p.1
Cardiovascular Pharmacology
What is the focus of the course NURS 3142?
Fundamental Pharmacology, specifically cardiovascular drugs and anti-coagulants.
p.2
Cardiovascular Pharmacology
What are the major classifications of agents used for hypertension?
Agents used for hypertension include diuretics, ACE inhibitors, beta-blockers, and calcium channel blockers.
p.2
Cardiovascular Pharmacology
What therapeutic effects do agents for angina provide?
Agents for angina help to relieve chest pain by improving blood flow to the heart.
p.2
Heart Failure Management
What is a common treatment for heart failure?
Common treatments include ACE inhibitors, beta-blockers, and diuretics.
p.2
Cardiovascular Pharmacology
What types of agents are used in the management of shocks/sepsis?
Vasopressors and inotropes are commonly used in the management of shocks/sepsis.
p.69
Arrhythmias and Antiarrhythmic Drugs
What is the primary action of Class I antiarrhythmic drugs?
They block Na influx into the cell during depolarization.
p.103
Anticoagulants and Antiplatelet Agents
In which clinical situations is Protamine used?
For neutralization of both UFH and LMWH.
p.19
Cardiovascular Pharmacology
In which journal was the pharmacotherapy update published?
Journal of Cardiovascular Pharmacology and Therapeutics.
p.37
Diuretics and Their Mechanisms
What is the mechanism of action of Mannitol as an osmotic diuretic?
It increases the osmotic pressure of glomerular filtrate and inhibits tubular reabsorption of water and electrolytes.
p.37
Diuretics and Their Mechanisms
What is the result of using Mannitol?
Increased urinary output.
p.75
Anticoagulants and Antiplatelet Agents
What is ASA commonly used for?
As an antiplatelet agent.
p.82
Anticoagulants and Antiplatelet Agents
What do platelet aggregation inhibitors do?
They interrupt chemical signals that promote platelet aggregation.
p.41
Diuretics and Their Mechanisms
What is the mechanism of action of Spironolactone and Eplerenone?
They block the effects of aldosterone in the collecting duct, leading to sodium loss and potassium retention.
p.74
Ischemic Heart Disease
What can cause reduced blood flow in coronary vessels?
Reduced diameter of the vessels.
p.84
Anticoagulants and Antiplatelet Agents
What is the mechanism of action for clopidogrel, prasugrel, and ticagrelor?
They block P2Y12 of ADP receptors on platelets, preventing platelet activation and aggregation.
p.18
Adrenergic Agonists and Antagonists
What is the effect of α1 receptor activation?
Contraction of vascular smooth muscle.
p.41
Diuretics and Their Mechanisms
What are the adverse effects associated with Eplerenone?
Hyperkalemia and hypertriglyceridemia.
p.66
Arrhythmias and Antiarrhythmic Drugs
What are ectopic pacemakers?
Ectopic pacemakers are abnormal pacemaker sites that can generate impulses outside of the normal SAN.
p.87
Anticoagulants and Antiplatelet Agents
What are the primary uses of Ticagrelor?
Acute Coronary Syndrome (ACS), Transient Ischemic Attack (TIA), and Percutaneous Coronary Intervention (PCI).
p.64
Cardiovascular Pharmacology
What are the components of fast fibers in electrical conduction?
His-Purkinje system, atria, and ventricles.
p.14
Adrenergic Agonists and Antagonists
What are the usual indications for Dobutamine?
Cardiogenic shock and acute decompensated heart failure (ADHF).
p.104
Anticoagulants and Antiplatelet Agents
What are the routes of administration for Vitamin K?
PO (oral), IV (intravenous), IM (intramuscular), and SC (subcutaneous).
p.58
Heart Failure Management
What is the toxic level of Digoxin?
Levels greater than 2 ng/mL.
p.19
Cardiovascular Pharmacology
What is the DOI of the pharmacotherapy update?
10.1177/1074248414559838.
p.80
Anticoagulants and Antiplatelet Agents
What is the focus of the article by Paulus et al.?
Anticoagulation Therapy Considerations in Factor VII Deficiency.
p.84
Anticoagulants and Antiplatelet Agents
What effect do antiplatelet agents like ticagrelor have on bleeding time?
They prolong bleeding time.
p.87
Anticoagulants and Antiplatelet Agents
What is a contraindication for Ticagrelor?
Prior intracranial hemorrhage (ICH).
p.54
Cardiovascular Pharmacology
What is the primary use of nitrates?
They are primarily used for angina, not hypertension (HTN).
p.101
Anticoagulants and Antiplatelet Agents
Do patients on warfarin require monitoring on aPTT?
False; they require monitoring on INR.
p.80
Anticoagulants and Antiplatelet Agents
What is Factor VII deficiency associated with?
Increased risk of bleeding due to impaired coagulation.
p.87
Anticoagulants and Antiplatelet Agents
What are some adverse effects (AEs) associated with Ticagrelor?
Bleeding, bradyarrhythmias, and Thrombotic Thrombocytopenic Purpura (TTP) which is rare but can be fatal.
p.67
Arrhythmias and Antiarrhythmic Drugs
How does impulse travel in a reentrant pathway?
In a circular manner to reexcite the same areas of the heart.
p.49
Calcium Channel Blockers
What is the effect of CCBs on cardiac muscle?
They promote relaxation of cardiac muscle.
p.53
Cardiovascular Pharmacology
What is Nitroglycerin used for?
Relieving acute coronary spasm and hypertension crisis.
p.56
Heart Failure Management
What is the primary issue in heart failure?
The heart fails to pump sufficient blood to match the body's demands.
p.60
Heart Failure Management
How does Dobutamine affect cardiac contractility?
It improves cardiac contractility and reduces the workload of the heart.
p.70
Drug Interactions and Adverse Effects
What are some common adverse effects (AEs) of Ranolazine?
Constipation, nausea, dizziness, syncope, headache, and QT prolongation.
p.52
Cardiovascular Pharmacology
What is the primary action of nitric oxide in vascular smooth muscle?
It activates guanylate cyclase, leading to relaxation and vasodilation.
p.52
Cardiovascular Pharmacology
What type of blood vessels does nitric oxide primarily dilate?
Both peripheral veins and arteries, with a more prominent effect on veins.
p.50
Calcium Channel Blockers
What class of drugs do Amlodipine and Nifedipine belong to?
Dihydropyridine Calcium Channel Blockers (CCBs).
p.64
Cardiovascular Pharmacology
What are the two types of fibers involved in electrical conduction at the cellular level?
Slow fibers and fast fibers.
p.74
Ischemic Heart Disease
What is a pharmacological intervention to reduce O2 demand in the heart?
Decreasing heart rate (HR) and cardiac contractility using beta-blockers (BB).
p.5
Adrenergic Agonists and Antagonists
What is the role of the post-ganglionic neuron in the autonomic nervous system?
It is part of the peripheral nervous system (Peripheral NS).
p.67
Arrhythmias and Antiarrhythmic Drugs
What causes a reentrant pathway in the cardiac system?
Conduction block or unidirectional block in an area of the cardiac system.
p.104
Anticoagulants and Antiplatelet Agents
What is the primary function of Vitamin K (phytonadione)?
Promotes liver synthesis of clotting factors II, VII, IX, and X to reverse INR.
p.76
Thrombolytics and Their Uses
What are the potential consequences of venous thrombosis?
Deep venous thrombosis (DVT) or pulmonary embolism (PE).
p.60
Heart Failure Management
What are the effects of Dobutamine on β1 and β2 receptors?
It acts as a positive inotrope on β1 and a vasodilator on β2, relaxing smooth muscle.
p.97
Anticoagulants and Antiplatelet Agents
What are the three thrombin inhibitors mentioned?
Argatroban (IV), bivalirudin (IV), dabigatran (PO).
p.30
Adrenergic Agonists and Antagonists
How do β blockers with ISA compare to other beta blockers in treating angina?
They are effective in treating angina like other beta blockers but cause less depression of cardiac function.
p.26
Adrenergic Agonists and Antagonists
What effect do β1 receptor antagonists have on heart rate?
They decrease heart rate (↓ HR).
p.85
Anticoagulants and Antiplatelet Agents
What is Clopidogrel primarily used for?
Vascular disease, TIA, and ACS.
p.22
Cardiovascular Pharmacology
What is the formula for Mean Arterial Pressure (MAP)?
MAP = Cardiac Output (CO) x Peripheral Resistance (PR).
p.86
Anticoagulants and Antiplatelet Agents
What is a primary use of Prasugrel?
