Block 2 Exam Review Flashcards by Julia Mooney

What are the major side effects of organic nitrates?

-Headache
-Reflex tachycardia
-Orthostatic hypotension
-Facial flushing
-Nitroglycerin specifically has significant interactions with sildenafil (Viagra) and can cause fatal hypotension

How well did you know this?

Not at all

Perfectly

What are the major side effects of β-blockers?

-Fatigue
-Bradycardia
-Hypotension
-Bronchoconstriction (only with non-selective β-blockers)

How well did you know this?

Not at all

Perfectly

What are the major side effects of calcium-channel blockers?

-Constipation (especially Verapamil)
-Headache
-Dizziness
-Flushing
-Non-dihydropyridines can cause heart failure to worsen due to negative intotropic effects

How well did you know this?

Not at all

Perfectly

What are the major side effects of sodium-channel blockers?

-Dizziness
-Headache
-Constipation
-QT interval prolongation

How well did you know this?

Not at all

Perfectly

What is the generic name of the sodium channel blocker?

Ranolazine

How well did you know this?

Not at all

Perfectly

What are the generic names of the K+ sparing diuretics?

-Spironolactone
-Triamterene

How well did you know this?

Not at all

Perfectly

What are the side effects of diuretics?

-Orthostatic hypotension
-Weakness
-Cardiac arrhythmias
-Fatigue
-Hyponatremia
-Hypokalemia

How well did you know this?

Not at all

Perfectly

What is the mechanism of action of sprionolactone?

Direct antagonist of aldosterone, which prevents salt retention, myocardial hypertrophy, and hypokalemia

How well did you know this?

Not at all

Perfectly

What is the mechanism of action of eplerenone?

Antagonist of aldosterone but with lower incidence of endocrine-related side effects

How well did you know this?

Not at all

Perfectly

What are the two aldosterone antagonists?

-Spironolactone
-Eplerenone

How well did you know this?

Not at all

Perfectly

What are the common side effects of aldosterone antagonists?

Hyperkalemia

How well did you know this?

Not at all

Perfectly

What is a common arterial dilator used for chronic heart failure?

Hydralazine

How well did you know this?

Not at all

Perfectly

What are the common side effects of hydralazine and isosorbide dinitrate?

-Headache
-Hypotension
-Tachycardia

How well did you know this?

Not at all

Perfectly

What patient population is the combination of hydralazine and isosorbide dinitrate for the treatment of heart failure used in? Why?

-Used in black patients
-Used because ACE inhibitors is not recommended in this group as there are excessive side effects

How well did you know this?

Not at all

Perfectly

What are common positive inotropic drugs used for the treatment of heart failure?

-Digoxin
-Dobutamine
-Milrinone

How well did you know this?

Not at all

Perfectly

What is a major downside of positive inotropic drugs?

All positive inotropic drugs have been associated with reduced survival in patients with HF, so they are only used for a short period of time with the exception of Digoxin

How well did you know this?

Not at all

Perfectly

Which coagulation factors are involved in the extrinsic pathway?

-Factor III
-Factor VII

How well did you know this?

Not at all

Perfectly

Which coagulation factors are involved in the intrinsic pathway?

-Factor XII
-Factor XI
-Factor IX
-Factor VIII

How well did you know this?

Not at all

Perfectly

Which coagulation factors are involved in the rest of the coagulation pathway?

-Factor X
-Prothrombin (Factor II)
-Prothrombin activator
-Thrombin
-Fibrinogen (Factor I)
-Fibrin

How well did you know this?

Not at all

Perfectly

Which coagulation factor is responsible for the conversion from factor X to prothrombin activator?

-Factor III
-Factor V

How well did you know this?

Not at all

Perfectly

What is the role of thrombin in the coagulation cascade?

Converts fibrinogen to fibrin

How well did you know this?

Not at all

Perfectly

What is the role of factor V in the coagulation cascade?

Converts prothrombin activator to thrombin

How well did you know this?

Not at all

Perfectly

What is the role of factor VIII in the coagulation cascade?

Converts fibrin to fibrin polymer

How well did you know this?

Not at all

Perfectly

What is the role of vitamin K in the coagulation pathway?

-Involved in the synthesis of vitamin K dependent clotting factors in the liver
-Factor II (prothrombin)
-Factor VII
-Factor IX
-Factor X

How well did you know this?

