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Pharm > Block 11 > Flashcards

Block 11 Flashcards

1
Q

Classes of drugs for CHF (7)

A 
Diuretics 
B blockers
ACEI/ARBs
CCB
Neprilysin I
If Na blocker
Inotropic drugs
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2
Q

Primary therapy for CHF

A

Diuretics
B blocker
ACEI/ARBs

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3
Q

Class of drug: sacubitril

A

Neprilysin I

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4
Q

Class of drug: metoprolol

A

B blocker

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5
Q

Class of drug: ivabradine

A

If Na blocker

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6
Q

Class of drug: amlodipine

A

CCB

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7
Q

Class of drug: verapamil

A

CCB

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8
Q

Class of drug: diltiazem

A

CCB

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9
Q

3 types of inotropic drugs

A

Digitalis
B agonist
PDE I

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10
Q

Class of drug: digoxin

A

Digitalis —>inotropic

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11
Q

Class of drug: dobutamine

A

B agonist —> inotropic

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12
Q

Class of drug: inamrinone

A

PDE I

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13
Q

What does a PDE3 I do

A

Stops hydrolysis of cAMP —> prolonged activation of PK-A

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14
Q

What does a B agonist do

A

Activated adenylyl cyclase —> inc Ca flow which increases force of contraction

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15
Q

What 2 drugs are used acutely in CHF

A

Dobutamine and inamrinone

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16
Q

2 things that can cause cardiac remodeling

A

High aldosterone and NE/Epi

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17
Q

How to treat remodeling: high aldosterone

A

Tx with ACEI/ARBs

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18
Q

How to treat remodeling: NE/Epi

A

Tx with B blocker

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19
Q

For which primary therapy drug of CHF is dose critical

A

B blocker (metoprolol)

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20
Q

Which diuretic affect remodeling

A

Spironolactone and eplerenone

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21
Q

Which diuretics dont affect remodeling

A

Loops and TZ’s

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22
Q

Class of drug: ivabradine

A

If Na blocker

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23
Q

Class of drug: sacubitirl

A

neprilysin I

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24
Q

With which inotropic drug should you monitor K

A

Digitalis (digoxin)

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25
Q

The P wave represents

A

Atrial depol

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26
Q

The QRS wave represents

A

Ventricular depol

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27
Q

The T wave represents

A

Ventricular repol

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28
Q

The PR interval represents

A

SA to AV node —> atrial conduction

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29
Q

The QT interval represents

A

Entire ventricle conduction

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30
Q

Which classes of drugs treat SVT

A

Class 2 and 4
Digoxin
Adenosine

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31
Q

Which classes of drugs treat VT

A

Class 1 and 3

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32
Q

Which classes of drugs cause torsades

A

1a and 3 - anything with K

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33
Q

Most common arrhythmia

A

A fib

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34
Q

Most dangerous arrhythmia

A

V fib

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35
Q

Antiarrhythmia drugs: class 1

A

Na blocker

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36
Q

Antiarrhythmia drugs: class 2

A

B blocker

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37
Q

Antiarrhythmia drugs: class 3

A

K blockers

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38
Q

Antiarrhythmia drugs: class 4

A

CCB

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39
Q

Drugs in class 2 for SVT Tx

A

Atenolol and metoprolol

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40
Q

Drugs in class 4 for SVT Tx

A

Verapamil and diltiazem

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41
Q

Drugs in class 1 for VT: 1a

A

Quinidine

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42
Q

What channels does quinidine block

A

Na and K

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43
Q

Drugs in class 1 for VT: 1b

A

Lidocaine

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44
Q

Drugs in class 1 for VT: 1c

A

Flecainaide

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45
Q

Drugs in class 3 for VT

A

Sotalol

Amiodarone and dronedarone

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46
Q

Which anti arrhythmia drug is given IV to avoid first pass

A

Ib - lidocaine

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47
Q

Drug of choice for SVT

A

Adenosine - temporary flatline - only acutely

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48
Q

3 drug classes to treat stable angina

A

Nitrates
B blockers
CCB

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49
Q

2 drug classes to treat variant angina

A

Nitrates

CCB

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50
Q

2 treatment methods for unstable angina

A
  • aspirin or IV heparin

- nitroglycerin, B block, CCB

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51
Q

Exercise induced angina

A

Stable

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52
Q

Angina not relieved by rest; O2 delivery dec bc of coronary vasospasm

A

Variant

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53
Q

Goal in treatment of stable angina

A

To slow HR

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54
Q

Goal in treatment of variant angina

A

Vasodilate

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55
Q

Most common drug to prevent stable angina

A

B blocker (-olols)