Acute Coronary Syndrome (ACS).
p.18
Adrenergic Agonists and Antagonists
What is the effect of α2 receptor activation?
Decreased blood pressure via inhibition of sympathetic outflow.
p.89
Anticoagulants and Antiplatelet Agents
What is the mechanism of action of IIb/IIIa receptor antagonists?
They block the binding site for fibrinogen on the IIb/IIIa receptor.
p.70
Heart Failure Management
What are the primary effects of Ranolazine?
Antianginal and anti-ischemic effects without affecting heart rate (HR) and blood pressure (BP).
p.89
Anticoagulants and Antiplatelet Agents
What is the primary effect of IIb/IIIa receptor antagonists?
Reversibly blocks platelet aggregation and prevents thrombosis.
p.86
Anticoagulants and Antiplatelet Agents
What serious condition can occur within 2 weeks of initiating Prasugrel?
Thrombotic Thrombocytopenic Purpura (TTP).
p.14
Adrenergic Agonists and Antagonists
What is the initial dosing recommendation for Dobutamine?
Titrate up from an initial dose of 2 mcg/kg/min.
p.9
Adrenergic Agonists and Antagonists
Give an example of an agonist and its effect.
Norepinephrine binds to beta receptor to increase heart rate.
p.65
Arrhythmias and Antiarrhythmic Drugs
What is the significance of cardiac ion channels?
They are crucial for electrical conduction in the heart.
p.49
Calcium Channel Blockers
What is the primary action of Calcium Channel Blockers (CCBs)?
They inhibit calcium ions from entering vascular smooth muscle and myocardium.
p.39
Diuretics and Their Mechanisms
What are the three thiazide diuretics mentioned?
Chlorothiazide, Hydrochlorothiazide (HCTZ), and Chlorthalidone.
p.14
Adrenergic Agonists and Antagonists
What receptors does Dobutamine primarily activate?
β1 > β2 >>> α1 receptors.
p.30
Adrenergic Agonists and Antagonists
What is the effect of ISA on heart rate and contractility?
It has less effect on heart rate and contractility.
p.40
Diuretics and Their Mechanisms
What is a common use of Spironolactone?
Congestive Heart Failure (CHF), Hypertension (HTN), Edema.
p.101
Anticoagulants and Antiplatelet Agents
Does UFH require renal adjustment?
False; it requires no renal adjustment.
p.36
Diuretics and Their Mechanisms
What is the usual indication for carbonic anhydrase inhibitors?
Edema with metabolic alkalosis.
p.68
Arrhythmias and Antiarrhythmic Drugs
What is the Vaughan Williams classification used for?
It is used to classify antiarrhythmic drugs.
p.76
Thrombolytics and Their Uses
What conditions can arterial thrombosis present as?
Stroke or myocardial infarction.
p.14
Adrenergic Agonists and Antagonists
What is the maximum dose of Dobutamine that can be used in severe hypoperfusion in ADHF?
As high as 40 mcg/kg/min.
p.53
Cardiovascular Pharmacology
What is Nitroprusside used for?
Hypertension crisis and acute decompensated heart failure (ADHF).
p.105
Anticoagulants and Antiplatelet Agents
What are some uses of tranexamic acid?
Abnormal uterine bleeding, perioperative bleeding, bleeding from dental procedures, trauma-associated hemorrhage, hemoptysis.
p.14
Adrenergic Agonists and Antagonists
What are some adverse effects (AEs) associated with Dobutamine?
Tachycardia, hypertension, and dyspnea.
p.11
Adrenergic Agonists and Antagonists
What similarities do adrenergic agonists have with Norepinephrine and Epinephrine?
They produce similar effects.
p.13
Adrenergic Agonists and Antagonists
What happens at high doses of Epinephrine?
α1 vasoconstriction + β2 vasodilation.
What is a potential adverse effect of Hydralazine?
Hydralazine-induced lupus-like syndrome.
p.65
Arrhythmias and Antiarrhythmic Drugs
In which journal was the article published?
Circulation: Arrhythmia and Electrophysiology.
p.5
Adrenergic Agonists and Antagonists
What are the three main divisions of the autonomic nervous system?
Sympathetic system, parasympathetic system, and enteric system.
p.10
Adrenergic Agonists and Antagonists
What specific cardiovascular functions can be regulated by norepinephrine receptor modulation?
Heart rate, contractility, and blood pressure.
p.73
Antiarrhythmias and Antiarrhythmic Drugs
What is the primary action of Class IV antiarrhythmic drugs?
They block calcium influx from phases 0-2, prolonging the refractory phase.
p.31
Adrenergic Agonists and Antagonists
What are the actions of β-blockers?
Decreased heart rate, contractility, and AV node conduction.
p.66
Arrhythmias and Antiarrhythmic Drugs
What are Early Afterdepolarizations (EADs)?
EADs occur when an action potential is prolonged and an additional depolarization happens before the cell has fully repolarized.
p.74
Ischemic Heart Disease
How do calcium channel blockers (CCB) help in ischemic heart disease?
They decrease systemic vascular resistance (SVR) and cardiac contractility.
p.39
Diuretics and Their Mechanisms
What are some adverse effects (AEs) of thiazide diuretics?
Hypokalemia, hyponatremia, hypercalcemia, hyperglycemia, hyperuricemia, metabolic acidosis, and muscle weakness.
p.87
Anticoagulants and Antiplatelet Agents
What is the onset time for Ticagrelor's effects?
2 weeks to 2 months from initiation.
p.67
Arrhythmias and Antiarrhythmic Drugs
What are some types of arrhythmias associated with reentrant pathways?
Atrial fibrillation, atrial flutter, or ventricular tachycardia.
p.9
Adrenergic Agonists and Antagonists
What is an agonist?
A substance that binds to a receptor and activates it, mimicking the effects of the endogenous substance.
p.83
Anticoagulants and Antiplatelet Agents
What type of drug is Aspirin?
NSAID (Non-Steroidal Anti-Inflammatory Drug).
p.31
Adrenergic Agonists and Antagonists
How do β-blockers affect hypoglycemia?
They potentiate and mask hypoglycemia (β2).
p.90
Anticoagulants and Antiplatelet Agents
What are the examples of Low Molecular Weight Heparin (LMWH)?
Dalteparin and Enoxaparin.
p.35
Diuretics and Their Mechanisms
What are the different types of diuretics?
Carbonic anhydrase inhibitors, osmotic diuretics, loop diuretics, thiazides, and potassium-sparing diuretics.
p.28
Adrenergic Agonists and Antagonists
What type of β blockers are Propranolol, Nadolol, Timolol, and Sotalol?
Non-selective β blockers.
p.68
Arrhythmias and Antiarrhythmic Drugs
What do Class II antiarrhythmic drugs do?
They are autonomic inhibitors and activators.
p.88
Anticoagulants and Antiplatelet Agents
What are some adverse effects of IV Dipyridamole?
Chest pain, dyspnea, and hypotension.
p.82
Anticoagulants and Antiplatelet Agents
What are the usual indications for antiplatelet agents?
Prevention of thrombosis and post-myocardial infarction (post-MI).
p.10
Adrenergic Agonists and Antagonists
Where are norepinephrine receptors found in the body?
In various parts of the body, not just within the cardiovascular system, except for the β1 receptor.
p.41
Diuretics and Their Mechanisms
What are common adverse effects of Spironolactone?
Hepatotoxicity, hyperkalemia, antiandrogen effects, and abdominal pain.
p.52
Cardiovascular Pharmacology
What are some adverse effects (AEs) associated with nitrates?
Headache, hypotension, and tolerance.
p.18
Adrenergic Agonists and Antagonists
Where is the α2 receptor primarily located?
In the central nervous system.
p.49
Calcium Channel Blockers
What are the two groups of Calcium Channel Blockers based on their structures?
Dihydropyridine and Non-dihydropyridine.
p.8
Cardiovascular Pharmacology
Which institution is associated with the document?
The Chinese University of Hong Kong.
p.86
Anticoagulants and Antiplatelet Agents
What are common adverse effects (AEs) of Prasugrel?
Bleeding, gastrointestinal bleeding (GIB), and epistaxis.
p.9
Adrenergic Agonists and Antagonists
What roles do receptors play?
Transmitting signals, mediating effects of neurotransmitters, hormones, drugs, and triggering biochemical reactions or signaling pathways within the cell.
p.70
Heart Failure Management
How does Ranolazine reduce myocardial oxygen consumption?
