beta blockers, diuretics, statins, other lipid lowering drugs

Question 2

Beta blockers indications

Answer 2

heart failure
HTN
anxiety
tremor
Arrhythmia

Question 3

beta blockers actions

Answer 3

antagonize (block the beta one and beta two receptors (decrease HR, contractility, renin release and decrease angiotensin 2)

Question 4

beta blocker specific to HF

Answer 4

restore heart rate variability
prevent arrhythmia occience
prevent./slow remodeling process
special dosing (target dosing and start low and go slow)

Question 5

beta blockers side effects

Answer 5

bronhopasm
HF
Bradycardia/bradyarrythmiasn
vasospasm
metabolic abnormalities ( hypo- or hyperglycemia/ decrease insulin sensitivity, may mask symptoms of hypoglycemia, decrease HDL)
depression
withdrawal syndrome (d/c over 1-2 weeks)

Question 6

beta blockers TOP 200

Answer 6

metoprolol
atenolol
propranolol
carvedilol
labetolol

Question 7

diuretics

Answer 7

Carbonic anhydrase inhibitors (acetazolamide)

Loops - furosemide (Lasix)

Thiazide, thiazide-like - hydrochlorothiazide

Potassium-sparing - triamterene
Also in many combinations (Dyazide, Maxzide)

Osmotic diuretics (mannitol)

Question 8

loops work where

Answer 8

ascending loop of henle

Question 9

thiazide work where

Answer 9

the distal convoluted tubule of a nephron

Question 10

potassium sparing work where

Answer 10

from the late distal tubule to the collecting duct.

Question 11

loops actions

Answer 11

inhibit a transport system that moves sodium, potassium and chloride across cell membranes

Question 12

thiazide actions

Answer 12

inhibition of the Na+/Cl− cotransporter (NCC)

Question 13

potassium-sparring actions

Answer 13

to prevent sodium reabsorption in the collecting tubule

by inhibiting aldosterone receptors This prevents excessive excretion of K+ in urine and decreased retention of water, preventing hypokalemia.

Question 14

diuretics indications

Answer 14

hypertension (go back to class two and read the slide on this one)
HF
edema
fluid retention

Question 15

loops diuretics are

Answer 15

more powerful to get rid of extra fluid

Question 16

thiasazide are

Answer 16

less potent and do not get rid of fluid

Question 17

loops have a

Answer 17

liner dose curve (double amount of urine lost when you double dose)

Question 18

thiazide has a

Answer 18

flat dose curve (amount of urine stays the same)

Question 19

diuretics side effects

Answer 19

hypovolemia
hyperglycemia
increased cholesterol and triglycerides

Question 20

electrolytes imbalance with diuretics

Answer 20

increased calcium with thiazides
decreases calcium with loops
decreased potassium and magnesium (may see hyperkalemia with potassium sparing agents)

hyperuricemia

Question 21

hypovolemia is a risk for

Answer 21

dizziness and falls

Question 22

loops waste calcium

Answer 22

in urine

Question 23

thiazides increase

Answer 23

calcium

Question 24

all increase

Answer 24

uric acid level

Question 25

A patient being treated with the ACE inhibitor ramipril (Altace) who is started on hydrochlorothiazide plus triamterene (Dyazide) has an increased risk for developing what side effect?

Answer 25

hyperkalemia

Question 26

diuretics interactions

Answer 26

digoxin
lithium (dangerous monitor lithium blood levels)
NSAIDS
ACE inhibitors
potassium supplements (K)

Question 27

potential problems with diuretics

Answer 27

diuretic resistance
thiazide sensitivity to renal function

Question 28

diuretics TOP 200

Answer 28

chlorthalidone
triamterene
spironolactone
furosemide
torsemide

Question 29

Statins TOP 200

Answer 29

lovastatin
pravastatin
simvastatin
atrovastain
rosuvastatin

Question 30

dyslipidemia TOP 200

Answer 30

ezetimibe
omega-3 ethyl esters

Question 31

fibrates TOP 200

Answer 31

gemfibrozil
fenofibrate

Question 32

statins are the

Answer 32

Gold staNDARD FOR LOWERING LDL

(not good for isolated him TG & may be good even if LDL id normal)

Question 33

statins have

Answer 33

flat dose curve

(only 5-6% lowering for double dose, should start with what is expected the patient needs)

Question 34

statins should be given at

Answer 34

evening or bed time (liver processes the most drugs at night)

Question 35

statins side effects

Answer 35

myalgias
myopathy/rhabdomyolysis

(stains cause muscle problems, CPK is lad for muscle detection but in non specific)