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56
Q

CCBs used in stable angina

A

Verapamil and diltiazem

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57
Q

CCBs used in variant angina

A

-dipines

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58
Q

Drug class used in Raynaud’s phenomenon

A

CCBs - -dipines

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59
Q

2 types of nitrates

A

Nitroglycerin

Isosorbide mono/dinitrate

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60
Q

How does nitroglycerin affect vessels

A

Vasodilate by NO

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61
Q

How is nitroglycerin given

A
  • Sublingual when attack is happening

- patch worn 12 hours a day

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62
Q

6 drug classes that treat hyperlipidemia

A
  • HMG CoA reductase I
  • fenofibrate
  • niacin
  • BAS
  • ezetemibe
  • PCSK9 I
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63
Q

Class of drug: -statins

A

HMG CoA reductase I

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64
Q

Class of drug: cholestyramine

A

BAS

65
Q

Class of drug: alirocumab

A

PCSK9 I

66
Q

Which hyperlipidemia drug blocks rate limiting step in cholesterol synthesis

A

Statins

67
Q

Which hyperlipidemia drug will affect all levels (dec LDL, dec TC and inc HDL)

A

Statins

68
Q

Which hyperlipidemia drug binds PPAR-alpha

A

Fenofibrate

69
Q

Which hyperlipidemia drug will only inc clearance of TG

A

Fenofibrate

70
Q

Which hyperlipidemia drug will lower LDL and inc HDL

A

Niacin

71
Q

Which hyperlipidemia drug will bind to bile salts to lower LDL and inc TG

A

BAS - cholestyramine

72
Q

Which hyperlipidemia drug dec GI uptake of cholesterol and dec LDL

A

Ezetemibe

73
Q

Which hyperlipidemia drug is expensive and dec LDL

A

PCSK9 I - alirocumab

74
Q

Normal levels for cholesterol: total

A

< 200

75
Q

Normal levels for cholesterol: LDL

A

< 100

76
Q

Normal levels for cholesterol: TG

A

<150

77
Q

Normal levels for cholesterol: HDL

A

> 40

78
Q

Leading cause of disability

A

Stroke

79
Q

5th leading cause of death

A

Stroke

80
Q

Clinical presentation of stroke

A

1 side weakness, inability to speak, vision loss, vertigo

81
Q

4 drug classes used to prevent strokes (antiplatelets)

A
  • aspirin
  • ADP receptor blocker
  • GP 2b/3a I
  • PDE3 I
82
Q

Class of drug: clopidogrel

A

ADP receptor blocker

83
Q

Class of drug: abciximab

A

GP 2B/3A I

84
Q

Class of drug: dipyridamole

A

PDE3 I

85
Q

Which stroke prevention drug irreversibly prevents synthesis of TXA2

A

Aspirin

86
Q

Which stroke prevention drug irreversibly inhibits ADP

A

ADP receptor blocker - clopidogrel

87
Q

Which stroke prevention drug blocks binding of fibrinogen and prevents cross linking

A

GP 2b/3a I - abciximab

88
Q

Which stroke prevention drug blocks breakdown of cAMP = less aggregating

A

PDE3 I - dipyridamole

89
Q

Drug used in immediate stroke Tx

A

Alteplase (clot buster)

90
Q

Clinical presentation of DVT

A

Leg welling, pain, warmth

91
Q

Clinical presentation of PE

A

Cough, chest pain, shortness of breath

92
Q

VTE drug class

A
  • Heparin
  • enoxaparin
  • warfarin
  • dabigatran
  • rivaroxaban
93
Q

Which VTE drug catalyze binding of antithrombin 3 to factors 2a 9a 10a 11a and 12a

A

Heparin

94
Q

Does heparin acts fast or slow

A

Fast

- given IV

95
Q

Antidote for heparin

A

Protamine sulfate

96
Q

Which VTE drug is low weigh heparin; against 10a

A

Enoxaparin

97
Q

Which VTE drug dec liver synthesis of vit K dependent factors

A

Warfarin

98
Q

Which VTE drug is given orally for long tern prevention

A

Warfarin

99
Q

Antidote to warfarin

A 
Slow = vit K
Fast = fresh, frozen plasma
100
Q

Which VTE drug is a direct thrombin I

A

Dabigatran

101
Q

Antidote of dabigatran

A

Idarucizumab

102
Q

Which VTE drug is a direct factor 10a I

A

Revaroxaban

103
Q

How quickly do dabigatran and revaroxaban take action

A

Fast

104
Q

Where is the Na/H pump located in the nephron

A

PCT

105
Q

Where is the Na, K, Cl pump in the nephron

A

Asc loop

106
Q

Where is the Na/Cl pump in the nephron

A

DCT

107
Q

Where are the principal cells with Na channels and intercalated cells located in the nephron