By decreasing intracellular calcium to reduce ventricular tension.
p.11
Adrenergic Agonists and Antagonists
What are drugs with adrenergic effects also called?
Adrenomimetics or sympathomimetics.
p.54
Cardiovascular Pharmacology
How is glyceryl nitrate available for fast relief of chest pain?
It is available as sublingual (SL) pills.
p.34
Diuretics and Their Mechanisms
What are the three main types of diuretics?
Thiazides, loop diuretics, and potassium-sparing diuretics.
p.44
Renin-Angiotensin System and Its Inhibitors
What is the focus of the study by Luther JM and Brown NJ?
The renin–angiotensin–aldosterone system and glucose homeostasis.
p.23
Adrenergic Agonists and Antagonists
What is the mechanism of action for Clonidine?
Stimulates α2 receptors in the brain, decreasing sympathetic outflow.
p.35
Diuretics and Their Mechanisms
What type of diuretic is a carbonic anhydrase inhibitor?
A class of diuretics that inhibit the enzyme carbonic anhydrase.
p.25
Adrenergic Agonists and Antagonists
What effect do α1-selective blockers have on blood vessels?
They lead to vasodilation.
p.99
Thrombolytics and Their Uses
What is the primary use of thrombolytics?
To prevent formation or spread of clots and to re-establish perfusion.
p.90
Anticoagulants and Antiplatelet Agents
What is the general mechanism of heparins?
They potentiate the action of antithrombin III to inactivate factor IIa (thrombin) and factors IXa, Xa, XIa, XIIa.
p.95
Anticoagulants and Antiplatelet Agents
What is the focus of the study mentioned?
Trends in the use of oral anticoagulants in older adults with newly diagnosed atrial fibrillation.
p.10
Adrenergic Agonists and Antagonists
What role do cardiac medications play in relation to norepinephrine receptors?
They can modulate NE receptors to regulate heart rate, contractility, and blood pressure.
p.37
Diuretics and Their Mechanisms
What can precipitation of crystals at low temperatures cause when using Mannitol?
Vascular and end-organ damage.
p.67
Arrhythmias and Antiarrhythmic Drugs
What is a reentrant pathway?
An abnormal electrical circuit contributing to arrhythmias.
p.73
Antiarrhythmias and Antiarrhythmic Drugs
How do Class IV antiarrhythmics affect conduction through the AV node?
They slow conduction through the AV node and prolong the plateau period.
p.11
Adrenergic Agonists and Antagonists
What is the major neurotransmitter of the sympathetic nervous system?
Norepinephrine (Noradrenaline; NE).
p.24
Adrenergic Agonists and Antagonists
What is the function of β-blockers?
They are primarily used to manage hypertension and other cardiovascular conditions.
p.59
Heart Failure Management
What is the primary action of Nitroprusside in acute heart failure?
Direct vasodilation of veins and arteries.
p.88
Anticoagulants and Antiplatelet Agents
What is the primary mechanism of action of Dipyridamole?
It causes accumulation of adenosine, adenine nucleotides, and cyclic AMP, inhibiting platelet aggregation.
p.35
Diuretics and Their Mechanisms
How do diuretics affect ion transport in the kidneys?
They inhibit ion transport.
p.53
Cardiovascular Pharmacology
How is Nitroglycerin administered?
SL (sublingual), IV (intravenous), TD (transdermal), and powder.
p.105
Anticoagulants and Antiplatelet Agents
What is the mechanism of action of tranexamic acid?
It forms a reversible complex that displaces plasminogen from fibrin, resulting in inhibition of fibrinolysis.
p.60
Heart Failure Management
What is the action of Dopamine at high doses?
It increases systemic vascular resistance (SVR), cardiac output (CO), and mean arterial pressure (MAP).
p.59
Heart Failure Management
What are the effects of Nitroprusside on systemic vascular resistance (SVR), cardiac output (CO), and venous pressure?
It decreases SVR, CO, and venous pressure.
p.26
Adrenergic Agonists and Antagonists
Where are β2 receptors primarily located?
In the smooth muscle of the respiratory tract, uterus, and blood vessels.
p.36
Diuretics and Their Mechanisms
What are some adverse effects of carbonic anhydrase inhibitors?
Metabolic acidosis, hypersensitivity reactions, paresthesia (at higher doses).
p.100
Anticoagulants and Antiplatelet Agents
What is the focus of the article by Malik, A., Ha, N. B., & Barnes, G. D.?
Choice and duration of anticoagulation for venous thromboembolism.
p.16
Adrenergic Agonists and Antagonists
What is one of the primary effects of Phenylephrine?
Systemic arterial vasoconstriction.
p.12
Adrenergic Agonists and Antagonists
What is the primary receptor activated by Norepinephrine?
α1 receptors more than β1 receptors.
p.68
Arrhythmias and Antiarrhythmic Drugs
What is the function of Class III antiarrhythmic drugs?
They are K channel blockers.
p.61
Heart Failure Management
What should be considered when dosing Milrinone?
Dose adjustment in renal dysfunction.
p.46
Renin-Angiotensin System and Its Inhibitors
What are the primary uses of ARBs?
Hypertension (HTN), heart failure (HF), and diabetic nephropathy.
p.19
Cardiovascular Pharmacology
What is the focus of the pharmacotherapy update by Jentzer et al.?
The use of vasopressors and inotropes in the intensive care unit.
p.5
Adrenergic Agonists and Antagonists
What is the structure of the autonomic nervous system?
It consists of a two-neuron pathway to communicate with target organs, including a pre-ganglionic neuron (CNS) and a post-ganglionic neuron (Peripheral NS).
p.20
Adrenergic Agonists and Antagonists
What is the primary reason for starting noradrenaline infusion in AA's treatment?
To achieve a mean arterial pressure (MAP) greater than 60.
p.80
Anticoagulants and Antiplatelet Agents
In which journal was the article published?
Drug Safety - Case Reports.
p.5
Adrenergic Agonists and Antagonists
What is the role of the pre-ganglionic neuron in the autonomic nervous system?
It originates in the central nervous system (CNS).
p.75
Anticoagulants and Antiplatelet Agents
Name three types of anticoagulants.
Warfarin, DOACs, and heparin.
p.64
Cardiovascular Pharmacology
What are the components of slow fibers in electrical conduction?
Sinoatrial Node (SAN) and Atrioventricular Node (AVN).
p.54
Cardiovascular Pharmacology
What is the mechanism of action of nitrates?
Their mechanism of action involves venodilation, but they also have arterial effects.
p.22
Cardiovascular Pharmacology
What are the factors that can increase Mean Arterial Pressure (MAP)?
Increased heart rate, increased inotropy, increased fluid/volume retention, and increased vasoconstriction.
p.61
Heart Failure Management
In which patients is Milrinone indicated?
In patients with low cardiac index (CI) and hypotension or end-organ hypoperfusion.
p.50
Calcium Channel Blockers
What is the route of administration for Verapamil?
Both intravenous (IV) and oral (PO).
p.31
Adrenergic Agonists and Antagonists
What can worsen symptoms in peripheral artery disease or Raynaud phenomenon?
Non-selective or high doses of cardioselective β-blockers.
p.44
Renin-Angiotensin System and Its Inhibitors
What system do drugs that work on the Renin-Angiotensin system target?
The renin–angiotensin–aldosterone system.
p.86
Anticoagulants and Antiplatelet Agents
What condition is associated with elevated cholesterol in relation to Prasugrel?
It can be a concern but is not a direct contraindication.
p.96
Anticoagulants and Antiplatelet Agents
What adjustments are required for Factor Xa inhibitors?
Adjustment required with renal/hepatic impairment.
p.36
Diuretics and Their Mechanisms
What is the primary effect of carbonic anhydrase inhibitors?
NaCl and NaHCO3 loss, leading to modest net diuresis.
p.97
Anticoagulants and Antiplatelet Agents
What is the primary use of Argatroban?
Heparin-induced thrombocytopenia (HIT).
p.88
Anticoagulants and Antiplatelet Agents
What are the contraindications for using Dipyridamole?
Bronchospastic lung disease with ongoing wheezing, uncontrolled hypertension, bradycardia/AV block, and recent acute coronary syndrome/myocardial infarction.
p.104
Anticoagulants and Antiplatelet Agents
What is the risk associated with IM administration of Vitamin K?
Risk of hematoma, except in newborns for prevention/treatment of vitamin K deficiency bleeding.
p.23
Adrenergic Agonists and Antagonists
What are the effects of Clonidine on the cardiovascular system?
