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Pharmacology Exam 2 > Cardiovascular/Renal 1 > Flashcards

Cardiovascular/Renal 1 Flashcards

1
Q

Name 2 Alpha-2 Agonists

A

Clonidine
Methyldopa

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2
Q

A-2 Agonist MOA

A

Stimulates A-2 adrenergic receptors in the brain, reducing sympathetic nervous system outflow, decreasing BP and HR.

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3
Q

A-2 Agonist SE

A

Dry mouth
Sedation
Constipation (Clonidine)
Hemolytic anemia (Methyldopa)

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4
Q

A-2 Agonist CI

A

Severe coronary insufficiency (Clonidine)
Active liver disease (Methyldopa)
Concurrent use w/ MAOIs (Methyldopa)

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5
Q

A-2 Agonist DDI

A

Enhanced sedation w/ alcohol
Iron supplements affect absorption (Methyldopa)
Tricyclic antidepressants decrease antihypertensive effects of Clonidine

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6
Q

Name 3 Alpha-1 Adrenergic Antagonists

A

Prazonsin
Doxazosin
Terazosin

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7
Q

A-1 Adrenergic Antagonist MOA

A

Block alpha1 receptors on vascular smooth muscle, leading to vasodilation and reduced blood pressure.

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8
Q

A-1 Adrenergic Antagonist SE

A

Dizziness, palpitations, orthostatic hypotension.

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9
Q

A-1 Adrenergic Antagonist CI

A

Known hypersensitivity
Caution in patients with congestive heart failure.

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10
Q

A-1 Adrenergic Antagonist DDI

A

Additive effects with other hypertensives, potential for severe hypotension with phosphodiesterase inhibitors.

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11
Q

2 Types of Beta Adrenergic Antagonists:
Selective vs. Non-selective

A

Selective: Block only beta1 receptors (except at really high doses).
Nonselective: Block both beta1 and beta2.

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12
Q

Name 3 Selective B Adrenergic Antagonists.

A

Metoprolol
Atenolol
Nebivolol

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13
Q

Selective B Adrenergic Antagonist MOA

A

Preferentially block beta1-adrenergic receptors in the heart, reducing cardiac output to lower blood pressure and heart rate.

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14
Q

Selective B Adrenergic Antagonist SE

A

Dizziness, bradycardia, fatigue, and depression.

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15
Q

Selective B Adrenergic Antagonist CI

A

Severe heart failure
AV block
Bradycardia

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16
Q

Selective B Adrenergic Antagonist DDI

A

Increased risk of bradycardia with digitalis, altered response with antidiabetics.

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17
Q

Nebivolol MOA

A

Blocks beta1 cardiac receptors with additional vasodilatory effects due to nitric oxide release.

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18
Q

Nebivolol SE

A

Headache, fatigue, dizziness, and nausea.

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19
Q

Nebivolol CI

A

Severe liver impairment, acute heart failure.

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20
Q

Nebivolol DDI

A

Potentiated effects with other beta blockers, interaction with CYP2D6 inhibitors (such as some antidepressants).

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21
Q

Name 2 Nonselective B Adrenergic Antagonists

A

Propranolol
Nadolol

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22
Q

Nonselective B Adrenergic Antagonist MOA

A

Block beta1 and beta2 receptors, reducing heart rate, force of contraction, and conduction through AV node.

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23
Q

Nonselective B Adrenergic Antagonist SE

A

Fatigue, cold extremities, sleep disturbances, and bronchospasm.

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24
Q

Nonselective B Adrenergic Antagonist CI

A

Asthma, chronic obstructive pulmonary disease, severe bradycardia.

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25
Q

Nonselective B Adrenergic Antagonist DDI

A

Can enhance effects of other beta blockers and interact with insulin or oral hypoglycemics masking signs of hypoglycemia.

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26
Q

Name 2 combined A and B Adrenergic Antagonists

A

Carvedilol
Labetolol

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27
Q

A/B Adrenergic Antagonist MOA

A

Blocks alpha1 and beta receptors, reducing heart rate, blood pressure, and vascular resistance.

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28
Q

A/B Adrenergic Antagonist SE

A

Dizziness, fatigue, hypotension, weight gain, potential for heart failure.

