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Pathophysiology & Pharmacology 218 > Antilipemic, Antianginal, Coagulation Modifier drugs (Week 2) > Flashcards

Antilipemic, Antianginal, Coagulation Modifier drugs (Week 2) Flashcards

1
Q

Define Antipemic

A

A drug that reduces lipid levels

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2
Q

HMG-CoA Reductase inhibitors suffix

A

“statins”

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3
Q

HMG-CoA Reductase inhibitors Theraputic Effect

A

Lower the Blood cholesterol level by decreasing the rate of cholesterol production.

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4
Q

HMG-CoA Reductase inhibitors MOA

A

Inhibit the enzyme HMG-CoA Reductase, and decrease cholesterol production.

The liver requires HMG-CoA Reductase to produce cholesterol so ^^^

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5
Q

HMG-CoA Reductase inhibitors Indications

A

First line drug therapy for hypercholesterolemia (most common and dangerous form of dyslipidemia)

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6
Q

HMG-CoA Reductase inhibitors Contraindications

A

Drug allergy, pregnancy, liver disease or increase liver enzymes

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7
Q

HMG-CoA Reductase inhibitors AE

A

Typically well Tolerated.
Common: Mild transient gastrointestinal disturbances and headache

Less common: myopathy (muscle pain) which can progress to rhabdomyolysis ( breakdown of muscle protein).

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8
Q

HMG-CoA Reductase inhibitors Drug interactions

A

Should be cautioned for pts taking anticoagulants.

Limit drinking of grapefruit juice to 1 L

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9
Q

Name 4 antilipemic drugs

A

HMG-CoA Reductase inhibitors
Bile Acid Sequestrants
Nicotinic Acid
Fibric Acid Derivatives.

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10
Q

Bile Acid Sequestrants Theraputic Effects

A

Lower the plasma concentrations of LDL by 15-30% and increase HDL cholesterol by 3-8% and increase liver triglyceride production

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11
Q

Bile Acid Sequestrants MOA

A

Bile Acid resins bind bile, preventing the reabsorption of bile acids from sm intestine.

Bile acids are necessary for the absorption of cholesterol from the sm intestine

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12
Q

Bile Acid Sequestrants Indications

A

Primary or adjunct therapy in the management of hyperlipoproteinemia

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13
Q

Bile Acid Sequestrants Contraindications

A

Drug allergy and bowel or biliary obstruction

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14
Q

Bile Acid Sequestrants AE

A

Common: Constipation accompanied by heartburn, nausea, belching and bloating

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15
Q

Bile Acid Sequestrants Interactions

A

High doses of Bile Acid Sequestrants will decrease the absorption rate of fat solubles (Vit A,D,E,K)

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16
Q

Nicotinic Acid MOA

A

Is a vitamin B that inhibits lipolysis in adipose tissue, decrease esterfication of triglycerides in the liver and increase the activity of lipoprotein lipase.

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17
Q

Nicotinic Acid Theraputic effects

A

Decrease LDL by 10-20%, decrease triglycerides from 30-70% and increase HDL by 20-35%.

18
Q

Nicotinic Acid Indications

A

> > Types IIa, IIb, II, IV, V hyperlipidemia

19
Q

Nicotinic Acid Contraindications

A

drug allergy, liver disease, htn, peptic ulcer, active hemorrhagic process

20
Q

Nicotinic Acid AE

A

Flushing, pruritus, and GI distress.

Take drug with meals to minimize undesired effects

21
Q

Fibric Acid Derivatives (FIBRATES) Theraputic Effects

A

Decrease LDL N Raise HDL

22
Q

Fibric Acid Derivatives (FIBRATES) MOA

A
  • Activate lipoprotein lipase, enzyme responsible for breaking down cholesterol
  • Suppress release of of free fatty acid from adipose tissue
  • inhibit synthesis of triglycerides in liver and increase secretion of cholesterol into bile
23
Q

Fibric Acid Derivatives (FIBRATES) Indications

A

IIa,IIb, IV, and V type of hyperlipidemias

24
Q

Fibric Acid Derivatives (FIBRATES) Contraindications

A

Drug allergies, severe kidney/liver disease, cirrhosis or gallbladder disease

25
Q

Fibric Acid Derivatives (FIBRATES) AE

A

Common: abdominal discomfort, diarrhea nausea, headache, blurred vision, increase risk for gallstones and prolonged prothrombin time.

26
Q

Key Patient education tips for Antilipemic drugs

A

-Notify Health care provider if there is any persistant:
GI upset, constipation, gas, bloating, heartburn, nausea, vomiting, abnormal or unusual bleeding
-Encourage pts to drink 2000 ml of fluids/day
-Encourage to exercise with supervision first d/t possible dizziness

27
Q

Name the 3 main Antianginal Drugs

A

Nitrates/Nitrites
B-Blockers
Calcium Channel Blockers

28
Q

Nitrates/Nitrites MOA

A

Dilate all blood vessels. Dominantly affect venous vascular beds. Dilation allows venous return and reduces preload of left ventricular end- diastolic volume

29
Q

Nitrates/Nitrites Indications

A

Stable, Unstable and Vasospastic (Prinzmetal’s) angina.

30
Q

Nitrates/Nitrites Contraindications

A

Drug allergy, severe anemia, closed angle glaucoma, hypotension, or severe head injury

31
Q

Nitrates/Nitrites AE

A

Mostly well tolerated.
Most common: headache, tachycardia, and postural hypotension, reflex tachycardia (if nitrate vasodilation happens too fast)

32
Q

Nitrates/Nitrites Interactions

A

Produce hypotensive effects if taken with

alcohol, calcium channel blockers, phenothiazines and erectile dysfunction drugs

33
Q

B-Blockers MOA

A

Decreases the heart rate, Decrease BP and suppress the hormone renin from being released

34
Q

B-Blockers Indications

A

Angina, MI and HTN

35
Q

B-Blockers Contraindications

A

Systolic heart failure, and conduction disturbances

Caution in the use of pts with bronchial asthma

36
Q

B-Blockers AE

A

CV: brady/tachy cardia, hypotension, 2nd or 3rd degree heart block, heart failure
CNS: dizzy, fatigue, drowsy, mental depresssion, lethargy, unusual dreams

37
Q

Calcium Channel Blockers MOA

A
  • Decrease muscle contractions and allows for muscle relaxation
  • Relaxation= dilation which allows increase blood flow to the heart, increasing o2 supply.
38
Q

Calcium Channel Blocker Indications

A

First line drug for angina, HTN, and supraventricular tachycardia.

39
Q

Calcium Channel Blocker Contraindications

A

drug allergy, acute MI, second or third atrioventricular block (unless pt has a pace maker) and hypotension

40
Q

Calcium Channel Blocker AE

A

CV: hypotension, palpitations, tachycardia or bradycardia, heart failure
GI: constipation nausea

41
Q

Calcium Channel Blocker Drug Interactions

A

B-Blockers- additive effects and results bradycardia or atrioventricular block
Digoxin- Interferes with elimination and results increased digoxin levels
H2 blockers- decreases H2 and results increase of calcium channel blockers

42
Q

Patient Education For Nitroglycerin

A
  • Instruct pt to have journal to keep track of when anginal episodes occur, intensity of pain, frequency and factors that relieve pain
  • Keep away from moisture, light, heat
  • Blurred vision, dry mouth or severe headaches may indicate drug overdose= IMMEDIATE MED ATTENTION
  • Take med before stressful sitations

Pathophysiology & Pharmacology 218 (20 decks)

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