Decreased peripheral/vascular resistance, heart rate (HR), and blood pressure (BP).
p.74
Ischemic Heart Disease
What happens when O2 supply to the heart is less than O2 demand by the body?
It indicates an incapability of coronary blood vessels to deliver enough blood flow.
p.66
Arrhythmias and Antiarrhythmic Drugs
What is disrupted automaticity in the context of arrhythmias?
It refers to the SAN failing to generate impulses at the appropriate rate, resulting in bradycardia or tachycardia.
p.22
Cardiovascular Pharmacology
What factors can cause an increase in Cardiac Output (CO)?
Increased heart rate (HR), increased inotropy (contractility), and increased sodium and water retention (volume).
p.76
Thrombolytics and Their Uses
What is thrombosis?
Formation of a blood clot within arterial or venous blood vessels, limiting the natural flow of blood.
p.39
Diuretics and Their Mechanisms
How do thiazide diuretics work?
They increase urinary and salt output by inhibiting Na, Cl, and H2O reabsorption in the distal tubule, resulting in diuresis.
p.24
Adrenergic Agonists and Antagonists
What are α1-blockers used for?
They are used in the treatment of hypertension.
p.9
Adrenergic Agonists and Antagonists
What are receptors?
Proteins on cell surface or within cells in different organs.
p.73
Antiarrhythmias and Antiarrhythmic Drugs
What type of arrhythmias are Class IV drugs more effective against?
They are more effective in atrial arrhythmias than ventricular arrhythmias.
p.74
Ischemic Heart Disease
What is the role of nitrates in managing O2 demand?
They decrease preload and O2 demand.
p.6
Adrenergic Agonists and Antagonists
What type of response does the sympathetic nervous system primarily control?
Acute stress response ('fight-or-flight').
p.92
Anticoagulants and Antiplatelet Agents
What is the primary action of Warfarin?
Inhibits vitamin K-dependent coagulation factors, preventing clotting.
p.42
Diuretics and Their Mechanisms
What is the mechanism of action of Triamterene and Amiloride?
They block Na reabsorption in the collecting duct and distal tubule.
p.47
Renin-Angiotensin System and Its Inhibitors
What is the primary action of Aliskiren?
Decreases plasma renin activity and inhibits conversion of angiotensinogen to angiotensin I.
p.88
Anticoagulants and Antiplatelet Agents
What are the uses of Dipyridamole?
Secondary prophylaxis against stroke and as an adjunctive agent with warfarin post mechanical valve replacement.
p.93
Anticoagulants and Antiplatelet Agents
How often should INR be monitored for patients on Warfarin until stable?
Frequently until stable, then every 4 - 12 weeks.
p.83
Anticoagulants and Antiplatelet Agents
How does Aspirin affect COX enzymes?
It irreversibly inhibits COX-1 and COX-2.
p.25
Adrenergic Agonists and Antagonists
What are the clinical uses of α1-selective blockers?
Hypertension (HTN) and Benign Prostatic Hyperplasia (BPH).
p.93
Anticoagulants and Antiplatelet Agents
How should maintenance doses of Warfarin be adjusted?
By calculating the weekly dose and reducing or increasing it by 5% – 10%.
p.26
Adrenergic Agonists and Antagonists
What is a potential problem caused by β2 receptor antagonists?
Contraction of the respiratory tract, which can lead to bronchial constriction in asthmatics.
p.71
Arrhythmias and Antiarrhythmic Drugs
What are selective and non-selective beta blockers used for?
For suppressing tachyarrhythmias from increased sympathetic activity.
p.57
Heart Failure Management
Do loop diuretics stop disease progression in heart failure?
No, they do not stop disease progression.
p.9
Adrenergic Agonists and Antagonists
Give an example of an antagonist and its effect.
Metoprolol binds to beta receptor to lower heart rate.
p.100
Anticoagulants and Antiplatelet Agents
In which journal was the article on VTE treatment published?
Journal of Clinical Medicine.
p.2
Arrhythmias and Antiarrhythmic Drugs
What are the therapeutic effects of agents used for arrhythmias?
Agents for arrhythmias help to restore normal heart rhythm and prevent irregular heartbeats.
p.42
Diuretics and Their Mechanisms
What are the adverse effects associated with Amiloride?
Hyperkalemia and metabolic acidosis.
p.17
Adrenergic Agonists and Antagonists
What effect does β2 stimulation have in Isoprenaline's action?
Vasodilation without α1 activity, leading to decreased peripheral resistance.
p.29
Adrenergic Agonists and Antagonists
In what forms is Labetalol available?
Oral (PO) and intravenous (IV).
p.89
Anticoagulants and Antiplatelet Agents
What are the names of the IIb/IIIa receptor antagonists?
Abciximab, eptifibatide, tirofiban.
p.37
Diuretics and Their Mechanisms
What are some adverse effects of Mannitol?
Dehydration, heart failure precipitation, hyponatremia, hypokalemia.
p.75
Cardiovascular Pharmacology
What is the purpose of lipid-lowering drugs in patients with CAD?
To lower the risk of heart attacks.
p.14
Adrenergic Agonists and Antagonists
What are the overall effects of Dobutamine?
Increases cardiac output (↑CO), decreases systemic vascular resistance (↓SVR), decreases central venous pressure (↓CVP), and decreases pulmonary capillary wedge pressure (↓PCWP).
p.66
Arrhythmias and Antiarrhythmic Drugs
What are Delayed Afterdepolarizations (DADs)?
DADs occur during the repolarization phase of an action potential with an abnormal increase in intracellular calcium levels.
p.11
Adrenergic Agonists and Antagonists
To which receptors does Norepinephrine bind?
α and β receptors, also known as adrenergic receptors.
p.54
Cardiovascular Pharmacology
What limits the use of nitrates over time?
Tolerance develops over time, limiting their effectiveness.
p.90
Anticoagulants and Antiplatelet Agents
What are the two types of heparin mentioned?
Unfractionated Heparin (UFH) and Low Molecular Weight Heparin (LMWH).
p.97
Anticoagulants and Antiplatelet Agents
How do thrombin inhibitors work?
They reversibly bind to the active site on thrombin, preventing the conversion of fibrinogen to fibrin.
p.104
Anticoagulants and Antiplatelet Agents
What is a warning associated with IV and IM use of Vitamin K?
Hypersensitivity reactions, including anaphylaxis.
p.30
Adrenergic Agonists and Antagonists
In what situation are β blockers with ISA rarely used?
In stable angina, except maybe in patients with bradycardia.
p.42
Diuretics and Their Mechanisms
What effect do Triamterene and Amiloride have on intracellular Na levels?
They decrease intracellular Na levels.
p.85
Anticoagulants and Antiplatelet Agents
What are common adverse effects (AEs) of Clopidogrel?
Bleeding, hypersensitivity, and thrombotic thrombocytopenic purpura (TTP).
p.44
Renin-Angiotensin System and Its Inhibitors
In which journal was the study on the renin–angiotensin–aldosterone system published?
Trends in Pharmacological Sciences.
p.81
Anticoagulants and Antiplatelet Agents
What are the main types of antiplatelet agents?
NSAIDs, P2Y12 receptor blockers, and IIb/IIIa receptor antagonists.
p.107
Heart Failure Management
What are the three categories of anemia based on RBC size?
Microcytic, Normocytic, Macrocytic.
p.35
Diuretics and Their Mechanisms
What is the role of potassium-sparing diuretics?
They help retain potassium while promoting urine output.
p.68
Arrhythmias and Antiarrhythmic Drugs
What type of blockers are Class IV antiarrhythmic drugs?
Calcium channel blockers.
p.13
Adrenergic Agonists and Antagonists
What are the usual indications for Epinephrine?
Septic shock, cardiogenic/anaphylactic shock, hypotension.
p.77
Cardiovascular Pharmacology
What is pulmonary embolism?
A blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots.
p.17
Adrenergic Agonists and Antagonists
What are the usual indications for Isoprenaline?
Cardiogenic shock due to bradycardia, symptomatic bradycardia/AV block, and congestive heart failure.
p.23
Adrenergic Agonists and Antagonists
What is the mechanism of action for Methyldopa?
Stimulates α2 receptors in the brain, decreasing sympathetic outflow to the heart, kidneys, and vasculature.
p.30
Adrenergic Agonists and Antagonists
What is intrinsic sympathomimetic activity (ISA)?
