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Pharmacology > Cardiovascular drugs > Flashcards

Cardiovascular drugs Flashcards

1
Q

What are the type of drugs acting on CVS?

A

anti-hypertensive
cardiotonic drugs
antiarrhythmic drugs
antianginal agents
lipid lowering agents
drugs affecting blood coagulation
drugs used to treat anemia

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2
Q

hypertension with no known underlying cause

A

essential hypertension

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3
Q

drugs that work by altering the normal reflexes that control blood pressure aimed at maintaining the blood pressure within normal limits to prevent the damage that hypertension can cause

A

anti-hypertensive drugs

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4
Q

subclasses of anti-hypertensive drugs

A

angiotensin-converting enzyme (ACE) inhibitors
angiotensin II receptor blockers (ARBs)
calcium-channel blockers
vasodilators

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5
Q

act in the lungs to prevent ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor and stimulator
of aldosterone release

A

ACE inhibitors

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6
Q

action leads to a decrease in BP an in
aldosterone secretion, with a resultant of?

A

slight increase in serum potassium and loss of serum sodium and fluid

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7
Q

Drugs Under ACE inhibitors?

A
  • Benazepril (Lotensin)
  • Captopril (Capoten)
  • Enalapril (Vasotec)
  • Enalaprilat (Vasotec IV)
  • Fosinopril (Monopril)
    *Lisinopril (Prinivil, Zestril)
  • Moexipril (Univasc)
  • Perindopril (Aceon)
  • Quinapril (Accupril)
  • Ramipril (Altace)
  • Trandolapril (Mavik)
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8
Q

for the treatment of heart failure and left ventricular dysfunction, ACE inhibitors can be taken with?

A

digoxin and diuretics

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9
Q

Contraindication for ACE inhibitors?

A

Allergy
Impaired Renal Function
Pregnancy
Lactation
Heart Failure
Salt/volume depletion

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10
Q

selectively bind with the angiotensin II receptors in vascular smooth
muscle and in the adrenal cortex to block vasoconstriction and the release of
aldosterone

A

Angiotensin II Receptor Blockers (ARBs)

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11
Q

Drugs under ARBs

A
  • Azilsartan (Edarbi)
  • Candesartan (Atacand)
  • Eprosartan (Teveten)
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Olmesartan (Benicar)
  • Telmisartan (Micardis)
  • Valsartan (Diovan)
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12
Q

These drugs are indicated to be used alone or in combination therapy for
the treatment of hypertension and for the treatment of heart failure in
patients who are intolerant to ACE inhibitors.

A

ARBs

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13
Q

They also slow the progression
of renal disease in patients with hypertension and type 2 diabetes

A

ARBs

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14
Q

ARBs are well
absorbed and undergo metabolism in the liver by
the?

A

cytochrome P450 system

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15
Q

ARBs cross the placenta and are excreted via?

A

urine and feces

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16
Q

ARBs contraindication?

A

Allergy
PRegnancy
Lactation
Presence of hepatic or renal dysfunction
Hypovolemia

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17
Q

The risk of decreased serum levels and loss of effectiveness
increases if the ARB is taken in combination with?

A

phenobarbital,
indomethacin, or rifamycin.

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18
Q

There may be a decrease in anticipated antihypertensive effects if
the ARBs is combined with

A

ketoconazole, fluconazole, or diltiazem

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19
Q

ARBs should not be used with ___ because of the potential for serious adverse effects

A

ACE inhibitors or renin inhibitors

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20
Q

These drugs inhibit the movement of calcium ions
across the membranes of myocardial and arterial muscle cells,
altering the action potential and blocking muscle cell contraction.

A

calcium-channel inhibitors

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21
Q

Drugs under calcium-channel blockers

A
  • Amlodipine (Norvasc)
  • Felodipine (Plendil)
  • Isradipine (DynaCirc, DynaCirc CR)
  • Nicardipine (Cardene, Cardene SR)
  • Diltiazem (Cardizem, Dilacor CR)
  • Nifedipine (Procardia XL)
  • Nisoldipine (Sular)
  • Verapamil (Calan SR)
  • Clevidipine (Cleviprex)
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22
Q

Calcium-channel blockers are also sometimes
used in the treatment of?

A

Raynaud’s disease and migraine headache

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23
Q

These calcium channel blockers are available in IV form for short-term
use when oral administration is not feasible

A

Nicardipine
Clevidipine

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24
Q

Contraindications of calcium-channel blockers

A

Allergy
Heart block or sick sinus syndrome
Renal or hepatic dysfunction
Pregnancy
Lactation

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25
Q

diltiazem calcium-channel blocker should not be taken with — cause it potentially serious effect to note which is an increase in serum levels and toxicity

A

cyclosporine

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26
Q

These anti-hypertensive drug act directly on vascular smooth muscle to cause muscle relaxation, leading to vasodilation and drop in BP.

