Anti-HTN and Lipids

Question 1

Amlodipine, nimodipine

Answer 1

MOA: CCB (L-typed Ca channels), vascular smooth muscle
Use: HTN, angina, raynauds
SE: cardiac depression, AV block, peripheral edema, flushing, dizziness

Question 2

Diltiazem, Verapamil

Answer 2

MOA: CCB (L-type), heart>vasculature
Use: HTN, angina, A fib
SE: Cardiac depression, AV block, Edema, A fib

Question 3

Hydralazine

Answer 3

MOA: Increase cGMP->smooth muscle relaxation, vasodilates arterioles>veins, Decrease afterload
Use: Severe HTN (pregnancy with methyldopa), CHF, prevent reflex tachy
SE: Compensatory tachy, fluid retention, Nausea, HA, angina, LUPUS like syndrome

Question 4

Nitroprusside, Fenoldopam

Answer 4

MOA: NP=Increase cGMP via NO release to decrease preload and afterload, F: D1 agonist->renal, splanchnic, coronary vasodilation
Use: HTN emergency!
SE: CN toxicity (NP releases CN)

Question 5

Nitroglycerin, isorbide, dinitrate

Answer 5

MOA: Increase NO in smooth muscle, increase cGMP->relaxation Veins»arteries (decrease preload)
Use: Angina, ACS, Pulm edema
SE: Reflex Tachy, hypotension, flushing, HA

Question 6

Statins

Answer 6

MOA: Inhibit HMG-CoA reductase, prevent cholesterol synthesis–>Increase LDLR!
Use: Decrease LDL and TG, Increase HDL
SE: Hepatotoxic (inc. LFTs), RHABDOMYOLYSIS (especialy with Fibrates)

Question 7

Niacin

Answer 7

MOA: Inhibi lipolysis, reduce VLDL synthesis
Use: Decrease LDL and TG, Increase HDL!
SE: red, flushed face, Hyperglycemia, hyperuricemia

Question 8

Cholestyramine, colestipol, colesevelam

Answer 8

MOA: Bile acid resin, prevent reabsorption of bile acids in GI, liver uses cholesterol to make more
Use: Decrease LDL, increase HDL and TG
SE: Bad taste, GI distress, cholesterol gallstones

Question 9

Ezetimibe

Answer 9

MOA: Prevents GI absorption of cholesterol
Use: Decrease LDL
SE: Increase LFTs, diarrhea

Question 10

Gemfibrozil, clofibrate, bezafibrate, fenofibrate

Answer 10

Fibrates
MOA: Upregulate LPL, Increase TG clearance, Activate PPAR alpha to Increase HDl synthesis
Use: Decrease LDL, TG!!, Increase HDL
SE: MYOSITIS (especially with statins), hepatotoxic, cholesterol gallstones