50-75 Test 1 Flashcards
Diltiazem
Brand: Cardizem, Cartia, Taztia, Tiazac
MOA: Inhibits calcium ions from entering select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization Schedule: legend
Dosing: 120mg to 320mg daily Max 480mg/day
Contraindication(s):
Sick sinus syndrome
second or thrid degree AV block
Hypotension
Acute MI
BBW: • None
Key Points:
Bradycardia
Constipation
Peripheral edema
Lightheadedness, dizziness, orthostasis, hypotension
Doxazosin
Brand: Cardura
MOA: Competitively inhibits postsynaptic alpha1-adrenergic receptors
Schedule: legend
Dosing: 1mg to 8mg once daily Max 8mg/day
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Dizziness
Orthostatic hypotension
Lethargy
Take at bedtime
Enalapril
Brand: Vasotec
MOA: Inhibits angiotensin converting enzyme, preventing the coversion of angiotensin I to angiotensin II
Schedule: legend
Dosing:
5mg to 40mg daily as a single dose or in 2 evenly divided doses
Doses 20mg or greater should be taken BID
Contraindication(s):
Angioedema related to previous treatment with an ACE inhibitor
Concurrent use with aliskiren in patients with diabetes
BBW:
• Fetal toxicity
Key Points:
May cause dry cough
Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting
AngioedemaLightheadedness, dizziness, orthostasis, hypotension
Enoxaparin
Brand: Lovenox
MOA: Strong inhibitor of factor Xa Schedule: legend
Dosing:
DVT Prophylaxis: 30mg SQ q 12 hours or 40mg SQ once daily
PE/DVT Tx: 1mg/kg q 12 hours or 1.5mg/kg once daily
Contraindication(s):
Hypersensitivity to heparin or pork products
Thrombocytopenia associated with a positive test for antiplatelet antibodies in the presence of enoxaparin
Active major bleeding
BBW:
• Spinal/Epidural hematoma
Key Points:
Bleeding
No routine lab monitoring
Inject in the fatty areas at the sides of the waist
Inject prefilled air bubble with medication
Esomeprazole
Brand: Nexium
MOA: Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell
Schedule: legend
Dosing:
20mg to 40mg once daily
Contraindication(s):
Severe hypersensitivity to PPIs
BBW: • None
Key Points:
Headache
Take 60 minutes before food.
Ezetimibe
Brand: Zetia
MOA: Inhibits absorption of cholesterol at the brush border of the small intestine via the sterol transporter, Niemann-Pick C1-Like1 (NPC1L1)
Schedule: legend
Dosing: 10mg once daily
Contraindication(s):
Concurrent use with a statin in patients with active hepatic disease
Pregnancy and breastfeeding when used with a statin
BBW:
Key Points:
Fatigue
Diarrhea
Arthralgia
Famotidine
Brand: Pepcid
MOA: Competitively inhibits histamine at H2 receptors of the gastric parietal cells, which inhibits gastric acid secretion
Schedule: legend
Dosing: 20mg to 40mg once daily or BID
Contraindication(s):
Hypersensitivity to other H2 antagonists
BBW:
Key Points:
Headache
Diarrhea
Fenofibrate and Derivatives
Brand: Tricor, Trilipix, Fenoglide, Fibricor, Lipofen
MOA: Agonist for the nuclear transcription factor peroxisome proliferator-activated receptor-alpha (PPAR-alpha), downregulates apoprotein C-III (an inhibitor of lipoprotein lipase) and upregulates the synthesis of apolipoprotein A-I, fatty acid transport prote
Schedule: legend
Dosing: 30mg to 160mg once daily
Contraindication(s):
Active liver disease
Severe renal impairment or ESRD
BBW: • None
Key Points:
Abdominal Pain
Hepatic injury
Myalgia, Diarrhea
Furosemide
Brand: Lasix