A

vasodilators

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27
Q

Example of vasodilators

A

Diazoxide (Hyperstat)
* Hydralazine (Apresoline)
* Minoxidil (Loniten)
* Nitroprusside (Nitropress)

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28
Q

vasodilators that are used intravenously

A

Diazoxide and nitroprusside

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29
Q

vasodilator that is available for oral and intramuscular

A

hydralazine

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30
Q

contraindication of vasodilators

A

Allergy
Pregnancy
Lactation
Peripheral vascular disease, CAD, heart failure,
tachycardia
Functional hypoglycemia

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31
Q

Hydralazine can produce additive hypotensive effects when given with

A

adrenergic or other anti-hypertensive drugs

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32
Q

medications used to treat hypertension

A

anti-hypertensive drugs

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33
Q

specific receptors found in blood
vessels and in the adrenal gland that react with angiotensin II to cause
vasoconstriction and release of aldosterone.

A

angiotensin II receptors

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34
Q

common, often asymptomatic disorder in which systolic blood pressure persistently exceeds 140 mm Hg and/or diastolic pressure exceeds 90
mm Hg

A

hypertension

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35
Q

sustained blood pressure that is lower than that required to adequately perfuse all of the body’s tissues

A

hypotension

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36
Q

force that resists the flow of blood through the vessels, mostly determined by the arterioles, which contract to increase resistance; important in determining overall blood pressure

A

peripheral resistance

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37
Q

are drugs used to increase
the contractility of the heart muscle for patients experiencing heart failure

A

cardiotonic agents

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38
Q

subclasses of cardiotonic agents

A

cardiac glycoside
phosphodiesterase inhibitors

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39
Q

The cardiac glycosides were originally derived from the

A

foxglove or digitalis plant

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40
Q

e foxglove or digitalis plant were once
ground up to make

A

digitalis leaf

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41
Q

a cardiotonic drug subclass which is indicated for treating heart failure and irregular heartbeats

A

cardiac glycosides

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42
Q

drugs under cardiac glycoside

A

digoxin
digitoxin

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43
Q

it has a brand name called Lanoxin.

A

digoxin

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44
Q

digoxin is most
frequently it is used for

A

atrial fibrillation, atrial flutter,
and heart failure

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45
Q

is a cardiac glycoside used for the
treatment of heart failure and certain kinds of heart arrhythmia

A

digitoxin

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46
Q

It is a phytosteroid and is similar in
structure and effects to digoxin.

A

digitoxin

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47
Q

cardiac glycosides has a rapid onset of action and rapid absorption of ___ when taken orally, and ___ minutes
when given intravenously

A

30-120, 5-30

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48
Q

There is a risk of increased therapeutic effects and toxic effects of
cardiac glycosides if it is taken with

A

verapamil, amiodarone,
quinidine, quinine, erythromycin, tetracycline, or cyclosporine

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49
Q

Cardiac glycosides drugs may be less effective if it is combined
with

A

thyroid hormones, metoclopramide, or penicillamine

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50
Q

Absorption of oral cardiac glycosides may be decreased if it is taken with

A

cholestyramine, charcoal, colestipol, antacids, bleomycin, cyclophosphamide, or methotrexate

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51
Q

This belongs to a second class
of drugs that act as cardiotonic (inotropic) agents

A

phosphodiesterase inhibitors

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52
Q

phosphodiesterase inhibitors include

A

inamrinone (Inocor) and milrinone (Primacor)

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53
Q

Approved only for use in patients with HF who does not have been responsive to digoxin, diuretics, or vasodilators

A

phosphodiesterase inhibitors

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54
Q

phospodiesterase inhibitors that are used intravenously

A

Inamrinone and milrinone

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55
Q

enlargement of the heart, commonly seen with chronic hypertension, valvular disease, and heart failure

A

cardiomegaly

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56
Q

a disease of the heart muscle that leads to an enlarged heart and eventually to complete heart muscle failure and death

A

cardiomyopathy

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57
Q

discomfort with respirations, often with a feeling of anxiety and inability to breathe, seen with left-sided heart failure.