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29
Q

A/B Adrenergic Antagonist CI

A

Asthma, bronchospastic disease, severe hepatic impairment
Severe bradycardia, overt cardiac failure

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30
Q

A/B Adrenergic Antagonist DDI

A

Can alter effects of antidiabetic drugs
Can enhance effects of CNS depressants

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31
Q

Renin-Angiotensin System Inhibitors: 2 Types

A

Angiotensin Converting Enzyme (ACE) inhibitors
Angiotensin Receptor Blockers (ARBs)

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32
Q

Name 5 ARBs

A

Losartan
Candesartan
Olmesartan
Telmisartan
Valsartan

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33
Q

ARB MOA

A

Blocks the angiotensin II AT1 receptor, preventing angiotensin II from exerting its vasoconstrictive and aldosterone-secreting effects.

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34
Q

ARB SE

A

Dizziness, hyperkalemia, mild renal impairment, and lower risk of cough or angioedema compared to ACEIs.

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35
Q

ARB CI

A

History of angioedema, bilateral renal artery stenosis, pregnancy.

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36
Q

ARB DDI

A

Reduced effect with NSAIDs, increased levels with CYP450 inhibitors.

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37
Q

Name 5 ACE Inhibitors

A

Lisinopril
Captopril
Enalapril
Benazepril
Ramipril

38
Q

ACEs MOA

A

Inhibits angiotensin-converting enzyme, decreasing production of angiotensin II, leading to vasodilation and reduced blood pressure.
Enalapril and Benazepril are prodrugs.

39
Q

ACEs SE

A

Dry cough, hyperkalemia, renal impairment, hypotension, and angioedema.

40
Q

ACEs CI

A

History of angioedema, bilateral renal artery stenosis, pregnancy.

41
Q

ACEs DDI

A

NSAIDs (may reduce antihypertensive effect), diuretics (risk of acute renal failure), lithium (increases lithium toxicity), anything that raises K levels.
Enalapril- Risk of increased serum levels of digoxin and lithium.

42
Q

Classes of Antiarrhythmics

A

Cardiac Glycosides

Class I-IV Antiarrhythmic

Class I has 3 subcategories (IA, IB, IC)

43
Q

Name 1 Cardiac Glycoside

A

Digoxin

44
Q

Digoxin MOA

A

Strong inhibitor of the sodium-potassium pump, resulting in increased intracellular sodium and calcium, enhancing inotropy.

45
Q

Digoxin SE

A

N/V
Fatigue, confusion
Visual disturbances
Arrhythmias

46
Q

Digoxin CI

A

AV block
RV failure
Electrolyte abnormalities

47
Q

Digoxin DDI

A

Interacts with drugs that alter electrolyte balance
Antiarrhythmics can decrease its clearance, leading to toxicity.

48
Q

Name 1 Class IA Antiarrhythmic

A

Disopyramide- Sodium channel blocker; reduces rate of ectopic foci firing and slows conduction

49
Q

Name 1 Class IB Antiarrhythmic

A

Mexiletine- Blocks both activated and inactivated sodium channels, more effective in depolarized or injured tissue.

50
Q

Name 2 Class IC Antiarrhythmic

A

Flecainide
Propafenone
Blocks sodium channels during phase 0 of the action potential, used for severe ventricular arrhythmias.

51
Q

Name 1 Class II Antiarrhythmic

A

Propranolol- Blocks beta-adrenergic receptors, reducing cardiac workload and oxygen demand.
Depresses phase 4 depolarization

52
Q

Name 3 Class III Antiarrhythmics

A

Amiodarone
Dronedarone
Sotalol
Prolongs action potential and refractory period, mainly by blocking potassium channels.
Prolongation of phase 3 (repolarization).

53
Q

Name 2 Class IV Antiarrhythmics

A

Diltiazem
Verapamil
Blocks calcium channels, reducing the force of cardiac contraction, slowing heart rate.
Depresses phase 4 depolarization and lengthens phases 1 and 2 of repolarization.

54
Q

Vasodilator Types

A

Drugs using Nitric Oxide

Potassium channel stimulants

CCBs

55
Q

Drugs acting through NO: Name 1

A

Hydralazine

56
Q

Hydralazine MOA

A

Directly relaxes arterial smooth muscle, decreasing systemic vascular resistance and arterial blood pressure.

57
Q

Hydralazine SE

A

Headache, palpitations, flushing, reflex tachycardia; long-term use can lead to a lupus-like syndrome.

58
Q

Hydralazine CI

A

Coronary artery disease (risk of reflex tachycardia), mitral valve rheumatic heart disease.

59
Q

Hydralazine DDI

A

Increased risk of hypotension with other antihypertensives; NSAIDs may reduce its antihypertensive effects.

