Term
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Definition
increase cGMP, vasodilates arteries > veins, afterload reduction
Severe HTN, CHF. With methyldopa for HTN in pregnancy. With b-blocker to prevent reflex tachycardia.
Compensatory tachycardia, fluid retention (reflex renin release), nausea, headache, angina. Drug-induced lupus. |
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Term
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Definition
Peripheral edema, flushing, dizziness, constipation
*"Nifedipine is similar to Nitrates in effect" |
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Term
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Definition
Non-dihydropyridine CCN
block voltage-dependent Ca channels on cardiac and smooth muscle
Non-DHPs: heart > vascular effect
HTN, angina, arrhythmias, Prinzmetal angina, Raynauds
Constipation, gingival hyperplasia. Cardiac depression, AV block, peripheral edema, flushing, dizziness. |
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Term
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Definition
Non-dihydropyridine CCN
block voltage-dependent Ca channels on cardiac and smooth muscle
Non-DHPs: heart > vascular effect
HTN, angina, arrhythmias, Prinzmetal angina, Raynauds
Cardiac depression, AV block, peripheral edema, flushing, dizziness, constipation |
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Term
Nitroglycerin
Mech?
Use?
Tox? |
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Definition
NO release, increase cGMP, smooth muscle dilation
Veins >> arteries, decrease preload
Angina, pulmonary edema, erection enhancer
Reflex tachycardia, hypotension, flushing, headache, "Monday disease" in industrial exposure |
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Term
Isosorbide dinitrate
Mech?
Use?
Tox? |
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Definition
NO release, increase cGMP, smooth muscle dilation
Veins >> arteries, decrease preload
Angina, pulmonary edema, erection enhancer
Reflex tachycardia, hypotension, flushing, headache, "Monday disease" in industrial exposure.
*NB: isorboside mononitrate is active metabolite, has 100% bioavail - dinitrate is hepatic glucoronidated. |
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Term
Nitroprusside
Mech?
Use?
Tox?
Antidote? |
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Definition
NO release, increase cGMP, smooth muscle dilation
Short acting, for malignant HTN
cyanide toxicity - thiosulfate to bind CN |
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Term
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Definition
D1 receptor agonist, relaxes renal smooth muscle.
Only agent that improves renal perfusion as it lowers blood pressure.
malignant hypertension |
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Term
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Definition
K+ channel opener - hyperpolarizes then relaxes smooth muscle.
Malignant hypertension.
Hyperglycemia (prevents insulin release) |
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Term
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Definition
HMG-CoA reductase inhibition, lower mavalonate. Compensatory increase in LDL uptake to make bile.
Lowers LDL, triglycerides, slight raise in HDL
Hepatotoxicity, rhabdomyolysis |
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Term
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Definition
Inhibits lipolysis in adipose tissue, reduces liver VLDL secretion
raises HDL, lowers LDL, lowers triglycerides.
*Also has vasodilatory effects
Flushing (block with ASA), hyperglycemia, hyperuricemia |
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Term
Cholestyramine, Colestipol, Colesevelam
Mech?
Use?
Tox? |
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Definition
Bile acid resins, prevent reabsorption of bile acids, liver uses cholesterol to make more.
Lowers LDL, slight HDL increase, slight triglyceride increase
Tastes bad, GI discomfort, fat-soluble vitamin def., cholesterol gallstones |
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Term
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Definition
Prevent cholesterol reabsorption at brush border
Lowers LDL
Rare hepatotoxicity |
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Term
Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate
Mech?
Use?
Tox? |
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Definition
Fibrates; upregulate LPL, increase TG clearance
large triglyceride reduction, lower LDL, raise HDL
Myositis, hepatotoxic, *cholesterol gallstones. |
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Term
Digoxin
Mech?
Use?
Tox?
Antidote? |
|
Definition
Direct inhibition of Na/K ATPase, indirect increase in Ca, positive inotropy. Stimulates vagus nerve, decreases AV conductivity, SA node activity.
CHF, atrial fibrillation.
Cholinergic: N/V, diarrhea, blurry yellow vision. ECG: increased PR, decreased QT, T-wave inversion, ventricular tachyarrythmia, hyperkalemia. Worse with renal failure (excretion), hypokalemia (competes for binding), quinidine (protein binding displacement).
Slowly normalize K+, lidocaine, anti-dig Fab, Mg++ |
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Term
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Definition
Class IA antiarrhythmic: Na channel blocker.
Decrease slope of depolarization, prolong cardiac action potential duration (prolong QRS), prolong QT interval.
Atrial and ventricular arrhythmias, esp. SVT, reentrant, V-tach.
Cinchonism, thrombocytopenia, torsades de pointes. Increased toxicity with hyperkalemia. |
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Term
Procainamide
Mech?
Use?
Tox? |
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Definition
Class IA antiarrhythmic: Na channel blocker.
Decrease slope of depolarization (prolong QRS), prolong cardiac action potential duration, prolong QT interval.
Atrial and ventricular arrhythmias, esp. SVT, reentrant, V-tach.
Drug-induced lupus, thrombocytopenia, torsades de pointes. Increased toxicity with hyperkalemia. |
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Term
Disopyramide
Mech?
Use?
Tox? |
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Definition
Class IA antiarrhythmic: Na channel blocker.
Decrease slope of depolarization (prolong QRS), prolong cardiac action potential duration, prolong QT interval.
Atrial and ventricular arrhythmias, esp. SVT, reentrant, V-tach.
