoxin

Answer 15

Cholinegic effects (nausea, vomiting and Diarrhea), blurry yellow vision, arrhythmia and AV block.

Question 16

Class 1A antiarrhythmics

Answer 16

Queen, Proclaims, disco
Quinidine, Procainamide, Disopyramidine
Moderate Na+ channel blockade, increased QT interval, some K channel blocking effect.

Question 17

Class 1A antiarrhythmics side effects

Answer 17

Cinchonism (headache, tinnitus)- Quinidine
SLE like syndrome- Procainamide
Thrombocytopenia, Torsades de pointes, Prolonged QT interval

Question 18

Class 1B

Answer 18

Lidocaine, Phenytoin, Mexiletine, Acute Ventricular arrhythmia specially post MI, digitalis induced,
CNS stimulation depression,
CVS depression.

Question 19

Class 1C

Answer 19

Flecainide and Propafenone, strong Na channel blockade, SVTs including aFib,

Question 20

Class 2 Antiarryhtmics,

Answer 20

Metoprolol, Propanolol, Esmolol, Atenolol, Timalol,
Decreased SA and AV nodal activity by reducing cAMP, Reduced Ca+ currents, Reduced phase 4,
Impotence, COPD worsening, Hypoglycemia, Dyslipidemia, worsens Vasospastic angina

Question 21

Class 3 antiarrhythmics

Answer 21

AIDS, Amiodrane, Ibutilide, Dofetilide, Sotalol,
K+ ion channels
Sotalol- Torsades de pointes, Beta blocker
Ibutilide-Torsades de pointes
Amiodarone-
Pulmonary fibrosis, Hepatotoxicity, Hyper, hypothyroidism, blue grey skin deposition, neurologic effects constipation, CV effects bradycardia, HB and HF
Pulmonary function tests, Liver function tests and thyroid function tests

Question 22

Amidarone

Answer 22

Amiodarone-
Pulmonary fibrosis, Hepatotoxicity, Hyper, hypothyroidism, blue grey skin deposition, neurologic effects constipation, CV effects bradycardia, HB and HF
Pulmonary function tests, Liver function tests and thyroid function tests

Question 23

Class 4 anti-Arryhthmics
(CCB)

Answer 23

Verapamil , Diltiazem, prevents nodal arrhythmias,
Constipation, flushing edema

Question 24

Adenosine

Answer 24

Increases K+ out of the cells, hyper polarizes them, reduces Ca, decreases AV nodal conductance, Flushing hypotension impeding sense of doom, Bronchospams

Question 25

Magnesium

Answer 25

Torsades and digoxin toxicity

Question 26

Calcium channel blockers

Answer 26

Block Voltage gated L type calcium channels verapamil and diltiazem blocks these channels on the heart and the rest block them on arteriolar smooth muscles

Question 27

CCB

Answer 27

Amlodipine, clevidipine, nicardipine and Nimodapine act on vascular smooth muscles

Question 28

Adverse effects

Answer 28

Peripheral edema, flushing and dizziness, cardiac depression, AV block, hyperprolactinemia and depression