Partial agonist activity at β receptors.
p.26
Adrenergic Agonists and Antagonists
What are common uses of β blockers?
Hypertension (HTN), arrhythmias, and angina.
p.96
Anticoagulants and Antiplatelet Agents
What are some examples of Factor Xa inhibitors?
Fondaparinux (IV, SC), Rivaroxaban, Apixaban, Edoxaban (PO).
p.24
Adrenergic Agonists and Antagonists
What are mixed α and β-blockers?
They block both α and β adrenergic receptors and are used in various cardiovascular treatments.
p.59
Heart Failure Management
How does Nitroprusside affect preload and afterload?
It decreases both preload and afterload.
p.89
Anticoagulants and Antiplatelet Agents
What are some adverse effects of IIb/IIIa receptor antagonists?
Bleeding (especially at arterial access), thrombocytopenia, hypotension.
p.56
Heart Failure Management
What are the goals of pharmacological intervention in heart failure?
Decrease cardiac workload, correct fluid overload, and improve heart contractility.
p.61
Heart Failure Management
What are the effects of Milrinone?
Positive inotropic action and vasodilatory effect.
p.68
Arrhythmias and Antiarrhythmic Drugs
What are Class I antiarrhythmic drugs?
Voltage-gated Na channel blockers.
p.6
Adrenergic Agonists and Antagonists
What effect do sympathetic stimulants have on norepinephrine?
They enhance NE release or mimic its effects.
p.96
Anticoagulants and Antiplatelet Agents
What is the mechanism of action of Factor Xa inhibitors?
Inhibition of factor Xa, which reduces thrombin generation and thrombus formation.
p.90
Anticoagulants and Antiplatelet Agents
What are the primary uses of heparins?
VTE prophylaxis/treatment and Acute Coronary Syndrome (ACS).
p.83
Anticoagulants and Antiplatelet Agents
What is the primary effect of Aspirin on platelets?
It inhibits platelet aggregation.
p.58
Heart Failure Management
Who is at higher risk for Digoxin toxicity?
Older adults, individuals with COPD, hypercalcemia, hypokalemia, hypomagnesemia, dehydration, low body weight, and kidney impairment.
p.56
Heart Failure Management
What is an inotrope used for in heart failure?
To improve heart contractility as indicated.
p.6
Adrenergic Agonists and Antagonists
What role do neurotransmitters play in the nervous system?
They are chemical messengers for signal transmission between neurons.
p.96
Anticoagulants and Antiplatelet Agents
Why are Factor Xa inhibitors preferred over warfarin?
They are preferred due to their safety profile and ease of use.
p.97
Anticoagulants and Antiplatelet Agents
What are some adverse effects of thrombin inhibitors?
Bleeding, hypotension (IV), and thrombotic events with abrupt discontinuation of dabigatran.
p.34
Adrenergic Agonists and Antagonists
What class of medications do α and β blockers belong to?
Sympathetic Nervous System depressants.
p.96
Anticoagulants and Antiplatelet Agents
What are some adverse effects (AEs) of Factor Xa inhibitors?
Hemorrhage and spinal or epidural hematomas.
p.95
Anticoagulants and Antiplatelet Agents
Who conducted the study?
Faculty of Medicine, The Chinese University of Hong Kong.
p.100
Anticoagulants and Antiplatelet Agents
What is the DOI for the article on VTE treatment?
https://doi.org/10.3390/jcm13010301.
p.12
Adrenergic Agonists and Antagonists
What are the usual indications for Norepinephrine?
Septic shock and cardiogenic shock.
p.18
Adrenergic Agonists and Antagonists
What is the primary effect of β2 receptor activation?
Relaxation of smooth muscle in vascular, respiratory, and uterine muscle.
p.103
Anticoagulants and Antiplatelet Agents
What is Protamine used for?
As an antagonist for heparin-induced hemorrhage.
p.6
Adrenergic Agonists and Antagonists
What is the primary neurotransmitter of the sympathetic nervous system?
Noradrenaline (Norepinephrine, NE).
p.27
Adrenergic Agonists and Antagonists
What does β1 selective mean in pharmacology?
It refers to cardioselective beta blockers that primarily affect the heart.
p.103
Anticoagulants and Antiplatelet Agents
What type of charge does Protamine have?
It is alkaline and positively charged.
p.47
Renin-Angiotensin System and Its Inhibitors
What is the primary use of Aliskiren?
Hypertension (HTN) in patients weighing 50 kg or more.
p.58
Heart Failure Management
What are common symptoms of Digoxin toxicity?
Arrhythmias, GI disturbances (nausea, diarrhea, anorexia), CNS depression (drowsiness, lethargy), and visual disturbances (yellow/blurred vision, 'halos').
p.92
Anticoagulants and Antiplatelet Agents
What is the bridging strategy when starting Warfarin?
Use rapid-acting anticoagulants (e.g. LMWH) for 5 days until INR is ≥ 2.0 for at least 24 hours.
p.103
Anticoagulants and Antiplatelet Agents
What happens when Protamine is given in the presence of heparin?
A stable salt is formed, neutralizing the anticoagulant activity of both drugs.
p.47
Renin-Angiotensin System and Its Inhibitors
What are some common adverse effects (AEs) of Aliskiren?
Cough, rash, diarrhea, elevated CK, AKI.
p.43
Heart Failure Management
What stage of heart failure is AB classified as?
Stage C (symptomatic HF).
p.46
Renin-Angiotensin System and Its Inhibitors
What are some examples of Angiotensin Receptor Blockers (ARBs)?
Candesartan, losartan, irbesartan, olmesartan, telmisartan, valsartan.
p.85
Anticoagulants and Antiplatelet Agents
What symptoms may indicate TTP in patients taking Clopidogrel?
Skin reactions or neurologic changes.
p.105
Anticoagulants and Antiplatelet Agents
What are some adverse effects of tranexamic acid?
Hypersensitivity, anaphylaxis, and thromboembolism.
p.7
Adrenergic Agonists and Antagonists
What is the primary function of the parasympathetic nervous system?
It is anabolic and conserves energy.
p.71
Arrhythmias and Antiarrhythmic Drugs
What is the use of Atropine?
It is a muscarinic M2 receptor inhibitor used for symptomatic bradycardia.
p.7
Adrenergic Agonists and Antagonists
What response is associated with the parasympathetic nervous system?
Relaxation response, also known as 'rest-and-digest'.
p.42
Diuretics and Their Mechanisms
In which patients is hyperkalemia a concern when using Triamterene and Amiloride?
In patients with impaired renal function.
p.107
Heart Failure Management
What is Erythropoietin used for?
To treat anemia, administered IV or SC.
p.72
Arrhythmias and Antiarrhythmic Drugs
What is the primary effect of Amiodarone on action potential?
Prolongs repolarization (prolongs duration of AP).
p.23
Adrenergic Agonists and Antagonists
What are some adverse effects (AEs) associated with Methyldopa?
Headache, dizziness, sedation, congestive heart failure, heart block.
p.7
Adrenergic Agonists and Antagonists
Where are muscarinic receptors located?
On all target organs, including the heart, smooth muscles, and pupils.
p.98
Anticoagulants and Antiplatelet Agents
What is the first-line treatment for acute DVT or PE according to ASH 2020 Guideline?
DOACs, preferred over Warfarin for most patients.
p.12
Adrenergic Agonists and Antagonists
What are some adverse effects of Norepinephrine?
Tachycardia, peripheral vascular insufficiency, gangrene, and extravasation.
p.62
Heart Failure Management
What can be used if a patient cannot tolerate ACE inhibitors?
Angiotensin receptor blockers (ARBs).
p.73
Antiarrhythmias and Antiarrhythmic Drugs
What is the effect of Class IV antiarrhythmics on reentry pathways?
They interrupt reentry pathways causing arrhythmias that require AV nodal conduction.
p.99
Thrombolytics and Their Uses
How do Alteplase and Tenecteplase work?
They bind to fibrin and convert plasminogen to plasmin.
p.9
Adrenergic Agonists and Antagonists
What is an antagonist?
A substance that binds to a receptor and inhibits it, reducing or reversing the effects of the endogenous substance.
p.6
Heart Failure Management
What are the effects of sympathetic stimulation on the heart?
Increases heart rate (HR) and contractility.
p.105
Anticoagulants and Antiplatelet Agents
What are the contraindications for tranexamic acid?
Subarachnoid hemorrhage (SAH) and thromboembolism.
p.60
Heart Failure Management
What is the significance of dose-dependent actions of Dopamine?
