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Pharm II > Anti-Anginals & Hyperlipidemia > Flashcards

Anti-Anginals & Hyperlipidemia Flashcards

0
Q

resins are ineffective for (2)

A

familial hypercholesterolemia

hypertriglyceridemia

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1
Q

resin MOA

A

binds bile acids, decreasing # of bile acids
this increases expression of hepatic LDL receptor
more uptake of LDL to make bile acids —> decreased LDL

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2
Q

Resins are effective when?

A

whenever LDL is elevated

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3
Q

Resin adverse effects?

A

Constipation & bloating
Steatorrhea
hyperprothrombinemia due to Vit K malabsorption

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4
Q

Niacin MOA (2)

A

inhibits VLDL secretion –> lower VLDL & LDL

inhibits hepatic cholesterologenesis

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5
Q

Niacin effects (3)

A

decrease VLDL
decrease LDL
increased HDL

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6
Q

Niacin side effects (4)

A

vasodilation/heat
GI discomfort
impairs glucose tolerance
rare hepatotoxicity

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7
Q

Statin MOA

A

inhibits HmG-CoA reductase, disrupting cholesterol synthesis & increasing the number of LDL receptors

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8
Q

Statin effects (5+)

A 
decrease LDL
decrease plasma TGs
Increase HDL
decrease C-reactive protein
increase plaque stability
enhance endothelial NO production, decrease lipoprotein oxidation, decrease platelet aggregation
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9
Q

statin side effects (4)

A

Increased aminotransferase levels
Liver damage
Increased creatinine kinase
Rhabdomyolysis

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10
Q

Statin contraindications (2)

A

Pregnancy

Active liver disease

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11
Q

Fibrates MOA (3)

A

PPAR-a ligand (nuclear receptor)
Upregulates LPL & other genes involved in fatty acid oxidation –> increased catabolism of VLDL
inhibits hepatic cholesterologenesis

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12
Q

Fibrates effects (3)

A

decreased VLDL
decreased triglycerides
decrease overall cholesterol

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13
Q

Fibrates unique adverse effects (5)

A 
Increased liver enzymes
Increased incidence of gallstones
Inhibits statin metabolism
Potent anticoagulant action of warfarin
May increase LDL
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14
Q

Ezetimibe MOA

A

selectively blocks intestinal absorption of cholesterols

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15
Q

ezetimibe effects (2)

A

moderate decrease in LDL

synergistic with a statin

16
Q

nitrate/nitrite MOA

A

NO –> cGMP –> myosin light chain dephosphorylation –> vasodilation

17
Q

effects of nitrates (3)

A

decrease myocardial oxygen requirement
decrease preload
decrease afterload

18
Q

how do vessels dilate with nitrates

A

large veins dilate more than arterioles

19
Q

nitrate adverse effects for anti-angina (5)

A 
reflex tachycardia
orthostatic hypotension
throbbing headaches
fast tolerance
cyanide
20
Q

how do you minimize reflex tachy. w/ nitrates for angina?

A

combine with CCBs or B-blockers

21
Q

most effective drug combo for angina

A

B-blockers & a Vasodilator

22
Q

nifedipine effects in angina (4)

A

increases HR
coronary vasodilation
increased myocardial O2 supply
decreased afterload

23
Q

verapamil/diltiazem effects in angina (2)

A

decreased myocardial contractility

bradycardia

24
Q

Nifedipine adverse effects (2)

A

reflex tachycardia

increased cardiac workload

25
Q

verapamil/diltiazem adverse effect

A

cardiac depression leading to further problems

26
Q

treatments for Prinzmetal’s angina (2)

A

nitrates

CCBs

27
Q

B-blockers effects in angina (2)

A

decreased sympathetic activation

decreased cardiac workload & O2 demand

28
Q

B-blockers effect on the kidneys

A

decreased renin

29
Q

why are B-blockers harmful in variant angina?

A

slowing HR prolongs the ejection time and increases the myocardial O2 demand

30
Q

Ranolazine MOA (2)

A

partial fatty-acid oxidation inhibitor: decreases O2 consumption in ischemic tissue
Also inhibits late inward sodium current- decreased contractility

31
Q

Ranolazine effects (2)

A

decreases left ventricular wall stiffness

improves coronary circulation

32
Q

the preferred drug for angina & CHF?

A

nitrates

33
Q

the preferred drugs for angina + asthma/diabetes? (2)

A

CCBs and nitrates

Pharm II (14 decks)

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