60
Q

Potassium channel stimulants: Name 1

A

Minoxidil

61
Q

Minoxidil MOA

A

Potent arteriolar vasodilator; decreases systemic vascular resistance and arterial pressure.

62
Q

Minoxidil SE

A

Hypertrichosis (excessive hair growth), pericardial effusion, tachycardia, nausea, edema.

63
Q

Minoxidil CI

A

Pheochromocytoma

64
Q

Minoxidil DDI

A

Increased risk of orthostatic hypotension with central nervous system depressants; concomitant use with beta-blockers to prevent reflex tachycardia.

65
Q

CCBs: 2 Types

A

Dihydropyridines

Non-dihydropyridines

66
Q

Name 3 Dihydropyridines

A

Nifedipine
Amlodipine
Felodipine

67
Q

Dihydropyridine MOA

A

Blocks calcium channels in vascular smooth muscle, leading to vasodilation.

68
Q

Dihydropyridine SE

A

Flushing, headache, peripheral edema, reflex tachycardia, dizziness.

69
Q

Dihydropyridine CI

A

Unstable angina, recent myocardial infarction, severe hypotension.

70
Q

Dihydropyridine DDI

A

increased plasma concentrations with grapefruit juice
potential interaction with simvastatin

71
Q

Name 2 Non-dihydropyridines

A

Varapamil
Diltiazem

72
Q

Non-dihydropyridine MOA

A

Inhibits calcium channels in cardiac muscle and vascular smooth muscle, reduces heart rate, and decreases myocardial contractility.

73
Q

Non-dihydropyridine SE

A

Constipation, dizziness, bradycardia, hypotension, AV block.

74
Q

Non-dihydropyridine CI

A

Severe left ventricular dysfunction, hypotension, sick sinus syndrome without a pacemaker, severe conduction abnormalities.

75
Q

Non-dihydropyridine DDI

A

Avoid concomitant use with beta-blockers due to additive effects on cardiac conduction; increased risk of toxicity with digoxin.

76
Q

3 Classes of Diuretics

A

Thiazide

Loop

Potassium-Sparing (Don’t use w/ ACE or ARBs)

77
Q

Name 3 Thiazide diuretics

A

Hydrochlorothiazide
Chlorthalidone
Metolazone

78
Q

Thiazide diuretic MOA

A

Inhibits sodium reabsorption in the distal convoluted tubule, increasing excretion of sodium, water, potassium, and hydrogen ions.

79
Q

Thiazides diuretic SE

A

Hypokalemia, hyponatremia, hypercalcemia, hyperuricemia, hyperglycemia, hypomagnesemia, increased cholesterol and triglycerides.

80
Q

Thiazide diuretic CI

A

Severe renal dysfunction, anuria, known hypersensitivity to sulfonamide-derived drugs.

81
Q

Thiazide diuretic DDI

A

Lithium: Decreased renal excretion, increasing lithium toxicity.
NSAIDs: Can reduce diuretic efficacy.
Digitalis: Increased risk of digitalis toxicity due to hypokalemia.

82
Q

Name 2 Loop diuretics

A

Furosemide
Bumetanide

83
Q

Loop diuretic MOA

A

Inhibits the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle, leading to significant diuresis.

84
Q

Loop diuretic SE

A

Electrolyte imbalances (hypokalemia, hyponatremia), dehydration, hypotension, ototoxicity.

85
Q

Loop diuretic CI

A

Anuria, hypersensitivity to furosemide or sulfonamides.

86
Q

Loop diuretic DDI

A

Aminoglycosides and Cisplatin: Increased risk of ototoxicity.
Antihypertensives: Potentiation of blood pressure-lowering effects.
NSAIDs: Can reduce diuretic and antihypertensive effect

87
Q

Name 2 Potassium-Sparing diuretics

A

Spironolactone
Amiloride

88
Q

Potassium-Sparing diuretics MOA

A

Amiloride: Blocks sodium channels in the distal nephron, reducing potassium and hydrogen secretion.
Spironolactone: Antagonizes aldosterone receptors in the distal nephron, promoting sodium excretion and potassium retention.

89
Q

Potassium-Sparing diuretics SE

A

Hyperkalemia, nausea, vomiting, headache.

90
Q

Potassium-Sparing diuretics CI

A

Hyperkalemia, severe renal impairment

91
Q

Potassium-Sparing diuretics DDI

A

ACE inhibitors and ARBs: Significantly increased risk of hyperkalemia.
Digoxin: Can alter digoxin blood levels and effects.

Pharmacology Exam 2 (1 decks)

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