A

dyspnea

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58
Q

a condition in which the heart muscle fails to adequately pump
blood around the cardiovascular system, leading to a backup or congestion of
blood in the system

A

heart failure

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59
Q

blood-tinged sputum, seen in left-sided heart failure when blood
backs up into the lungs and fluid leaks out into the lung tissue

A

hemoptysis

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60
Q

getting up to void at night, reflecting increased renal perfusion with fluid
shifts in the supine position when person has gravity-dependent edema related to
heart failure; other medical conditions, including urinary tract infection, increase
the need to get up and void

A

nocturia

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61
Q

difficulty breathing when lying down, often referred to by the
number of pillows required to allow a person to breath comfortably

A

orthopnea

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62
Q

effect resulting in an increased force of contraction

A

positive inotropic

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63
Q

severe left-sided heart failure with backup of blood into the lungs, leading to loss of fluid into the lung tissue

A

pulmonary edema

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64
Q

rapid and shallow respirations, seen with left sided heart failure

A

tachypnea

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65
Q

also known as
cardiac dysrhythmia medications, are a
group of pharmaceuticals that are used to
suppress abnormal rhythms of the heart
(cardiac arrhythmias), such as atrial
fibrillation, atrial flutter, ventricular
tachycardia, and ventricular fibrillation

A

antiarrhythmic agents

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66
Q

classes of antiarrhythmic agents

A

class 1,2,3,4

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67
Q

antiarrhythmics that are fast sodium channel blockers

A

class 1

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68
Q

class 1a antiarrhythmic drugs

A

Disopyramide (Norpace)
Procainamide (Pronestyl)
quinidine (Generic)

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69
Q

class 1b antiarrhythmics

A

lidocaine (Xylocaine)
mexiletine (Mexitil)

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70
Q

class 1c antiarrhythmics

A

Flecainide (Tambocor)
Propafenone (Ryhtmol)

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71
Q

antiarrhythmic drugs preferable in conditions such as tachycardia, in which the sodium gates are open frequently

A

class 1a

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72
Q

Also for the treatment of potentially life-threatening ventricular arrhythmias and should not be used to treat other arrhythmias because of the risk of a proarrhythmic effect

A

class 1a antiarrhythmic drugs

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73
Q

class 1a antiarrhythmic drugs should not be used to treat other arrhythmias because of the risk of

A

proarrhythmic effect

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74
Q

class 1 antiarrhythmic available in oral form

A

Disopyramid, Flecainide, and propafenone

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75
Q

class 1a available in intramuscular (IM), intravenous (IV), and oral forms

A

Procainamide and Quinidine

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76
Q

class 1b antiarrythmic that is administered by the IM or IV route, and can also be
given as a bolus injection in emergencies when monitoring is not available to document the exact arrhythmia

A

Lidocaine

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77
Q

class 1b antiarrhythmics that is an oral drug administered to adults only

A

Mexiletine

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78
Q

antiarrhythmics that are conventional beta blockers

A

class 2

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79
Q

Drug under Class II Antiarrhythmics

A

● Acebutolol
● Esmolol
● Propranolol

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80
Q

these drugs competitively block
beta-receptor sites in the heart and kidneys

A

class 2 antiarrythmics

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81
Q

class 2 antiarrhythmics are indicated for the treatment of

A

supraventricular tachycardias and PVCs

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82
Q

Acebutolol is administered

A

orally

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83
Q

Esmolol is administered

A

intravenously

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84
Q

Propranolol is administered

A

orally or intravenously

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85
Q

The use of class 2 antiarrhythmic drugs is contraindicated in the presence
of

A

sinus bradycardia (rate less than 45 beats/min)
AV block
cardiogenic shock
HF
asthma
respiratory depression
diabetes
thyroid dysfunction

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86
Q

these drugs act by blocking depolarizing currents and thereby prolonging the
effective refractory period of the myocardium.

A

class 3 antiarrhythmics

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87
Q

drugs under class 3 antiarrhythmics

A

● Amiodarone
● Dofetilide
● Ibutilide
● sotalol

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88
Q

these drugs block potassium channels and slow the outward movement of potassium during phase 3 of the action potential, prolonging it. All of these drugs are proarrhythmic and have the potential of inducing arrhythmias

A

class 3 antiarrhythmics

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89
Q

class 3 antiarrhythmic drug that is indicated for initiation of treatment
and prophylaxis of frequently recurring ventricular fibrillation and hemodynamically unstable ventricular tachycardia in patients refractory to
other therapy

A

Amiodarone HCl injection

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90
Q

Amiodarone is available in

A

an oral or intravenous form

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91
Q

Dofetilide and sotalol are administered only in

A

oral form

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92
Q

Ibutilide is given

A

IV

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93
Q

antiarrhythmic drugs that are slow non-dihydropyridine calcium channel blockers

A

class 4 antiarrhythmics

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94
Q

Drug under Class IV Antiarrhythmics

A

● Diltiazem
● Verapamil

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95
Q

these antiarrhythmic drugs block the movement of calcium ions across the
cell membrane, depressing the generation of action potentials and delaying
phases 1and 2 of repolarization, which slows automaticity and conduction.

A

class 4 antiarrhythmics

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96
Q

diltiazem and verapamil are used as

A

antihypertensives and to treat
angina

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97
Q

● Diltiazem is administered .

