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Definition
Vasodilator
Mech: incr. cGMP ‚Üí sm. m. relax (arterioles > vv.) ‚Üí afterload reduction
Use: combo w/ methyldopa as 1st line for HTN in preg (not ACE-I b/c teratogenic)
Tox: lupus-like synd; reflex tachy (contra: angina/CAD; prevent w/ β-blocker), angina, salt retention (prevent w/ diuretic) |
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Definition
Vasodilator (AKA: Rogaine)
Mech: K+ chan opener ‚Üí hyperpol/relaxes sm. m. (arterioles > vv.)
Use: severe HTN
Tox: hypertrichosis, reflex tachy (prevent w/ β-blocker), angina, salt retention (prevent w/ diuretic) |
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Term
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Definition
Dihydropyridine Ca chan blocker -
others: amlodipine, felodipine, nicardipine
Mech: block V-dep L-type Ca chans in vascular sm. m. >> heart ‚Üí decr. contractility
Use: HTN, Prinzmetal's angina, arrhythmias (not nifedipine)
Tox: cardiac depressionNote: dihydropyridines are fairly selective for vascular sm. m. |
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Term
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Definition
Ca chan blocker
Mech: block V-dep L-type Ca chans in vascular sm. m. & heart ‚Üí decr. contractility
Use: HTN, Prinzmetal's angina, arrhythmias (not nifedipine)
Note: more selective for heart than diltiazem
Tox: cardiac depression |
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Term
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Definition
Ca chan blocker
Mech: block V-dep L-type Ca chans in vascular sm. m. & heart ‚Üí decr. contractility
Use: HTN, Prinzmetal's angina, arrhythmias (not nifedipine)
Note: less selective for heart than verapamil |
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Term
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Definition
Vasodilator
Mech: release NO → incr. cGMP → dilate vv. >> arterioles (decr. preload)
Tox: Monday dz" in industrial exposure - lose tolerance over weekend ‚Üí tachy |
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Term
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Definition
Vasodilator
Mech: release NO → incr. cGMP → dilate vv. >> arterioles (decr. preload)
Tox: Monday dz" in industrial exposure - lose tolerance over weekend ‚Üí tachy |
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Definition
Vasodilator (short-acting)
Mech: release NO → incr. cGMP
Use: malignant HTN |
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Definition
D1 Ag
Mech: dilates renal bv (maintains renal flow) while decr. BP; also promotes natriuresis
Use: malignant HTN |
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Term
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Definition
VasodilatorK+ chan opener ‚Üí hyperpol & relaxes vascular sm. m.
Use: malignant HTN |
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Term
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Definition
HMG-CoA reductase inhib -
others: pravastatin, simvastatin
Mech: inhib production of mevalonate (Chl precursor); upreg. liver LDL Rs
Tox: incr. LFTs, rhabdomyolysisInteract: incr. conc. (& SE) w/ P-450 3A4 inhibitors |
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Term
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Definition
Lipid-lowering agent (AKA: nicotinic acid)
Mech: inhibs lipoysis in adipose; decr. hepatic VLDL secr
Tox: red/flushed face (decr. w/ ASA or l-t use) |
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Definition
Bile acid resin
Mech: prevent intestinal reabs of bile acids
Tox: tastes bad & GI discomfort (pts hate it); decr. abs of fat-sol vitaminsContra: pts w/ gallstones  |
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Definition
Bile acid resin
Mech: prevent intestinal reabs of bile acids
Tox: tastes bad & GI discomfort (pts hate it); decr. abs of fat-sol vitaminsContra: pts w/ gallstones |
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Term
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Definition
Bile acid resin
Mech: prevent intestinal reabs of bile acids
Tox: tastes bad & GI discomfort (pts hate it); decr. abs of fat-sol vitaminsContra: pts w/ gallstones |
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Term
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Definition
Mech: prevents Chl reabs in SI
Tox: incr. LFTs (rare); caution if gallbladder dz |
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Term
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Definition
Fibrate"
Mech: upreg lipoprotein lipase ‚Üí incr. TG clearance
Tox: myositis |
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Definition
Fibrate" -
others: bezafibrate
Mech: upreg lipoprotein lipase ‚Üí incr. TG clearance
Tox: myositis |
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Term
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Definition
Cardiac glycoside
Mech: inhibs Na/K pump ‚Üí indirectly inhibs Na/Ca exch ‚Üí incr. [Ca]i ‚Üí positive ionotropy; also stims vagus n.
