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CardioRenal III > CR3 pharm 1-3 > Flashcards

CR3 pharm 1-3 Flashcards

1
Q

First line drug in the treatment of primary hypertension

A

ACE inhibitors (Captopril, Enalapril, Lisinopril)

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2
Q

First line drug in the treatment of all stages of heart failure

A

ACE inhibitors (Captopril, Enalapril, Lisinopril)

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3
Q

which RAAS inhibitor can be given for acute MI

A

ACE inhibitors (Captopril, Enalapril, Lisinopril)

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4
Q

which RAAS inhibitor can be given for chronic renal disease. What is the mechanism at play

A

ACE inhibitors (Captopril, Enalapril, Lisinopril) - Slows the rate of decline in renal function hy reducing intra-glomerular pressure and by increasing permeability selectivity of the filtering membrane

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5
Q

Angioedema and cough are side effects of which drug class

A

ACE inhibitors (Captopril, Enalapril, Lisinopril)

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6
Q

Indication for use of Alisikren

A

Primary hypertension (not first line)

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7
Q

Side effects common to all RAAS inhibitors

A

GI distrubance, headache, dizziness, HYPOtension, Renal function impairment

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8
Q

indication for use of AT1 receptor Blockers (ARB)

A

Losartan and Valsartan are used as alternatives to ACE inhibitors (for patients who cant tolerate ACE inhibitors)

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9
Q

which drug/class is used to treat Angioedema (both hereditary and drug induced)

A

Bradykinin Receptor Blocker (Icatibant)

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10
Q

Name the endothelin receptor antagonists

A

Bosentsan (nonselective) and Ambresentan (Eta-selective)

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11
Q

Patient presents with Pulmonary and Atrial hypertension- drug of choice

A

endothelin receptor antagonists = Bosentsan or Ambresentan

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12
Q

Adverse effects of endothelin receptor antagonists

A

Headache, flushing, HYPOtension, peripheral edema, palpations, reflex tachycardia, increased hepatic enzymes

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13
Q

Contraindication for the use of endothelin receptor antagonists

A

pregnancy (teratogenic)

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14
Q

Acute decompensated heart failure - durg choice

A

IV Nestiritide (Natiuritic peptide antagonist)

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15
Q

Indication for the use of Sacubitril + Valsartan (what are the drug drug interactions and counteridications for this regimen)

A

Chronic Heart failure. DD= other RAAS inhibitors CI - History of Angioedema and ARB CI (pregnancy and bilateral renal stenosis)

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16
Q

MOA Aliskiren

A

supress plasma renin activity (prevent the conversion of Angiotensinogen to AGT1 resulting in reduced AT2 levels)

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17
Q

MOA ACE inhitors

A

inhibit the conversion of AT1 to AT2 (reduce circulating levels of AT2)

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18
Q

MOA Lossartan and Valsartan

A

Block the AT1 receptor leading to reduced circulating levels of AT2

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19
Q

MOA Icatibant

A

blocks bradykinin receptor thereby reducing vascular permeability

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20
Q

MOA Borsentsan and Ambrisentan

A

blocks endothilin receptors to relax smooth muscle

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21
Q

Nesiritide MOA

A

Naturietic peptide agonist - relax arteries and veins and promote diruresis and naturesis

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22
Q

Sacubitril MOA

A

Enhances the effects of ANP and BNO by blocking Neprilysin (the enzyme that breaks them down)

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23
Q

Name the thiazide diuretics

A

Hydrochlorothiazide and chlorthalidone

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24
Q

MOA Hydrochlorothiazide

A

Inhibits Na/Cl cotranporter in the DCT and enhanced Ca reabsortion in the PCT and DCT. Results in increased excretion of NaCl, K, and water and decreased excretion of Ca

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25
Q

MOA Chlorthalidone

A

Inhibits Na/Cl cotranporter in the DCT and enhanced Ca reabsortion in the PCT and DCT. Results in increased excretion of NaCl, K, and water and decreased excretion of Ca