A

intravenously

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98
Q

When used as an antiarrhythmic, verapamil is used

A

intravenously

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99
Q

drugs that affect the action potential of cardiac cells and are used to
treat arrhythmias and restore normal rate and rhythm

A

antiarrhythmics

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100
Q

slower-than-normal heart rate (usually less than60 beats/min)

A

bradycardia

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101
Q

the amount of blood the heart can pump per beat; influenced by the
coordination of cardiac muscle contraction, heart rate, and blood return to the heart

A

cardiac output

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102
Q

large research study run by the National
Heart and Lung Institute that found that long-term treatment of arrhythmias may havea questionable effect on mortality, and in some cases actually lead to increased cardiac death; basis for the current indication for antiarrhythmics (short-term use to treat life-threatening ventricular arrhythmias).

A

Cardiac Arrhythmia Suppression Test (CAST)

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103
Q

-blocks to conduction of an impulse through the cardiac conduction
system; can occur at the atrioventricular node, interrupting conduction from the
atria into the ventricles, or in the bundle branches within the ventricles,preventing
the normal conduction of the impulse.

A

heart blocks

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104
Q

the study of the forces moving blood throughout the cardiovascular

A

hemodynamics

105
Q

drugs are used to reduce ischemia by increasing the delivery of oxygen-rich blood to cardiac tissues or by reducing oxygen consumption by the coronary vessels.
Either of these mechanisms can reduce ischemia and lead to a decrease in anginal pain.

A

antianginal agents

106
Q

antianginal agents subclasses

A

nitrites and nitrates
beta blockers
calcium channel blockers

107
Q

antianginals that work mainly by decreasing venous return to the heart (preload) and decreasing systemic vascular resistance (afterload)

A

nitrites and nitrates

108
Q

are the rapid- and long-acting nitrates available for clinical use

A

Amyl nitrite (rapid acting)
Nitroglycerin (both rapid and long acting
Isosorbide dinitrate (both rapid and long acting)
Isosorbide mononitrate (primarily long acting)

109
Q

antianginal agent that are used to treat stable, unstable, and vasospastic (Prinzmetal) angina.

A

nitrates

110
Q

Rapid-acting dosage forms of nitrates are most often

A

sublingual nitroglycerin tablets, or an intravenous drip

111
Q

contraindication of nitrites and nitrates

A

severe anemia
allergy to nitrates
head trauma and cerebral hemorrhage
pregnancy and lactation
renal and hepatic disease

112
Q

Nitrate antianginal drugs can produce additive hypotensive effects when taken in combination with

A

alcohol
beta blockers
calcium channel blockers,
phenothiazines
erectile dysfunction drugs

113
Q

erectile dysfunction drugs examples

A

sildenafil (Viagra) , tadalafil, and vardenafil.

114
Q

sildenafil should not be taken with erectile dysfunction drugs coz it will ___

A

cause dangerous drop in bp

115
Q

Nitroglycerin is contraindicated in patients who have

A

severe anemia
increased intracranial pressure
hypersensitivity
circulatory failure

116
Q

these antianginals help by slowing the heart rate and decreasing
contractility, thereby decreasing oxygen demands

A

beta blockers

117
Q

beta blockers approved as antianginal drugs are

A

atenolol,
metoprolol,
nadolol,
propranolol

118
Q

these drugs are most effective in the treatment of exertional
angina (i.e., that caused by exercise).

A

beta blockers

119
Q

For an individual (often elderly) with significant angina, “exercise” may simply be carrying out the activities of daily living, such as

A

bathing
dressing
cooking
housekeeping

120
Q

The beta blockers are also approved for the treatment of

A

MI
hypertension
cardiac dysrhythmias
essential tremor

121
Q

these drugs decrease calcium influx into the smooth muscle, causing vascular relaxation. This either reverses or prevents
the spasms of coronary vessels that cause the anginal pain associated with Prinzmetal or chronic angina.

A

calcium-channel blockers

122
Q

There are three chemical classes of calcium channel blockers (CCBs)

A

phenylalkylamines, benzothiazepines, and
dihydropyridines, commonly represented by verapamil, diltiazem, and amlodipine, respectively

123
Q

these are considered first-line
drugs for the treatment of such conditions as angina, hypertension, and
supraventricular tachycardia

A

calcium-channel blockers

124
Q

The dihydropyridine CCB nimodipine is indicated solely for

A

cerebral artery spasms
associated with aneurysm rupture

125
Q

CCBs are also used for the
short-term management of

A

atrial fibrillation and flutter, migraine headaches, and Raynaud’s disease (a type of peripheral vascular disease)

126
Q

contraindications of CCB

A

drug allergy
acute MI
second or third-degree AV block (unless the patient has a pacemaker)
hypotension

127
Q

Chest pain that occurs when the heart’s supply of blood carrying oxygen is insufficient to meet the demands of the heart

A

angina pectoris

128
Q

A common form of arteriosclerosis involving deposits of fatty,
cholesterol-containing material (plaques) within arterial walls