Use: CHF (incr. contract), a.fib (decr. conduction at AV, depression of SA)
Tox: EKG (incr. PR, decr. QT, scooping ST, T inversion), parasymp SE, blurry yellow vision, arrhythmiaTox incr. by renal failure (urinary excr), hypokalemia (competes w/ K for Na/K pump), & quinidine (decr. clearance & displaces from tissue-binding sites)
Antidote: normalize K, lidocaine, cardiac pacer, anti-dig Fab, Mg2+
Notes: 75% bioavail, 30% protein-bound, 40h t1/2 |
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Term
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Definition
Na channel blocker - Class IA antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; incr. AP duration, ERP, & QT
Use: both atrial and. vent arrhythmias, esp. reentrant or ectopic supravent & vent. tachy
Tox: cinchonism (h/a + tinnitus), thrombocytopenia, torsades (d/t incr. QT)
Note: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IA antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; incr. AP duration, ERP, & QT
Use: both atrial and. vent arrhythmias, esp. reentrant or ectopic supravent & vent. tachy
Tox: reversible SLE-like syndNote: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IA antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; incr. AP duration, ERP, & QT
Use: both atrial and. vent arrhythmias, esp. reentrant or ectopic supravent & vent. tachy
Note: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IB antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; decr. AP duration
Use: acute vent arrhythmias (esp. post MI) & digitalis-induced; affects ischemic/depol Purkinje & vent tissue
Tox: local anesthetic; CNS stim/depr, CV depressionNote: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IB antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; decr. AP duration
Use: acute vent arrhythmias (esp. post MI) & digitalis-induced; affects ischemic/depol Purkinje & vent tissue
Tox: local anesthetic; CNS stim/depr, CV depression
Note: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IB antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; decr. AP duration
Use: acute vent arrhythmias (esp. post MI) & digitalis-induced; affects ischemic/depol Purkinje & vent tissue
Tox: local anesthetic; CNS stim/depr, CV depression
Note: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IC antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; no effect on AP duration
Use: V-tachs that progress to VF; intractable SVT; last resort for refractory tachyarrhythmias; for pts w/o structural abnl only
Tox: proarrhythmic (esp. post-MI, which is contra); prolongs refractory period in AV
Note: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IC antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; no effect on AP duration
Use: V-tachs that progress to VF; intractable SVT; last resort for refractory tachyarrhythmias; for pts w/o structural abnl only
Tox: proarrhythmic (esp. post-MI, which is contra); prolongs refractory period in AV
Note: hyperkalemia incr. tox for all class I |
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Term
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Definition
Na channel blocker - Class IC antiarrhythmic
Mech: decr. conduction, decr. phase 4 slope, incr. threshold; no effect on AP duration
Use: V-tachs that progress to VF; intractable SVT; last resort for refractory tachyarrhythmias; for pts w/o structural abnl only
Tox: proarrhythmic (esp. post-MI, which is contra); prolongs refractory period in AV
Note: hyperkalemia incr. tox for all class I |
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Term
| Propranolol (as an antiarrhytmic) |
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Definition
β-blocker - Class II antiarrhythmic -
others: esmolol, metoprolol, atenolol, timolol
Mech: decr. cAMP ‚Üí prevents P of Ca chan ‚Üí decr. Ca currentsEffect: decr. phase 4 slope; incr. PR (d/t sensitivity of AV node)
Use: v.tach, SVT, slowing vent rate during a.fib or flutter
Tox: β-block effects; mask signs of hypoglycemia (caution in DM); dyslipidemia (metoprolol) |
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Term
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Definition
K channel blocker - Class III antiarrhythmic
Mech: incr. AP duration, incr. ERP, incr. QT
Use: when other arrhythmics fail
Tox: torsades, excessive β block |
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Term
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Definition
K channel blocker - Class III antiarrhythmic
Mech: incr. AP duration, incr. ERP, incr. QT
Use: when other arrhythmics fail
Tox: torsades |
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Term
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Definition
K channel blocker - Class III antiarrhythmic
Mech: incr. AP duration, incr. ERP, incr. QT
Use: when other arrhythmics fail
Tox: pulm fibrosis, corneal deposits, hepatotox, skin deposits (photodermatitis), neuro SE, constipation, CV SE, hypo/hyperthyr
Note: check PFTs, LFTs, & TFTs |
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Term
| Verapamil (as antiarrhythmic) |
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Definition
Ca channel blocker - class IV antiarrhythmic
Mech: decr. conduction velocity, incr. ERP, incr. PR; mainly affects AV node
Use: prevention of nodal arrhythmias (SVT)
Tox: constip, flushing, CV SE |
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Term
| Diltiazem (as antiarrhythmic) |
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Definition
Ca channel blocker - class IV antiarrhythmic
Mech: decr. conduction velocity, incr. ERP, incr. PR; mainly affects AV node
Use: prevention of nodal arrhythmias (SVT)
Tox: constip, flushing, CV SE |
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Term
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Definition
Antiarrhythmic
Mech: incr. K outflow ‚Üí hyperpol & decr. Ca flow
Use: choice for dx/abolishing AV node arrhythmias
Tox: flushing, hypoTN, CP
Note: very short acting (15s) |
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Term
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Definition
Antiarrhythmic
Mech: depresses ectopic pacemakers in hypokalemia (IE: digitoxin tox) |
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Term
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Definition
Antiarrhythmic
Use: torsades de pointes & digitoxin tox |
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