MOA: Inhibits reabsorption of sodium and chloride in the ascending loop of Henle and proximal and distal renal tubules, interfering with the chloride-binding cotransport system, thus causing increased excretion of water, sodium, chloride, magnesium, and calciu
Schedule: legend
Dosing:
20mg to 80mg once daily up to q 6 hours
Contraindication(s):
Hypersensitivity
Anuria
BBW:
• Fluid/electrolyte loss
Key Points:
Hypokalemia
Take in the morning
Hyperuricemia
Possible sulfa cross-allergy
Gemfibrozil
Brand: Lopid
MOA: Inhibits lipolysis and decreases subsequent hepatic fatty acid uptake, inhibits hepatic secretion of VLDL
Schedule: legend
Dosing:
600mg BID 30 minutes before breakfast and dinner
Contraindication(s):
Hepatic or severe renal dysfunction
Primary biliary cirrhosis
Preexisting gallbladder disease
Concurrent use with dasabuvir, repaglinide, or simvastatin
BBW: • None
Key Points:
Upset stomach
Fatigue and Lethargy
Abdominal Pain
Hydralazine
Brand: Apresoline
MOA: Direct vasodilation of arterioles
Schedule: legend
Dosing:
10mg to 50mg QID Max 300mg/day
Contraindication(s):
Coronary artery disease
Mitrial valve rheumatic heart disease
BBW: • None
Key Points:
Headache
palpitations/increase in HR
Rarely lupus-like syndrome
Hydrochlorothiazide
Brand: Microzide
MOA: Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions
Schedule: legend
Dosing: 12.5mg to 50mg once daily
Contraindication(s):
Hypersensitivity
Anuria
BBW: • None
Key Points:
Hypokalemia
Photosensitivity
possible sulfa cross-allergy
Irbesartan
Brand: Avapro
MOA: Antagonizes angiotensin receptors
Schedule: legend
Dosing: 150mg to 300mg once daily
Contraindication(s):
Hypersensitivity
Concurrent use with aliskiren in patients with diabetes
BBW: • Fetal toxicity
Key Points:
Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting
Lightheadedness, dizziness, orthostasis, hypotension
Irbesartan and Hydrochlorothiazide
Brand: Avalide
MOA: See individual agents
Schedule: legend
Dosing: See individual agents
Contraindication(s):
Hypersensitivity
Concurrent use with aliskiren in patients with diabetes
Anuria
BBW: • Fetal toxicity
Key Points:
See Individual Agents
Isosorbide Dinitrate
Brand: Isordil
MOA: Activates cGMP leading to dephosphorylation of myosin light chains and smooth muscle relaxation
Schedule: legend
Dosing:
IR: 10mg to 40mg BID ro TID;
SR: 40mg to 160mg once daily >14 hour nitrate free time for IR, >18 hour nitrate free time for SR
Contraindication(s):
Concurrent use with phosphodiesterase inhibitors or riociguat
BBW: • None
Key Points:
May cause headache, dizziness
For angina, should be dosed to preserve a nitrate-free period
Isosorbide mononitrate
Brand: Imdur
MOA: Activates cGMP leading to dephosphorylation of myosin light chains and smooth muscle relaxation
Schedule: legend
Dosing:
IR: 20mg BID given+B12 5-7 hours apart;
XR: 60mg to 120mg once daily
Contraindication(s):
Concurrent use with phosphodiesterase inhibitors or riociguat
BBW: • None
Key Points:
May cause headache, dizziness
For angina, should be dosed to preserve a nitrate-free period
Lansoprazole
Brand: Prevacid
MOA: Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell
Schedule: legend
Dosing:
Ulcer/GERD: 15mg to 30mg once daily
H. pylori eradication: 30mg BID or TID
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Headache
Diarrhea
Take 30 minutes before food.