A

atherosclerosis

129
Q

Chest pain that is primarily caused by atherosclerosis, which results in a long-term but relatively stable level of obstruction in one or more coronary arteries

A

chronic stable angina

130
Q

Arteries that deliver oxygen to the heart muscle

A

coronary arteries

131
Q

Any one of the abnormal conditions that can affect the arteries of the heart and produce various pathological effects,
especially a reduced supply of oxygen and nutrients to the myocardium

A

coronary artery disease

132
Q

Poor blood supply to an organ

A

ischemia

133
Q

Poor blood supply to the heart via the coronary arteries

A

ischemic heart disease

134
Q

Necrosis of the myocardium following interruption of
blood supply; it is almost always caused by atherosclerosis of the coronary
arteries and is commonly called a heart attack

A

Myocardial Infarction

135
Q

A rapid heartbeat caused by a variety of autonomic nervous
system effects, such as blood pressure changes, fever, or emotional stress.

A

reflex tachycardia

136
Q

Early stage of progressive coronary artery disease.

A

unstable angina

137
Q

induced myocardial chest pain caused by spasms of the coronary arteries; also referred to as Prinzmetal or variant angina.

A

vasospastic angina ischemia

138
Q

these drugs lower serum levels of
cholesterol and various lipids. These include bile acid sequestrants, HMG-CoA reductase inhibitors, and a
cholesterol absorption inhibitor

A

lipid-lowering agents

139
Q

subclasses of lipid lowering agents

A

bile acid sequestrants
HMG-COA Reductase Inhibitors/ Statins
cholesterol absorption inhibitors

140
Q

these drugs prevent the reabsorption of bile salts, which are very high in cholesterol. Consequently, the liver will pull
cholesterol from the blood to make new bile acids, lowering the
serum cholesterol level.

A

bile acid sequestrants

141
Q

drugs under bile acid sequestrants

A

● Cholestyramine (Questran)
● Colestipol (Colestid)
● Colesevelam (WelChol)

142
Q

these drugs bind with bile acids in the intestine to form an insoluble complex that is then excreted in the feces.

A

bile acid sequestrants

143
Q

these contain
high levels of cholesterol.

A

bile acids

144
Q

the liver use it to make more bile acids

A

cholesterol

145
Q

This is used to treat
pruritus associated with partial biliary obstruction.

A

Cholestyramine

146
Q

Cholestyramine is a power that must be mixed with liquids
and taken up to

A

6x a day

147
Q

Colestipol is available in

A

powder and tablet form

148
Q

Colestipol is taken only

A

4x a day

149
Q

Colesevelam is available in

A

tablet form

150
Q

Colesevelam is taken only

A

once or 2x a day

151
Q

Bile Acid sequestrants are contraindicated in the presence of allergy to

A

any bile acid sequestrant

152
Q

bile acid sequestrants also are contraindicated in the following
conditions:

A

complete biliary obstruction
abnormal intestinal function
pregnancy or lactation

153
Q

bile acid sequestrants decrease or
delay the absorption of

A

thiazide diuretics
digoxin
warfarin
thyroid hormones
corticosteroids

154
Q

Consequently, any
of these drugs should be taken ____
after the bile acid sequestrant

A

1hour before or 4 to 6 hours

155
Q

these drugs block the enzyme HMG-CoA reductase, resulting in lower serum cholesterol levels, a resultant breakdown of LDLs, and a slight increase in HDLs

A

HMG-CoA reductase inhibitors, or statins

156
Q

Drug under HMG-COA Reductase inhibitors/ statins

A

● Artovastatin (Lipitor)
● Fluvastatin (Lescol)
● Lovastatin (Mevacor)
● Pravastatin (Pravachol)
● Rosuvastatin (Crestor)
● Simvastatin (Zocor)

157
Q

The early rate-limiting step in the synthesis of cellular cholesterol
involves the enzyme

A

HMG-COA reductase

158
Q

if HMG-CoA reductase is blocked, what happens

A

serum cholesterol and LDL levels decrease because more LDLs are absorbed by the cells for processing into cholesterol

159
Q

these enzymes block HMG-CoA reductase from completing the
synthesis of cholesterol

A

HMG-CoA reductase inhibitor

160
Q

(one of the oldest HMG-CoA drugs available

A

pravastatin
lovastatin

161
Q

are indicated for patients with documented CAD to slow
progression of the disease

A

simvastatin

162
Q

these statins are used to prevent a first myocardial infarction (MI) in patients who have multiple risk factors for developing CAD.