It works on different receptors in different dosing ranges.
p.42
Diuretics and Their Mechanisms
What are some adverse effects of Triamterene?
Hyperkalemia, nephrotoxicity, nephrolithiasis, metabolic acidosis.
p.99
Thrombolytics and Their Uses
What conditions are treated with thrombolytics?
Acute ischemic stroke, pulmonary embolism (PE), and STEMI.
p.62
Heart Failure Management
What are the benefits of ACE inhibitors (ACEIs) in heart failure management?
They improve symptoms, slow disease progression, and prolong survival.
p.93
Anticoagulants and Antiplatelet Agents
What are some non-bleeding adverse effects of Warfarin?
Purple toe syndrome and skin necrosis.
What is a toxicity concern for Hydralazine in certain patients?
Toxicity in slow acetylators.
p.81
Anticoagulants and Antiplatelet Agents
What are IIb/IIIa receptor antagonists?
Abciximab, eptifibatide, tirofiban.
p.2
Cardiovascular Pharmacology
What is dyslipidemia and how is it treated?
Dyslipidemia is an abnormal amount of lipids in the blood, treated with statins and other lipid-lowering agents.
p.57
Heart Failure Management
What serum concentration range is required for Digoxin monitoring?
0.5 to 0.9 ng/mL (SI: 0.6 to 1.2 nmol/L).
p.57
Heart Failure Management
What should be monitored in patients taking Digoxin?
Potassium (K), Magnesium (Mg), and Calcium (Ca) levels.
What is hypertrichosis in relation to Minoxidil?
An adverse effect that causes excessive hair growth.
p.51
Calcium Channel Blockers
How do Non-dihydropyridine CCBs affect cardiac function?
They are less potent vasodilators and have a greater depression on cardiac conductivity and contractility.
p.107
Heart Failure Management
What is Cyanocobalamin used for?
To treat Vitamin B12 deficiency, administered IV or PO.
p.102
Anticoagulants and Antiplatelet Agents
What is the affinity of Idarucizumab for dabigatran compared to thrombin?
Approximately 350 times greater.
What cardiovascular response can occur due to vasodilation?
Reflex tachycardia and increased cardiac output (CO).
p.91
Anticoagulants and Antiplatelet Agents
What are some adverse effects (AEs) associated with heparins?
HITT, bleeding, osteoporosis (with UFH, long-term use in pregnancy), spinal/epidural hematomas (with LMWH).
p.33
Cardiovascular Pharmacology
What is the relationship between vasoconstriction and blood pressure?
Vasoconstriction leads to increased Peripheral Resistance, which can raise blood pressure.
p.72
Arrhythmias and Antiarrhythmic Drugs
What effect does Dofetilide have on the QT interval?
It significantly increases QTc.
p.11
Adrenergic Agonists and Antagonists
What are some effects of adrenergic agonists?
Raise blood pressure and improve cardiac output.
p.70
Antiarrhythmias and Antiarrhythmic Drugs
What class of drugs does Ranolazine belong to?
Class I (Na Channel Blockers).
p.60
Heart Failure Management
What limits the clinical use of Dopamine?
Tachycardia, which may lead to myocardial ischemia.
p.57
Heart Failure Management
What is the primary use of loop diuretics in heart failure management?
Symptomatic relief of pulmonary congestion.
p.61
Heart Failure Management
What are some adverse effects (AEs) of Milrinone?
Arrhythmias, hypotension, thrombocytopenia (rare).
p.97
Anticoagulants and Antiplatelet Agents
What condition is bivalirudin primarily used for?
ST-elevation myocardial infarction (STEMI).
p.83
Anticoagulants and Antiplatelet Agents
What are some common adverse effects of Aspirin?
GI effects (GI bleed, ulcers, dyspepsia), hypersensitivity reactions (anaphylaxis, angioedema), and Reye's syndrome in pediatrics.
p.23
Adrenergic Agonists and Antagonists
What are some adverse effects (AEs) associated with Clonidine?
Dry mouth, headache, somnolence, AV block, contact dermatitis (patch).
p.98
Anticoagulants and Antiplatelet Agents
In which patients should DOACs be used cautiously?
Patients with kidney issues.
p.51
Calcium Channel Blockers
What are common adverse effects (AEs) of Dihydropyridine CCBs?
Dose-dependent peripheral edema, headache (HA), and flushing.
p.98
Anticoagulants and Antiplatelet Agents
How do Rivaroxaban and Apixaban compare to Warfarin regarding VTE recurrence rates?
They provide similar recurrence rates but with potentially less major bleeding.
p.7
Adrenergic Agonists and Antagonists
What are the two types of receptors in the parasympathetic nervous system?
Muscarinic receptors and nicotinic receptors.
p.98
Anticoagulants and Antiplatelet Agents
What is the risk associated with combining Aspirin and DOAC therapy?
Significantly increases bleeding risk.
p.62
Heart Failure Management
What effect do ACE inhibitors have on left ventricular hypertrophy?
They decrease left ventricular hypertrophy.
p.81
Anticoagulants and Antiplatelet Agents
What are thrombin inhibitors?
Argatroban, bivalirudin, dabigatran.
p.69
Arrhythmias and Antiarrhythmic Drugs
Which drugs belong to Class Ib (Rapid Dissociation) of Na Channel Blockers?
Lidocaine and mexiletine.
p.33
Cardiovascular Pharmacology
What effect does vasoconstriction have on Peripheral Resistance (PR)?
It increases Peripheral Resistance (PR).
p.69
Arrhythmias and Antiarrhythmic Drugs
What is the unique feature of Ranolazine in the context of Na Channel Blockers?
It is classified as Id (Late Current).
p.72
Arrhythmias and Antiarrhythmic Drugs
What are the contraindications for Dronedarone?
Congestive heart failure (CHF), coronary artery disease (CAD), and permanent atrial fibrillation.
p.104
Anticoagulants and Antiplatelet Agents
Why is subcutaneous administration of Vitamin K considered unreliable?
Due to unreliable absorption.
p.34
Renin-Angiotensin System and Its Inhibitors
What are RAAS blockers?
Medications that inhibit the Renin-Angiotensin-Aldosterone System.
p.97
Anticoagulants and Antiplatelet Agents
What is dabigatran used for?
Deep vein thrombosis (DVT) prophylaxis and stroke prophylaxis.
p.85
Anticoagulants and Antiplatelet Agents
What is thrombotic thrombocytopenic purpura (TTP) associated with Clopidogrel?
Onset usually within 2 weeks of initiation; not dose related, characterized by thrombocytopenia, hemolytic anemia, kidney failure, and fever.
p.36
Diuretics and Their Mechanisms
Who are at higher risk for adverse effects from carbonic anhydrase inhibitors?
Older adults, individuals with diabetes, COPD, and renal impairment.
p.83
Anticoagulants and Antiplatelet Agents
What are the therapeutic uses of Aspirin?
Anti-inflammatory and analgesic effects, primarily for antiplatelet effect.
p.13
Adrenergic Agonists and Antagonists
What are the overall effects of Epinephrine?
Increases HR, stroke volume, and cardiac output.
p.71
Adrenergic Agonists and Antagonists
What is Isoproterenol and its effects?
A beta agonist that stimulates β1 and β2 receptors, increasing heart rate (HR), stroke volume (SV), and contractility.
p.90
Anticoagulants and Antiplatelet Agents
What do heparins prevent in the coagulation process?
The conversion of fibrinogen to fibrin.
p.57
Heart Failure Management
What is the mechanism of action of Digoxin?
Inhibits Na-K-ATPase in cardiac cells to increase calcium influx, enhancing contractility.
p.51
Calcium Channel Blockers
What is a key characteristic of Dihydropyridine CCBs?
They are potent vasodilators with little to no negative effect on cardiac contractility or conduction.
p.38
Diuretics and Their Mechanisms
How do loop diuretics primarily work?
By inhibiting the absorption of Na, Cl, and K in the proximal and distal tubules, and Loop of Henle.
p.93
Anticoagulants and Antiplatelet Agents
What dietary advice should be given to patients on Warfarin?
Advise patients to be on vitamin K consistent diets.
p.99
Thrombolytics and Their Uses
What is the mechanism of action for Alteplase and Tenecteplase?
They selectively activate plasminogen that is bound to fibrin.
p.69
Arrhythmias and Antiarrhythmic Drugs
How do Class I antiarrhythmics affect automaticity in fast fibers?