A

CD

108
Q

Where in the nephron do CAIs work

A

PCT

109
Q

Since bicarb is lost when pt is on CAIs, what can occur

A

Metabolic acidosis

110
Q

Drug class: acetazolamide

A

CAI

111
Q

CAIs often used to treat

A
  • Closed angle glaucoma to dec AH formation in CB

- acute mountain sickness

112
Q

Where in the nephron do loop diuretics work

A

Ascending loop

113
Q

As K is pumped into the ascending loop in the Na/K/Cl pump, what happens

A

Cells separate and allow Mg and Ca to leak into the blood

114
Q

What diuretics lose Ca

A

Loops

115
Q

Drug class: -semides

A

Loops

116
Q

What side affects can loops cause

A

Hypokalemic alkalosis

Ototoxicity

117
Q

Where in the nephron do the TZs act

A

DCT

118
Q

TZs block the activity of the Na/Cl pump, so the Na/K ATPase activity increases and what happens

A

Inc in Na moving in = inc in Ca moving in

119
Q

What diuretics save Ca

A

TZs

120
Q

Which diuretic is often used in hypercalciuria, neph diabetes insipidus

A

TZ

121
Q

Where in the nephron do K sparing drugs work

A

CD

122
Q

What channels are in the principal cells in the CD

A

Na/K channel
Aldosterone
Androgen receptors

123
Q

Normally, as Na moves into the principal cells what happens

A

K secreted from principal cells, causing H to be secreted from the intercalated cells

124
Q

Drug class: amiloride

A

K sparing = block Na channels

125
Q

Drug class: eplerenone

A

K sparing = block aldosterone

126
Q

Drug class: spironolactone

A

K sparing = block aldosterone and androgen receptors

127
Q

K sparing drugs can cause what

A

Hyperkalemia

128
Q

Normally, as the CD loses K and H, what can occur

A

Hypokalemic alkalosis

129
Q

First line Tx of HTN

A

ACEI/ARBs, CCB, diuretics (TZ)

130
Q

Typical combo therapy in HTN

A

ACEI/ARBs + CCB

131
Q

Typical treatment of HTN in black pts

A

Diuretics
CCBs

Bc their plasma renin is lower

132
Q

Main sites of BP regulation

A

Arterioles
Postcapillary venules
Heart
Kidneys

133
Q

Is most HTN primary or secondary

A

90% primary (unknown cause)

134
Q

Adverse effects of diuretics in treatment of HTN

A

K depletion

135
Q

2 classes of drugs used in HTN treatments in patients with diabetic nephropathy

A

ACEI and ARBs

136
Q

Which 2 drug classes are not used in patients with bilateral renal artery stenosis and why

A

ACEI and ARBs

- cause acute renal failure

137
Q

Which drug classes can cause angioedema

A

ACEI and renin I

138
Q

Which drug class do you not want to use in the Tx of HTN in asthmatics and diabetics

A

B blockers (A-M olols)

139
Q

Which drug class can cause gingival hyperplasia in Tx of HTN

A

CCB - -dipines

140
Q

HTN drug that also treats BPH

A

Alpha1 blockers (-zosin)

141
Q

Which drug class can cause hemolytic anemia

A

Central alpha2 agonist (methyldopa)

142
Q

Which HTN drug is safe for preggo

A

Methyldopa

143
Q

Drug used in hypertensive emergencies

A

Labetalol

144
Q

Which HTN drug blocks Beta 1 and vasodilate via NO

A

Nebivolol

145
Q

Diuretic used to relieve the symptoms of acute pulmonary edema

A

-semides (loops)

146
Q

Which hyperlipidemia drug blocks chol reuptake

A

Ezetemibe

147
Q

Which hyperlipidemia drug dec VLDL synthesis

A

Niacin

148
Q

Which hyperlipidemia drug binds to bile salts

A

BAS - choestyramine

149
Q

Which hyperlipidemia drug blocks the rate limiting step in cholesterol synthesis

A
  • statin
150
Q

Which hyperlipidemia drug prevents breakdown of LDL receptors

A

PCSK9 I - alirocumab

151
Q

Only B blocker you dont take all the time - not compatible with Cronin oral therapy for arrhythmia

A

Esmolol

152
Q

Which 2 HTN drugs are harmful to fetus

A

ACEI and ARBs

153
Q

Amiodarone can cause what side effects

A

Problems with lungs, liver, eyes and thyroid

Also blue skin

154
Q

What drugs with CHF patients always get

A

ACEI and metoprolol

155
Q

If CHF patient also has edema and HTN, what drugs will you give them

A

ACEI + metoprolol + HCTZ

156
Q

Drug class that prolongs the QRS complex

A

Class 1 - Na blocker

157
Q

Drug class that prolongs the entire QT interval

A

Class 1A and 3 - K blockers

158
Q

SVT drugs prolong what part of the ECG

A

PR interval

159
Q

DOC for acute SVT

A

Adenosine

Pharm (2 decks)

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