Thrombocytopenia, torsades de pointes. Increased toxicity with hyperkalemia. |
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Term
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Definition
Class IB antiarrhythmic: Na channel blocker
Decrease slope of depolarization (prolong QRS), shorten cardiac action potential. Preferentially affect ischemic or depolarized tissue.
Acute ventricular arrythmias (MI), digitalis-induced arrhytmias.
Local anesthetic, CNS stimlation/depression, CV depression. Increased toxicity with hyperkalemia. |
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Term
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Definition
Class IB antiarrhythmic: Na channel blocker
Decrease slope of depolarization (prolongs QRS), shorten cardiac action potential. Preferentially affect ischemic or depolarized tissue.
Acute ventricular arrythmias (MI), digitalis-induced arrhytmias.
Local anesthetic, CNS stimlation/depression, CV depression. Increased toxicity with hyperkalemia. |
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Term
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Definition
Class IB antiarrhythmic: Na channel blocker
Decrease slope of depolarization (prolongs QRS), shorten cardiac action potential. Preferentially affect ischemic or depolarized tissue.
Acute ventricular arrythmias (MI), digitalis-induced arrhytmias.
Local anesthetic, CNS stimlation/depression, CV depression. Increased toxicity with hyperkalemia. |
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Term
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Definition
Class IC antiarrythmic: Na channel blocker.
Decrease slope of depolarization (prolongs QRS), no effect on cardiac action potential length.
V-fib, intractable SVT. Last resort. CI: structural abnormalities (post-MI)
Proarrythmic, esp. post-MI. AV node block. Increased toxicity with hyperkalemia. |
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Term
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Definition
Class IC antiarrythmic: Na channel blocker.
Decrease slope of depolarization (prolongs QRS), no effect on cardiac action potential length.
V-fib, intractable SVT. Last resort. CI: structural abnormalities (post-MI)
Proarrythmic, esp. post-MI. AV node block. Increased toxicity with hyperkalemia. |
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Term
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Definition
Class IC antiarrythmic: Na channel blocker.
Decrease slope of depolarization (prolong QRS), no effect on cardiac action potential length.
V-fib, intractable SVT. Last resort. CI: structural abnormalities (post-MI)
Proarrythmic, esp. post-MI. AV node block. Increased toxicity with hyperkalemia. |
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Term
Class II anti-arrhythmics
Mech?
Use?
Tox?
Antidote? |
|
Definition
= beta-blockers
lower cAMP, lower Ca currents. Slower automaticity. Prolonged PR interval (AV node block).
V-tach, SVT, atrial fibrillation and flutter.
Asthma/COPD CI, CNS effects. Can decrease insulin release and mask effects of hypoglycemia.
Glucagon. |
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Term
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Definition
B-SAID block K!
Class III antiarrhythmics: K channel blockers
Prolong action potential duration, prolong QT interval.
Last resort!
New arrhythmias, hypotension |
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Term
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Definition
B-SAID block K!
Class III antiarrhythmics: K channel blockers
(sotalol: beta-block and K channel block)
Prolong action potential duration, prolong QT interval.
Last resort!
torsades de pointes, beta-block toxicity |
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Term
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Definition
B-SAID block K!
Class III antiarrhythmics: K channel blockers
Prolong action potential duration, prolong QT interval. Amiodarone effects lipid membrane, numerous effects.
Last resort!
**Pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroidism (PFTs/LFTs/TFTs). Corneal deposits, blue/grey skin discoloration, photosensitivity, neurologic effects, constipation, CV depression. |
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Term
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Definition
B-SAID block K!
Class III antiarrhythmics: K channel blockers
Prolong action potential duration, prolong QT interval.
Last resort!
Torsades de pointes |
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Term
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Definition
B-SAID block K!
Class III antiarrhythmics: K channel blockers
Prolong action potential duration, prolong QT interval.
Last resort!
Torsades de pointes |
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Term
Class IV anti-arrhythmics
Mech?
Use?
Tox? |
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Definition
= Non-DHP CCBs: Verapamil, Diltiazem
Decrease conduction velocity, increase PR interval.
SVT, nodal arrythmias
Constipation, flushing, edema, CV depression |
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Term
Adenosine
Mech?
Use?
Tox?
Antidote? |
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Definition
Inhibit adenylyl cyclase, hyperpolarize cells.
Will abolish AV node re-entrant SVTs, use for Dx.
Flushing, hypoTN, chest pain.
Block with theophylline. |
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Term
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Definition
Adenosine deaminase inhibitor
allows for accumulation of adenosine, same effects and uses. |
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Term
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Definition
dihydropyridine CCB (-dipines)
block voltage gated Ca channels
DHPs: vascular > cardiac
HTN, Prinzmetal's angina, Raynauds. Not for typical angina, arrythmias - not cardioselective, reflex tachycardia.
Peripheral edema, flushing, dizziness, constipation. |
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Term
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Definition
Phosphodiesterase inhibitor
Increases cardiac contractility, decreases preload and afterload.
IV only, short term therapy. |
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Term
Steps to lower LDL?
Steps to lower TG?
Steps to raise HDL? |
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Definition
LDL: Diet & exercise -> Statin -> Ezetimibe.
TG: Diet & exercise -> Fibrate -> Niacin
HDL: Diet & exercise -> Niacin |
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Term
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Definition
Irreversibly bind presynaptic vesicles in adrenergic neurons. Blocks monoamine transport into vesicles, allowing them to be degraded by MAOs.
Cheap anti-hypertensive, not used in developed world anymore due to AEs.
Depression (anti-NE and 5HT effects), nasal congestion (anti-adrenergic), increased gastric acid secretion (anti-adrenergic). |
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