A

pravastatin
lovastatin
simvastatin
atorvastatin

163
Q

The peak effect of statin drugs is usually seen

A

within 2 to 4 weeks

164
Q

a breakdown of muscles whose waste
products can injure the glomerulus and cause acute renal failure, has also occurred with the use of all of these drugs

A

Rhabdomyolysis

165
Q

The risk of rhabdomyolysis increases if any of statin drugs is combined with

A

erythromycin
cyclosporine
gemfibrozil
niacin
antifungal drugs

166
Q

Serum levels and the risk of toxicity increase if statin drugs are
combined with

A

grapefruit juice

167
Q

works in the brush border of the small intestine to prevent the absorption of dietary cholesterol, which leads to increased clearance of cholesterol by
the liver and a resultant fall in serum cholesterol.

A

cholesterol absorption inhibitor ezetimibe

168
Q

these are very important parts of
the overall treatment of a patient receiving a cholesterol absorption inhibitor

A

Change in diet and increased exercise

169
Q

this drug works in the brush border of the small intestine to decrease
the absorption of dietary cholesterol from the small intestine.

A

ezetimibe

170
Q

Ezetimibe is absorbed well after oral administration, reaching
peak levels in

A

4-6 hours

171
Q

ezetimibe is metabolized in the liver and the small intestine, with a half-life of

A

22 hours

172
Q

The risk of elevated serum levels of ezetimibe increases if it is given with

A

cholestyramine
fenofibrate
gemfibrozil
antacids

173
Q

ezetimibe should be taken
at least___ before or ___ after the other drugs.

A

2 hours before
4 hours after

174
Q

The risk of toxicity also increases if ezetimibe is combined with

A

cyclosporine

175
Q

If ezetimibe is combined with any fibrate, the risk of ___ increases.

A

cholethiasis

176
Q

___ levels increase
in a patient who is also taking ezetimibe

A

warfarin

177
Q

general term used for drugs used to lower lipid levels in the blood.

A

Antihyperlipidemic agents

178
Q

cholesterol-containing acids found in the bile that act like detergents
to break up fats in the small intestine

A

bile acids

179
Q

necessary component of human cells that is produced and
processed in the liver, then stored in the bile until stimulus causes the
gallbladder to contract and send the bile into the duodenum via the common
bile duct; a fat that is essential for the formation of steroid hormones and cell
membranes; it is produced in cells and taken in by dietary sources

A

cholesterol

180
Q

carrier for lipids in the bloodstream, consisting of proteins, lipids,
cholesterol, and so forth.

A

chylomicron

181
Q

endogenous substances that activate nervous system receptors that are important in the regulation of appetite, food intake, and metabolism.

A

Endocannabinoids

182
Q

loosely packed chylomicron containing fats, able to absorb fats and fat remnants in the periphery; thought to have a protective
effect, decreasing the development of coronary artery disease.

A

HDL

183
Q

enzyme that regulates the last step in cellular cholesterol synthesis

A

HMG-CoA reductase

184
Q

HMG-CoA reductase stands for

A

hydroxymethylglutaryl-coenzyme A reductase

185
Q

increased levels of lipids in the serum, associated with increased
risk of coronary artery disease development.

A

hyperlipidemia

186
Q

tightly packed fats that are thought to contribute to the development of coronary artery disease when remnants left over from the LDL are processed in the arterial lining.

A

LDL

187
Q

a collection of factors, including insulin resistance, abdominal obesity, low high-density lipoprotein and high triglyceride levels, hypertension, and proinflammatory and prothrombotic states, that increase the
incidence of coronary artery disease

A

metabolic syndrome

188
Q

factors that have been identified as increasing the risk of the
development of a disease; for coronary artery disease, risk factors include
genetic predisposition, gender, age, high-fat diet, sedentary lifestyle, gout,
hypertension, diabetes, and estrogen deficiency

A

risk factors

189
Q

subclasses of drugs affecting blood coagulation

A

anticoagulants
antiplatelet drugs
thrombolytic drugs

190
Q

are drugs that interfere with the normal coagulation process
by interfering with the clotting cascade and thrombin formation

A

anticoagulants

191
Q

Drug under Anticoagulants

A

·antithrombin III (Thrombate III)
·argatroban (Acova)
·bivalirudin (Angiomax)
·desirudin (Iprivask)
·fondaparinux (Arixtra)
·heparin (generic)
· warfarin (Coumadin)

192
Q

these drugs interfere with the normal cascade of events
involved in the clotting process

A

anticoagulants

193
Q

these block the formation of thrombin from prothrombin

A

Heparin, argatroban, and bivalirudin

194
Q

Adverse effects of anticoagulants can range from

A

bleeding gums with tooth brushing to severe internal hemorrhage

195
Q

Warfarin has been associated with

A

alopecia
dermatitis
bone marrow depression

196
Q

what happens if heparin is combined with oral anticoagulants, salicylates, penicillins, or cephalosporins

A

increased bleeding

197
Q

this can occur if heparin is combined with nitroglycerin

A

decreased anticoagulation

198
Q

To treat heparin drug overdose,

A

protamine sulfate

199
Q

used to treat warfarin overdose

A

Vitamin K

200
Q

this drug decrease the formation of the platelet plug by decreasing the
responsiveness of the platelets to stimuli that would cause them to stick and
aggregate on a vessel wall

A

antiplatelet agents

201
Q

Drug under anticoagulant

A

·abciximab (ReoPro)
·anagrelide (Agrylin)
·aspirin
·cilostazol (Pletal)
·clopidogrel (Plavix)
·dipyridamole (Persantine)
·eptifibatide (Integrilin)
·sulfinpyrazone (Anturane)
·ticlopidine (Ticlid)
·tirofiban (Aggrastat).