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26
Q

MOA Furcosemide

A

inhibits Na/K/2Cl transporter in the thick ascending loop of henle. Results in increased excretion of NaCl, K, H20, Mg, and Ca in urine

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27
Q

Name the potassium sparing diuretics

A

Spironlactone and Epleronone

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28
Q

MOA Spironolactone

A

Calcium sparing diureticL Aldosterone receptor antagonist in the collecting tubule. Results in decreased Na and Cl reabsorption and preservation of K (ONLY CLASS OF DRUGS NOT REQUIRED TO BE SECRETED TO PRODUCE EFFECTS)

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29
Q

MOA Epleronone

A

Calcium sparing diuretic: Aldosterone receptor antagonist in the collecting tubule. Results in decreased Na and Cl reabsorption and preservation of K (ONLY CLASS OF DRUGS NOT REQUIRED TO BE SECRETED TO PRODUCE EFFECTS)

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30
Q

what diuretic is used to treat mild CHF

A

Thiazide diuretic (hydrochlorothiazide, Chlorothlidone)

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31
Q

what drug is used to treat lithium induced nephrogenic diabetes incipitous

A

Thiazide diuretic (hydrochlorothiazide, Chlorothlidone)

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32
Q

what diuretic can be used to relieve polyuria and polydipsia

A

thiazide diuretic (hydrochlorothiazide, Chlorothlidone)

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33
Q

what drug can be used to treat nephrolithiasis (kidney stones)

A

thiazide diuretic (hydrochlorothiazide, Chlorothlidone)

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34
Q

what drug can be used to treat diabetes incipitous

A

thiazide diuretic (hydrochlorothiazide, Chlorothlidone)

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35
Q

Hypokalemic metabolic acidosis and Dilutional hyponatremia are AE of what class

A

Thiazide diuretic (hydrochlorothiazide, Chlorothlidone) and loop diuretics (Furcosemide)

36
Q

ototoxicity is an AE of what class

A

Loop Diuretics (Furcosemide) - also have Hypokalemic metabolic acidosis and dilutional hyponatremia as AE (just like thiazides)

37
Q

drug of choice for severe HF with renal insuficiency

A

loop diuretics (Furcosemide)

38
Q

Drug of choice for acute pulmonary edema

A

loop diuretics (Furcosemide)

39
Q

treatment of hypercalcemia with renal failure or HF

A

loop diuretics (Furcosemide) + saline

40
Q

what drug is added to diuretic therapy for treatment of edema and hypertension

A

potassium sparing diruetic (Spironolactone, Epleronone) - combined with other drugs to normalize plasma K

41
Q

what drug is used to treat both primary and hyperaldosteronemia

A

potassium sparing diruetic (Spironolactone, Epleronone)

42
Q

diuretic of choice for chronic heart failure

A

potassium sparing diruetic (Spironolactone, Epleronone)

43
Q

drug of choice for hepatic cirrhosis

A

potassium sparing diruetic (Spironolactone, Epleronone)

44
Q

Spironolactone and Epleronone should not be given with what other drugs

A

Oral K, other K sparing diuretics, and NSAIDS

45
Q

Contraindications for the use of Spirinolactone and Epleronone

A

Hyperkalemia and Renal insuficiency

46
Q

what drug is used to treat nonlife threatening hyperkalemia

A

Patiromer

47
Q

MOA Patiromer

A

Osmotic Diuretic: Binds excess potassium in the intestine promoting its excretion

48
Q

MOA Mannitol

A

increases the osmolality of renal tubular fluid by preventing H2O reabsorption in the PCT and DLH and oppose the action of ADH in the collecting tubules

49
Q

Pulmonary Edema, Poor cardiac reserve, severe dehydration, and active cranial bleeding are all contrindications for what class

A

osmotic diuretics (mannitol)

50
Q

which drug is used to treat intracranial hemotoma or cerebral edema

A

osmotic diuretics (mannitol)

