Cardiovascular System Drugs Flashcards

Which adverse effect is most associated with ACE inhibitors and results from bradykinin accumulation?

Answer: Dry persistent cough

ACE inhibitors block the breakdown of bradykinin, causing a characteristic dry, persistent cough in up to 20% of patients.

A patient on warfarin begins taking amiodarone. What INR adjustment is expected?

Answer: INR will increase; reduce warfarin dose

Amiodarone inhibits CYP2C9, reducing warfarin metabolism and raising INR, so the warfarin dose must be reduced.

Which calcium channel blocker subclass has the greatest selectivity for cardiac conduction tissue and is used to slow ventricular rate in atrial fibrillation?

Answer: Phenylalkylamines (e.g., verapamil)

Verapamil (phenylalkylamine) has the highest cardiac selectivity among calcium channel blockers and effectively slows AV nodal conduction.

Hydralazine exerts its antihypertensive effect primarily by:

Answer: Directly relaxing arteriolar smooth muscle

Hydralazine is a direct-acting arteriolar vasodilator that reduces systemic vascular resistance without significant venodilation.

Which antiarrhythmic drug prolongs the QT interval by blocking potassium channels and carries a risk of torsades de pointes?

Answer: Sotalol

Sotalol (Class III antiarrhythmic) blocks IKr potassium channels, prolonging repolarization and QT interval, predisposing to torsades de pointes.

Ezetimibe lowers LDL cholesterol by which mechanism?

Answer: Inhibiting cholesterol absorption in the small intestine brush border

Ezetimibe inhibits the NPC1L1 transporter at the intestinal brush border, reducing dietary and biliary cholesterol absorption.

A patient with heart failure is started on carvedilol. Unlike metoprolol, carvedilol also blocks which receptor type, contributing to afterload reduction?

Answer: Alpha-1 adrenergic receptors

Carvedilol is a non-selective beta-blocker that also blocks alpha-1 receptors, causing vasodilation and reducing afterload in heart failure.