202
Q

this inhibit platelet adhesion and aggregation by blocking receptor sites on the platelet membrane, preventing platelet–platelet interaction or the interaction of platelets with other clotting chemicals.

A

antiplatelet agents

203
Q

One drug ___
blocks the production of platelets in the bone marrow.

A

anagrelide

204
Q

These agents are used
effectively to treat cardiovascular diseases that are prone to produce occluded
vessels; for the maintenance of venous and arterial grafts; to prevent
cerebrovascular occlusion; and as adjuncts to thrombolytic therapy in the
treatment of myocardial infarction (MI) and the prevention of reinfarction after
MI. T

A

antiplatelet

205
Q

these drugs break down the thrombus that has been formed by
stimulating the plasmin system

A

thrombolytic agents

206
Q

drugs under thrombolytic agents

A

·alteplase (Activase)
·reteplase (Retavase)
·streptokinase (Streptase)
·tenecteplase (TNKase)
·urokinase (Abbokinase)

207
Q

All of the
drugs that are available for this purpose work to activate the
natural anticlotting system—conversion of plasminogen to ___

A

plasmin

208
Q

The thrombolytics are effective only if
the patient has ___ in the plasma

A

plasminogen

209
Q

The most common adverse effect associated with the
use of thrombolytic agents is

A

bleeding

210
Q

The risk of hemorrhage increases if thrombolytic agents are
used with

A

any anticoagulant or antiplatelet drug

211
Q

Arrange to administer ___ to
reduce mortality associated with acute MI as soon as
possible after the onset of symptoms

A

tenecteplase or streptokinase

212
Q

what to do with heparin if it is being given
administration of a thrombolytic agent

A

discontinue

213
Q

drugs that block or inhibit any step of the coagulation process,
preventing or slowing clot formation

A

anticoagulants

214
Q

drugs that interfere with the aggregation or clumping of
platelets to form the platelet plug

A

antiplatelet agents

215
Q

the process of blood’s changing from a fluid state to a solid state
to plug injuries to the vascular system

A

coagulation

216
Q

drugs that lyse, or break down, a clot that has formed; these drugs activate the plasminogen mechanism to dissolve fibrin threads

A

thrombolytic agents

217
Q

drugs used to treat anemia subclasses

A

erythropoiesis stimulating agents
agents used for iron-deficiency anemia
agents used for other anemias

218
Q

A substance that stimulates the bone marrow to make more red blood cells

A

erythropoiesis stimulating agents

219
Q

are used to treat anemia caused by chronic
kidney failure, some anticancer drugs, and certain treatments for HIV. They may also be used to lower the number of blood transfusions needed during and after
certain major surgeries

A

erythropoiesis stimulating agents

220
Q

drugs under erythropoiesis stimulating agents

A

● Darbepoetin alfa
● Epoetin alfa
● Methoxy polyethylene glycol-epoetin beta

221
Q

Is a man-made form of a
protein that helps your body produce red blood-cells. It is used to treat anemia caused by chemotherapy or chronic
kidney disease.

A

Darbepoetin alfa (Aranesp)

222
Q

This medicine is used to treat anemia
associated with renal failure and patients on dialysis; reduction in
need for transfusions in surgical patients; treatment of anemia
associated with AIDS therapy; treatment of anemia associated
with cancer chemotherapy

A

Epoetin alfa (Epogen)-

223
Q

Used to
treat anemia associated with chronic renal failure, including in
dialysis patients

A

Methoxy polyethylene glycol-epoetin beta (Mircera)

224
Q

Generally indicated in conditions where there is

A

impaired red blood
cell production

225
Q

The two primary FDA approved indications for ESAs are

A

anemia secondary to chronic kidney disease
chemotherapy-induced anemia in patients with cancer

226
Q

All ESA drugs are contraindicated in the presence of

A

uncontrolled hypertension

227
Q

drugs under agents used for iron-deficiency anemia

A

● Ferrous fumarate (Feostat)
● Ferrous gluconate (Fergon)
● Ferrous sulfate (Feosol)
● Ferrous sulfate exsiccated (Feratab, Slow FE)
● Iron dextran (InFeD)