They suppress spontaneous initiation of electrical impulses.
p.62
Heart Failure Management
What hormones are decreased by ACE inhibitors?
Aldosterone and antidiuretic hormone production.
p.71
Drug Interactions and Adverse Effects
What is a contraindication for Adenosine?
Bronchospastic lung disease.
p.45
Renin-Angiotensin System and Its Inhibitors
What are some common adverse effects (AEs) of ACE inhibitors?
Cough, angioedema, hyperkalemia, acute kidney injury (AKI), and hypotension.
p.7
Adrenergic Agonists and Antagonists
What functions are associated with nicotinic receptors?
Muscle contractility and nerve impulses.
p.72
Arrhythmias and Antiarrhythmic Drugs
What types of properties does Amiodarone have?
Alpha- and beta-blocking properties, affects Na, K, and Ca channels.
p.102
Anticoagulants and Antiplatelet Agents
What are antidotes for?
They are used for drug-induced life-threatening bleeding.
p.34
Renin-Angiotensin System and Its Inhibitors
Name two types of Angiotensin-converting enzyme inhibitors (ACEIs).
Angiotensin II receptor antagonists (ARBs) and aldosterone antagonists.
p.96
Anticoagulants and Antiplatelet Agents
What are the clinical uses of Factor Xa inhibitors?
Non-valvular atrial fibrillation (afib), Heparin-Induced Thrombocytopenia (HIT), Venous Thromboembolism (VTE).
p.17
Adrenergic Agonists and Antagonists
What are the effects of β1 stimulation by Isoprenaline?
Increased heart rate (HR), stroke volume, and contractility.
p.107
Heart Failure Management
What causes Microcytic anemia?
Iron deficiency (late) and anemia of chronic disease.
p.16
Adrenergic Agonists and Antagonists
How does Phenylephrine affect systemic vascular resistance (SVR) and blood pressure (BP)?
Increases SVR, leading to increased BP.
p.56
Heart Failure Management
What role do vasodilators play in heart failure treatment?
They help to decrease cardiac workload.
p.12
Adrenergic Agonists and Antagonists
What are the main effects of Norepinephrine?
Vasoconstriction, increased contractility, and increased heart rate.
p.107
Heart Failure Management
What conditions can lead to Normocytic anemia?
Early iron deficiency, anemia of chronic disease, hypothyroidism, hypopituitarism, alcoholism, bone marrow suppression, chronic kidney disease (CKD).
p.2
Anticoagulants and Antiplatelet Agents
What is the purpose of anticoagulation agents?
Anticoagulation agents are used to prevent blood clots.
p.56
Heart Failure Management
Which class of drugs is referred to as ACEIs?
Angiotensin-Converting Enzyme Inhibitors.
p.45
Renin-Angiotensin System and Its Inhibitors
What are some common members of the ACE inhibitors class?
Captopril, enalapril, benazepril, lisinopril, quinapril, ramipril.
p.48
Heart Failure Management
What is the condition of the patient in the case?
Chronic hypertension (cHTN).
p.45
Renin-Angiotensin System and Its Inhibitors
What are the primary uses of ACE inhibitors?
Hypertension (HTN), heart failure (HF), and diabetic nephropathy.
p.71
Arrhythmias and Antiarrhythmic Drugs
What is the role of Adenosine in cardiac treatment?
It is an adenosine A1 receptor activator used for paroxysmal supraventricular tachycardia (PSVT).
p.69
Arrhythmias and Antiarrhythmic Drugs
What is the overall effect of Class I antiarrhythmics on conduction velocity?
They decrease conduction velocity and firing rate.
p.81
Anticoagulants and Antiplatelet Agents
Name two examples of low molecular weight heparin (LMWH).
Enoxaparin and dalteparin.
p.102
Anticoagulants and Antiplatelet Agents
How does Idarucizumab work?
It binds to dabigatran and its metabolites.
p.72
Arrhythmias and Antiarrhythmic Drugs
What is a significant characteristic of Amiodarone's half-life?
It can be up to 100 days.
p.102
Anticoagulants and Antiplatelet Agents
What is Andexanet alfa used for?
It binds and isolates factor Xa inhibitors.
p.15
Adrenergic Agonists and Antagonists
What happens at higher doses of dopamine?
More α1 effects (vasoconstriction) along with effects of lower doses.
p.51
Calcium Channel Blockers
What are the primary uses of Dihydropyridine calcium channel blockers (CCBs)?
Usually used for hypertension (HTN) and stable angina.
p.38
Diuretics and Their Mechanisms
What are the main loop diuretics mentioned?
Frusemide (Furosemide), Bumetamide, and Torsemide.
p.26
Adrenergic Agonists and Antagonists
What effect can β blocker antagonists have on hypoglycemia?
They can mask hypoglycemia.
p.81
Anticoagulants and Antiplatelet Agents
List three P2Y12 receptor blockers.
Clopidogrel, prasugrel, ticagrelor.
p.16
Adrenergic Agonists and Antagonists
What is a reflex response to the use of Phenylephrine?
Decreased heart rate (HR) and cardiac output (CO).
p.69
Arrhythmias and Antiarrhythmic Drugs
What effect do Class I antiarrhythmics have on phase 0 of depolarization?
They decrease or delay the rise of phase 0.
p.46
Renin-Angiotensin System and Its Inhibitors
How do ARBs work?
They interfere with the binding of angiotensin II to its receptor and prevent activation of the angiotensin receptor.
p.71
Heart Failure Management
What condition is Digoxin used to treat?
Atrial fibrillation (Afib), atrial flutter (afl), and supraventricular tachycardia (SVT).
p.95
Anticoagulants and Antiplatelet Agents
What population is being studied in the research?
Older adults with newly diagnosed atrial fibrillation.
p.16
Adrenergic Agonists and Antagonists
What is the starting dose for Phenylephrine?
Titrate up from 0.5 mcg/kg/min.
p.13
Adrenergic Agonists and Antagonists
What are some adverse effects of Epinephrine?
Dyspnea, tachycardia, hypertension, local tissue necrosis with extravasation.
p.71
Adrenergic Agonists and Antagonists
What effect does activation of M2 receptors have on the cardiac system?
It decreases heart rate (HR).
p.91
Anticoagulants and Antiplatelet Agents
What is a contraindication for using LMWH?
History of HIT within the past 100 days.
p.51
Calcium Channel Blockers
What are common adverse effects (AEs) of Non-dihydropyridine CCBs?
Dose-dependent constipation, bradycardia, and low cardiac output (CO).
p.32
Heart Failure Management
What stage of heart failure is AB classified as?
Stage C (symptomatic HF).
p.98
Anticoagulants and Antiplatelet Agents
What should be monitored when using DOACs?
Renal function and liver function tests (LFT).
p.57
Heart Failure Management
What is the therapeutic index (TI) of Digoxin?
Narrow therapeutic index.
p.107
Heart Failure Management
What causes Macrocytic anemia?
Vitamin B12 or folate deficiency, alcoholism, hypothyroidism.
p.34
Adrenergic Agonists and Antagonists
What is the role of clonidine in antihypertensive therapy?
It acts as a sympathetic nervous system depressant.
p.77
Cardiovascular Pharmacology
What are common risk factors for pulmonary embolism?
Prolonged immobility, surgery, certain medical conditions, and smoking.
p.46
Renin-Angiotensin System and Its Inhibitors
What are some adverse effects (AEs) of ARBs?
Acute kidney injury (AKI) and hyperkalemia.
p.38
Diuretics and Their Mechanisms
What are common clinical uses for loop diuretics?
Fluid removal in congestive heart failure (CHF) and edema.
p.46
Renin-Angiotensin System and Its Inhibitors
How do ARBs compare to ACE inhibitors regarding cough?
ARBs cause less cough than ACE inhibitors (ACEIs).
p.69
Arrhythmias and Antiarrhythmic Drugs
Name a drug from Class Ia (Intermediate Dissociation) of Na Channel Blockers.
Quinidine, disopyramide, or procainamide.
p.46
Renin-Angiotensin System and Its Inhibitors
Are ARBs safe to use during pregnancy?
No, they are contraindicated (C/I) in pregnancy.
p.7
Adrenergic Agonists and Antagonists
Where are nicotinic receptors found?
At ganglia and neuromuscular junctions.
p.43
Diuretics and Their Mechanisms
Where is the site of action for loop diuretics?
The loop of Henle in the nephron.
p.45
Renin-Angiotensin System and Its Inhibitors
Are ACE inhibitors contraindicated in pregnancy?