51
Q

which drug can prevent anuria caused by hemolysis or rhabdomyolysis

A

osmotic diuretics (mannitol)

52
Q

Acetazolamide MOA

A

Carbonic Anhydrase Inhibitor: Renal= produces diuresis by decreases NaHCO3 reapsorption and NaCl reabsorption in PCT Eye/CNS: decreased secretion of aqueous humor and cerebrospinal fluid

53
Q

what drug is used to prevent and treat acute mountain sickness

A

acetazolamide

54
Q

what drug is used to treat compensatory metabolic acidosis caused by excessive use of diuretics or respiratory acidosis

A

acetazolamide

55
Q

what drug is used to treat urinary acidosis

A

acetazolamide

56
Q

Renal stones, Metabolic acidosis and potassium wasting are AE of

A

acetazolamide

57
Q

AE of large doses of acetazolamide

A

drowsiness and parasthesia

58
Q

what drug is used to treat hypertensive patients with other indications such as MI, angina, migraine, arrythmia, and HF

A

Propranolol

59
Q

which betablocker can be used in a hypertensive crisis

A

labetalol

60
Q

treatment oc chronic hypertension with BPH

A

prazosin

61
Q

name the Beta blockers used in HTN treatment

A

Propranolol(nonselective) Metoprolol (B1 selective) Labetalol (nonselective B and a1)

62
Q

alpha 1 blocker used in HTN

A

prazosin

63
Q

drugs that are used in HTN that block alpha and beta

A

cavedilol and labetalol

64
Q

alpha 2 agonists used in treatment of HTN

A

Clonidine and a-methyldopa

65
Q

major site of loop diuretics

A

thick ascending limb of the loop of henle

66
Q

major site of thiazide diuretics

A

Distal convoluted tubule

67
Q

Calcium channel blockers used in the treatment of HTN

A

Amlodipine and Nefedlipine

68
Q

MOA Amlodipine and Nifedlipine

A

reduce calcium influx into vascular smooth muscle to relax blood vessels and lower BP

69
Q

flushing, headache, peripheral edema AE of what class

A

calcium channel blockers

70
Q

arterial dilators must be combined with what other drugs to maintian hypotensive effects

A

Sympatholytic and diuretic

71
Q

lupus erythematous like syndrome is an AE of

A

Hydralazine

72
Q

indications for use of Hydralazine

A

1.) Moderate to severe hypertension 2.) Chronic heart failure

73
Q

what drug is used to treat serve refractory hypertension

A

Minoxidil

74
Q

MOA Minoxidil

A

Arterial Dilator: Potassium channel opener (hyperpolarizes the membrane and inhibits Ca influx)

75
Q

stimulation of hair growth is an AE of what drug

A

Minoxidil

76
Q

what drug acts as both an arterial and venous dilator

A

Nitroprusside

77
Q

MOA Nitroprusside

A

NO donor- relaxes both veins and arteries to reduce preload and afterload

78
Q

indication for use of Nitroprusside

A

Hypertensive Emergency

79
Q

Cyanide toxicity is an AE of what drug

A

Nitroprusside

80
Q

Pregnancy, Leber’s optic atrophy and tobacco amblyopia, and impaired renal function are contraindications for what drug

A

Nitroprusside

81
Q

drug of choice for hypertensive emergency in a patient with good renal function

A

nitroprusside

82
Q

drug of choice in hypertensive emergency in patient with renal failure

A

fenoldopam

83
Q

MOA Fenoldopam

A

activates dopamine receptors on coronary arteries causing relaxation of vessels

84
Q

Fenoldopam contraindication

A

Glaucoma

85
Q

which drugs can be used with diabetes and HTN in non-black patient

A

ACE inhibitors and ARB

86
Q

which drugs can be used to treat HTN in pregnancy

A

Ca blockers, methyldopa

87
Q

which drugs can be used to treat HTN with diabetes in a black patient

A

thiazide diuretic and CCB

CardioRenal III (13 decks)

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