228
Q

Treatment of iron deficiency in
patients undergoing chronic hemodialysis or nondialysis patients with renal failure who are also receiving supplemental erythropoietin therapy

A

Iron sucrose (Venofer)

229
Q

Treatment of iron deficiency in patients undergoing chronic hemodialysis who are also receiving supplemental
erythropoietin therapy

A

Sodium ferric gluconate complex (Ferrlecit)

230
Q

agents used for iron-deficiency anemia may also be used as adjunctive therapy in patients receiving an

A

erythropoiesis-stimulating drug

231
Q

is a parenteral form of iron given by the Z-track method

A

Iron dextran

232
Q

agents used for iron-deficiency anemia that are available for oral administration

A

Ferrous fumarate
ferrous gluconate
ferrous sulfate

233
Q

agents used for iron-deficiency anemia are contraindicated in the following conditions

A

hemochromatosis
(excessive iron)
hemolytic anemias
normal iron balance
peptic ulcer
colitis
regional enteritis

234
Q

Iron absorption decreases if iron preparations are taken with

A

antacids,
tetracyclines, or cimetidine

235
Q

Increased iron levels occur if iron preparations are
taken with

A

chloramphenicol

236
Q

AGENTS FOR MEGALOBLASTIC ANEMIAS

A
  1. Folic Acid Derivatives
  2. Vitamin B12
237
Q

AGENT FOR SICKLE CELL ANEMIA

A

Hydroxyurea

238
Q

a synthetic form of folate, a B vitamin, used
to treat or prevent low folate levels, which can lead to certain types of anemia or birth defects.

A

Folic acid (Folvite)

239
Q

used as “leucovorin rescue” after
chemotherapy, allowing non cancerous cells to survive the chemotherapy; used with fluorouracil for palliative treatment of
colorectal cancer

A

Leucovorin (Wellcovorin)

240
Q

Folic Acid Derivatives

A

Folic acid (Folvite)
Leucovorin (Wellcovorin)
Levoleucovorin

241
Q

used in adults and children to prevent harmful effects of methotrexate (Trexall) when methotrexate is used to treat osteosarcoma (cancer that forms in bones)

A

Levoleucovorin

242
Q

a man-made form of vitamin B12 used
to prevent and treat low blood levels of this vitamin.

A

Cyanocobalamin (Nascobal)

243
Q

a manufactured version of the
vitamin B12. It is used to treat and prevent vitamin B12 deficiency anemia

A

Hydroxocobalamin (Hydro-Crysti-12)

244
Q

Vitamin B12 drugs

A

Cyanocobalamin (Nascobal)
Hydroxocobalamin (Hydro-Crysti-12)

245
Q

Megaloblastic anemia is treated with folic acid and vitamin B12 tissue.

A

folic acid and vitamin B12 tissue.

246
Q

Vitamin B12 is also necessary for
maintenance of the

A

myelin sheat in nerve tissue

247
Q

Folate deficiency may result from increased loss of

A

folate

248
Q

False low serum and red cell folate levels may occur if the patient has been taking
antibiotics, such as tetracycline, which suppress the growth of

A

Lactobacillus casei

249
Q

a cytotoxic antineoplastic drug that is also used to treat leukemia, ovarian cancer and melanoma. It
interferes with the growth of cancer cells, which are eventually destroyed by the body.

A

Hydroxyurea

250
Q

Reduction of frequency of painful crisis and need for blood
transfusions in adult patients with

A

sickle cell anemia

251
Q

used to treat sickle cell anemia

A

hydroxyurea

252
Q

hydroxyurea has a half life of

A

3-4 hours

253
Q

hydroxyurea has a peak levels of

A

1-4 hours

254
Q

disorder involving too few red blood cells (RBCs) or ineffective RBCs that can
alter the blood’s ability to carry oxygen

A

anemia

255
Q

RBCs, responsible for carrying oxygen to the tissues and removing
carbon dioxide; they have no nucleus and live approximately 120 days

A

erythrocytes

256
Q

process of RBC production and life cycle; formed by megaloblastic cells in the bone marrow, using iron, folic acid, carbohydrates, vitamin B12, and amino
acids; they circulate in the vascular system for about 120 days and then are lysed and
recycled

A

erythropoiesis

257
Q

glycoprotein produced by the kidneys, released in response to
decreased blood flow or oxygen tension in the kidney; controls the rate of RBC
production in the bone marrow

A

erythropoietin

258
Q

low RBC count with low iron available because of high
demand, poor diet, or poor absorption; treated with iron replacement

A

iron-deficiency anemia

259
Q

anemia caused by lack of vitamin B12 and/or folic acid, in which RBCs are fewer in number and have a weak stroma and a short lifespan; treated by
replacement of folic acid and vitamin B12

A

megaloblastic anemia

Pharmacology (9 decks)

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