Yes, ACE inhibitors are contraindicated in pregnancy.
p.6
Adrenergic Agonists and Antagonists
Which neurotransmitters are involved in the sympathetic nervous system aside from norepinephrine?
Epinephrine (EPI) and Acetylcholine (ACh).
p.62
Heart Failure Management
How do ACE inhibitors affect cardiac output?
They decrease afterload, preload, and systolic wall stress, leading to increased cardiac output.
p.16
Adrenergic Agonists and Antagonists
What are the indications for using Phenylephrine?
Hypotension, shock, and as an alternative when norepinephrine causes tachycardia.
p.62
Heart Failure Management
What effect do ACE inhibitors have on renal function?
They increase salt excretion by increasing renal blood flow.
p.81
Anticoagulants and Antiplatelet Agents
What are the two types of heparins?
Unfractionated heparin (UFH) and low molecular weight heparin (LMWH).
p.102
Anticoagulants and Antiplatelet Agents
What type of molecule is Idarucizumab?
A monoclonal antibody fragment (Fab).
p.107
Heart Failure Management
What are common iron supplements for anemia?
Ferrous sulfate (PO), iron sucrose (IV), etc.
p.72
Arrhythmias and Antiarrhythmic Drugs
What are the administration routes for Amiodarone?
Oral (PO) and intravenous (IV).
p.77
Cardiovascular Pharmacology
What is the importance of diagnosis in pulmonary embolism?
Early diagnosis is crucial for effective treatment and reducing complications.
p.16
Adrenergic Agonists and Antagonists
What are some adverse effects (AEs) of Phenylephrine?
Decreased cardiac output, worsening angina, heart failure, and pulmonary hypertension.
p.69
Arrhythmias and Antiarrhythmic Drugs
What drugs are classified under Class Ic (Slow Dissociation) of Na Channel Blockers?
Propafenone and flecainide.
p.72
Arrhythmias and Antiarrhythmic Drugs
What are some serious adverse effects of Amiodarone?
Pulmonary fibrosis, thyrotoxicity, neurotoxicity, hepatotoxicity.
p.25
Adrenergic Agonists and Antagonists
What are some adverse effects (AEs) of α1-selective blockers?
Orthostatic hypotension, peripheral edema, headache (HA), somnolence, syncope, dizziness.
p.90
Anticoagulants and Antiplatelet Agents
Do heparins dissolve already formed clots?
No, they do not dissolve already formed clots.
p.12
Adrenergic Agonists and Antagonists
What does Norepinephrine increase in the cardiovascular system?
Peripheral resistance (PR), cardiac output, and mean arterial pressure (MAP).
p.6
Adrenergic Agonists and Antagonists
What is the nature of the sympathetic nervous system in terms of energy?
It is catabolic (consumes energy).
p.38
Diuretics and Their Mechanisms
How do loop diuretics compare in potency to thiazides?
They are more potent than thiazides.
What effect does Minoxidil have on fluid retention?
It can cause fluid retention.
p.51
Calcium Channel Blockers
What are the primary uses of Non-dihydropyridine CCBs?
Usually used for hypertension (HTN), chronic stable angina, and arrhythmias.
p.45
Renin-Angiotensin System and Its Inhibitors
What is the mechanism of action of ACE inhibitors?
They prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.
p.77
Cardiovascular Pharmacology
What is a key aspect of managing pulmonary embolism?
Preventive management to reduce the risk of blood clots.
p.38
Diuretics and Their Mechanisms
What are some adverse effects (AEs) of loop diuretics?
Hypokalemia, hyponatremia, hypomagnesemia, hyperglycemia, hypovolemia, hypotension, metabolic alkalosis, hypersensitivity reactions, and ototoxicity (at higher doses).
p.51
Calcium Channel Blockers
What effect do Non-dihydropyridine CCBs have on the AV node?
They slow automaticity and conduction of the AV node.
p.81
Anticoagulants and Antiplatelet Agents
List three Factor Xa inhibitors.
Apixaban, edoxaban, rivaroxaban.
p.45
Renin-Angiotensin System and Its Inhibitors
What is a common practice regarding ACE inhibitors in patients with AKI?
It is common practice to hold ACE inhibitors in cases of acute kidney injury (AKI).
p.15
Adrenergic Agonists and Antagonists
What effects are observed at intermediate doses of dopamine?
Inodilator-like effects through activation of D1 and D2 receptors.
p.102
Anticoagulants and Antiplatelet Agents
What is Idarucizumab used for?
It is a reversal agent for dabigatran.
p.93
Anticoagulants and Antiplatelet Agents
Is Warfarin contraindicated in pregnancy?
Yes, it is contraindicated in pregnancy.
p.45
Renin-Angiotensin System and Its Inhibitors
How do ACE inhibitors affect aldosterone secretion?
They reduce aldosterone secretion, leading to decreased sodium and water reabsorption.
p.33
Cardiovascular Pharmacology
What are the factors that can cause an increase in Cardiac Output (CO)?
Increased Heart Rate (HR), Increased Inotropy, Increased Na and H2O retention.
p.107
Heart Failure Management
What is Folic Acid used for?
To treat folate deficiency, administered IV or PO.
p.98
Anticoagulants and Antiplatelet Agents
What is required before starting Edoxaban and Dabigatran?
5 days of subcutaneous anticoagulation (UFH, LMWH, fondaprinux).
p.62
Heart Failure Management
What are other ways to reduce cardiac workload in heart failure?
Beta-blockers (BB) and vasodilators.
p.69
Arrhythmias and Antiarrhythmic Drugs
In what forms are Procainamide and Lidocaine available?
Procainamide and lidocaine are available in IV form; other forms are PO.
p.15
Adrenergic Agonists and Antagonists
What are the dose-dependent effects of dopamine?
Increased cardiac output (CO), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance (SVR), and central venous pressure (CVP).
p.91
Anticoagulants and Antiplatelet Agents
What is the effect of LMWH on aPTT compared to UFH?
LMWH has less effect on aPTT.
p.17
Adrenergic Agonists and Antagonists
What are the common adverse effects (AEs) of Isoprenaline?
Tachycardia, syncope, and hypotension.
p.57
Heart Failure Management
What type of actions does Digoxin have?
Concentration-dependent actions.
What is the primary action of vasodilators like Hydralazine and Minoxidil?
They directly relax arterioles.
p.62
Heart Failure Management
Do ACE inhibitors affect heart rate?
No, they do not affect heart rate.
p.98
Anticoagulants and Antiplatelet Agents
What is the dosing strategy for DOACs?
Start with a higher dose, then switch to a maintenance dose, and do not need routine monitoring.
p.51
Calcium Channel Blockers
What precautions should be taken when using Non-dihydropyridine CCBs?
Caution is advised if the patient is on beta-blockers (BBs), has heart failure with reduced ejection fraction (HFrEF), or has atrioventricular block (AVB).
p.72
Arrhythmias and Antiarrhythmic Drugs
What is Dronedarone used for?
Atrial fibrillation (Afib) and atrial flutter (Aflutter).
p.72
Arrhythmias and Antiarrhythmic Drugs
What are the contraindications for Sotalol?
Congestive heart failure (CHF), asthma, and chronic obstructive pulmonary disease (COPD).
p.15
Adrenergic Agonists and Antagonists
What types of receptors does dopamine activate?
Adrenergic and dopaminergic receptors.
p.15
Adrenergic Agonists and Antagonists
What are some adverse effects (AEs) of dopamine?
Chest pain, hypertension, and arrhythmias.
p.102
Anticoagulants and Antiplatelet Agents
What effect does Andexanet alfa have on thrombin generation?
It inhibits the factor Xa inhibitor, increasing thrombin (II) generation.
p.72
Arrhythmias and Antiarrhythmic Drugs
What is a notable effect of Sotalol on the QT interval?
It significantly increases QTc.
p.15
Adrenergic Agonists and Antagonists
What are the usual indications for dopamine?
Cardiogenic shock and congestive heart failure.
p.15
Adrenergic Agonists and Antagonists
What effects are seen at lower doses of dopamine?
Mainly dopaminergic (D1) effects, renal and coronary vasodilation, and activation of β1 receptors in the heart.
p.15
Adrenergic Agonists and Antagonists
What is an 'inodilator'?
A drug that activates β1 and β2 (or D1) receptors, resulting in increased heart rate (INOtropy) and vasodilation (VasoDILation).