Lisinopril
Brand: Zestril, Prinivil
MOA: Inhibits angiotensin converting enzyme, preventing the coversion of angiotensin I to angiotensin II
Schedule: legend
Dosing:
5mg to 40 mg once daily
Contraindication(s):
Angioedema related to previous treatment with an ACE inhibitor
Cocomitant use of aliskerin in patients with diabetes
BBW: • Fetal toxicity
Key Points:
May cause dry cough
Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting
AngioedemaLightheadedness, dizziness, orthostasis, hypotension
Lisinopril and Hydrochlorothiazide
Brand: Zestoretic
MOA: See individual agents
Schedule: legend
Dosing: See individual agents
Max 80mg/50mg once daily
Contraindication(s):
Hypersensitivity to sulfonamide-derived drugs
Angioedema related to previous treatment with an ACE inhibitor
Cocomitant use of aliskerin in patients with diabetes
Idiopathic or heredetary angioedema
BBW: • Fetal toxicity
Key Points:
See Individual Agents
Losartan
Brand: Cozaar
MOA: Antagonizes angiotensin receptors, blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II
Schedule: legend
Dosing:
50mg to 100mg once daily
Contraindication(s):
Cocomitant use of aliskerin in patients with diabetes
BBW: • Fetal toxicity
Key Points:
Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting
Lightheadedness, dizziness, orthostasis, hypotension
Losartan and Hydrochlorothiazide
Brand: Hyzaar
MOA: See individual agents
Schedule: legend
Dosing: See individual agents
Contraindication(s):
Hypersensitivity to sulfonamide-derived drugs
Cocomitant use of aliskerin in patients with diabetes
anuria
BBW: • Fetal toxicity
Key Points:
See Individual Agents
Metoprolol
Brand: Lopressor, Toprol
MOA: Selectively blocks beta1-receptors Schedule: legend
Dosing:
IR: Angina, afib, HTN: 50mg to 100 mg BID Does not treat HF
ER: Angina and HTN: 25mg to 100 mg once daily
Afib: 50mg to 400 mg once daily
HF: Initiate 12.5mg to 25mg once daily and titrate to target 200mg once daily
Contraindication(s):
Second or third degree heart block
Sinus bradycardia
Cardiogenic shock
BBW: • Ischemic heart disease
Key Points:
Fatigue and Lethargy
Bradycardia (or rebound tachycardia if stopped abruptly)
Impotence
Succinate = long acting Tartrate = short acting
Niacin
Brand: Niaspan
MOA: Inhibits of release of free fatty acids from adipose tissue and increases lipoprotein lipase activity
Schedule: legend
Dosing:
IR: 1.5g to 3g daily in two to three evenly divided doses (Max 6g/day)
ER: 1g to 2g q HS (Max 2g/day)
Contraindication(s):
Active liver disease
Active peptic ulcer
Arterial hemorrhage
BBW: • None
Key Points:
Flushing reaction
Hepatic injury
Can take with cold water or food to reduce flushing
Flushing will get less severe with time
Nifedipine
Brand: Adalat, Procardia, Afeditab
MOA: Acts on vascular smooth muscle to produce peripheral arterial vasodilation by inhibiting calcium ions from entering select voltage-sensitive areas of vascular smooth muscle
Schedule: legend
Dosing:
IR: Angina only: 10mg to 20mg TID (Max 180mg/day)
ER: HTN and angina: 30mg to 90mg once daily (Max 120mg/day)
Contraindication(s):
Use in patients with STEMI
BBW: • None
Key Points:
Peripheral edema
Flushing
hypotensiongingival hyperplasia
Nitroglycerin
Brand: Nitrostat, Nitro-Bid, Nitro-Dur, Nitrolingual
MOA: Activates cGMP leading to dephosphorylation of myosin light chains and smooth muscle relaxation
Schedule: legend
Dosing:
Sublingual tablet: 0.3mg to 0.6mg q 5 minutes (Max 3 tablets within 15 mintues)
PO tablet: 2.5mg to 6.5 mg TID or QID
Contraindication(s):
Concurrent use with phosphodiesterase inhibitors or riociguat
BBW: • None
Key Points:
Place under tongue, do not swallow or chew
Keep in original bottle - Replace routinely and check expiration date
May use up to 3 doses q5 min. If no symptom relief after 1 dose, call 911.
Used for chest pain, sit before taking dose, may cause dizziness