Not at all

Perfectly

What are the side effects of warfarin (Coumadin)?

-Hemorrhage -Fetotoxic -Many drugs interactions

What are the side effects of heparins?

-Hemorrhage -Thrombocytopenia -Osteoporosis with long term use -Hypersensitivity reactions

What is the MOA of aspirin for anticoagulation?

Inhibits COX enzyme which converts arachidonic acid to thromboxane A2, which activates platelets and causes them to clump together

What is the MOA of Clopidogrel for anticoagulation?

Prevents platelets from sticking together by inhibiting a receptor on the platelet called P2Y12

What is the MOA of Ticagrelor and Prasugrel for anticoagulation?

Same mechanism as Clopidogrel but has different pharmacokinetics and dynamics

What is the MOA of Dipyridamole for anticoagulation?

-Used in combination with aspirin -Inhibits phosphodiesterase enzyme which leads to the increase of cAMP in platelets which inhibits their aggregation

What is a rare but serious side effect of Clopidogrel?

Thrombotic thrombocytopenic purpura (TTP): rare but severe condition where small blood clots form throughout the body

What are the antithrombotic/antiplatelet drugs?

-Aspirin -Clopidogrel -Ticagrelor -Prasugrel -Dipyridamole

What are the thrombolytic drugs?

-Alteplase (tPA) -Reteplase -Tenecteplase -Streptokinase -Urokinase

What are the suffixes for thrombolytic drugs?

-"plase" -"kinase"

What are the suffixes for direct thrombin inhibitors?

-"tran" -"ban" -"udin"

What are the suffixes for anti-thrombotics?

-"grel" -Aspirin -Dipyridamole

What are the suffixes for factor Xa inhibitors?

"xaban"

What is the MOA of statins?

Inhibits the HMG-CoA reductase enzyme which plays a role in production of cholesterol

What are the major side effects of statins?

-Muscle pain and weakness -Fatigue -Rhabdomyolysis

What is the mechanism of action of bile acid sequestrants?

-Bind to bile acid in the intestines, forming a complex that is excreted in the feces -Bile acids are made in the liver from cholesterol -By binding these acids and promoting excretion, the liver compensates by converting

What is the only cholesterol absorption inhibitor?

Ezetimibe

What are the rapid acting insulin?

-Lispro -Aspart -Glulisine

What are the short acting insulin?

Crystalline

What are the intermediate acting insulin?

-NPH -Lente

What are the long acting insulin?

-Detemir -Glargine

What are the suffixes of sulfonylureas?

-First generation: "amide" -Second generation: "ide" -Third generation: "piride"

What are the adverse effects of sulfonylureas?

-Hypoglycemia -Cholestatic jaundice -Weight gain -Fetal hypoglycemia

What are the suffixes of meglitinides?

"glinide"

What are the common adverse effects of meglitinides?

Hypoglycemia

What is the only biguanide?

Metformin

What are the adverse effects of metformin?

-GI side effects -Lactic acidosis

What is the suffix for thiazolidinediones?

"glitazone"

What are the adverse effects of thiazolidinediones?

Edema

What are the alpha-glucosidase inhibitors?

-Acarbose -Miglitol

What are the adverse effects of alpha-glucosidase inhibitors?

-Flatulence -Diarrhea

What is the suffix for GLP-1 analogs?

"tide"

What are the adverse effects of GLP-1 analogs?

-GI issues -Injection site reactions -Pancreatitis

What is the suffix for DPP-4 inhibitors?

"gliptin"

What are the adverse effects of DPP-4 inhibitors?

-Nasopharyngitis -Headache -Pancreatitis

What is the suffix for SGLT-2 inhibitors?

"gliflozin"

What are the adverse effects of SGLT-2 inhibitors?

-Genital yeast infections -Urinary tract infections -Bone fracture risk -Ketoacidosis

What are the short acting β-2 agonists?

-Albuterol -Levalbuterol

What are the long acting β-2 agonists?

-Salmeterol -Formoterol

What are the injectable disease modifying drugs for MS?

-Avonex -Betaseron -Copaxone

What are the oral disease modifying drugs for MS?

-Gilenya -Tecfidera

What are the infused disease modifying drugs for MS?

-Novantrone -Ocrevus -Tysabri