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Pharm 3 > E3: Cardiovascular Pharm > Flashcards

E3: Cardiovascular Pharm Flashcards

1
Q

What are Loop diuretics used for?

A
  • Used to move an large volume of fluid

- Treats edema, and alt agent for HTN

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2
Q

What kind of drugs are Furosemide, Torsemide, Bumetanide, and Ethacrynic acid?

A

Loop diuretic

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3
Q

What is the contraindication to loop diuretics?

A

Anuria

- Furosemide, torsemide, and Bumetanide have sulfa hypersensitivity

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4
Q

What is the main concern with Ethacrynic acid?

A

Ototoxicity

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5
Q

What are the side effects of Loop diuretics?

A
  • Hypokalemia, hyponatremia, hypocalcemia, and hyperuricemia

- May precipitate gout at high doses

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6
Q

What kind of drugs are HCTZ, chlorothiazide, and Metalazone?

A

Thiazide diuretics

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7
Q

What is the use of thiazide diuretics?

A
  • Treated edema and mild fluid retention in HF

- Treated HTN, enhances antihypertensive actions of other drugs

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8
Q

What are the contraindications to thiazide diuretics?

A
  • Anuria

- Don’t use in patients with sulfa allergies (Metalazone less so, but still use caution)

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9
Q

What are the side effects of thiazide diuretics?

A
  • Hypokalemia, hyponatremia, hyperuriecemia, hypocholesterolemia, hyperglycemia, and ED
  • May precipitate gout at high doses
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10
Q

What kind of drugs are spironolactone and eplernone?

A

potassium sparing diuretic- aldosterone antagonist

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11
Q

What kind of drugs are Triamterene and Amiloride?

A

Potassium sparing diuretic - direct inhibitors of Na flux

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12
Q

What is the use of potassium sparing diuretics?

A
  • Overall weak diuretic effect, used in combination with other diuretics
  • Treats Edema and HF, alt agent for HTN
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13
Q

What is the contraindication for all potassium sparing diuretics?

A

Hyperkalemia

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14
Q

What are the contraindications of the direct inhibitors of Na flux potassium sparing diuretics?

A

Anuria, severe progressive kidney disease/dysfunction

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15
Q

What are the side effects of potassium sparing diuretics?

A

Hyperkalemia

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16
Q

What medications are used to reduce mortality and improve symptoms in heart failure?

A

-ACE inhibitor, BB, and loop diuretic

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17
Q

What is the MOA of ACE-I?

A

-Blocks angiotensin converted enzyme and stops formation of AT II

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18
Q

What is the use of ACE-I?

A
  • Treats HFrEF, HTN, and STEMI

- Decreases preload and afterload

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19
Q

What are the contraindications of ACE-I?

A

Angioedema, pregnancy

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20
Q

What are the side effects of ACE-I?

A

Dry cough, orthostatic hypotension, hyperkalemia, angioedema, and rash

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21
Q

What is considered first line in all patients with DM, CKD, and HFrEF?

A

ACE-I and ARBs

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22
Q

What is the use of beta blockers?

A
  • Decreased chronotropy, inotropy, and cardiac output
  • Treates angina, HFrEF, and HTN
  • decrease mortality rate s/p MI, stable class II and III HF
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23
Q

What are the contraindications of beta blockers?

A
  • Severe bradycardia
  • 2nd and 3rd degree AV block
  • uncompensated HF
  • SBP <100
  • cardiogenic shock
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24
Q

What are the side effects of non-selective beta blockers?

A

-Bronchospasm, worsen CHF, raise lipids, impaired glucose tolerance, fatigue, decreased libido, depression, and insomnia

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25
Q

What are the non selective beta blockers?

A

Propranolol, nadolol, and time lol

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26
Q

What are the cardioselective Beta blockers?

A

Acebutolol, Atenolol, metoprolol, Nebivolol

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27
Q

What are the beta blockers with intrinsic sympathomimetic activity?

A

Acetubolol and Pindolol

28
Q

What do you need to keep in mind when taking a patient off Beta blockers?

A

-You must avoid abrupt withdrawal because it can precipitate acute coronary events and severe increases in BP

29
Q

If a patient taking an ACE-I comes in complaining of a cough, what should you do?

A

Reassure them that a cough a common with an ACE-I, or switch them to an ARB if the cough is too bothersome

30
Q

What is the MOA of ARBs?

A

Blocks angiotensin II from binding to AT1 receptor

31
Q

What is the use of ARBs?

A
  • Treats HFrEF, HTN, and STEMI

- decreases preload and afterload

32
Q

What are the contraindications to ARBs?

A

Angioedema and pregnancy

33
Q

What are the side effects of ARBs?

A

Orthostatic hypotension, Hyperkalemia

34
Q

What are the uses of Digoxin?

A
  • Increase contractility, decrease chronotropy, and increase cardiac output
  • treats mild to moderate HFrEF and atrial fibrillation
35
Q

What are the side effects of Digoxin?

A
  • Arrhythmias, headache, fatigue, drowsiness

- Narrow margin of safety, monitor closely, especially patients with reduced renal clearance and hypokalemia

36
Q

What is the first line treatment of hypertension?

A

-Lifestyle modifications!! Smoking cessation, salt restriction, diet, exercise, weight management

37
Q

What are the first line medications for HTN?

A

-HCTZ, ACE-I, ARB, and CCB

38
Q

What medications are preferred for HTN in black patients?

A

HCTZ and CCB

39
Q

What medications are preferred for HTN in non-black patients?

A

ACE-I and BB

40
Q

What medications are preferred for HTN in patients with CKD?

A

ACE-I, ARB

41
Q

What is the drug titration strategy in HTN?

A

-Maximize first medication before adding a second
OR
-add a second medication before reaching maximum dose of first medication
OR
-Start with two medication classes separately or as a fixed dose combination

42
Q

What is the use of CCBs?

A
  • Decrease inotropy, relax smooth muscles

- Treats HTN and vasospastic angina

43
Q

What do the dihydropyridine CCBs do?

A

Potent vasodilators that cause arterial smooth muscle relaxation and decrease PVR

44
Q

What kind of drug is Nifedipine?

A

Dihydropyridine CCB

45
Q

What are the side effects of dihydropyridine CCBs?

A

Short acting CCBs may cause mild to moderate reflex tachycardia, flushing, and peripheral edema
-Long acting usually only cause edema

46
Q

What do the Non-dihydropyridines do?

A

Less vasodilation, decreases inotropy and chronotropy

47
Q

What kind of drugs are Verapamil and Diltiazem?

A

Non-dihydropyridine CCBs

48
Q

What are the side effects of non-dihydropyridine CCBs?

A

Constipation, bradycardia, SA node dysfunction, heart block

49
Q

What are the contraindications for non-dihydropyridines?

A

SA or AV node abnormalities , BB, and HF

50
Q

What is the use of alpha blockers?

A
  • Treats HTN and BPH

- Decrease vasoconstriction and reduce PVR

51
Q

What are the selective alpha blockers?

A

Prazosin, doxazosin, and terazosin

52
Q

What is the non-selective alpha blocker?

A

Phenoxybenzamine

53
Q

What are the side effects of alpha blockers?

A

-Orthostatic hypotention (first dose phenomenon), fatigue, weakness, nasal congestion, and headache

54
Q

When are alpha blockers first line for HTN?

A

When there is concomitant BPH

55
Q

If you are treated a patient with resistant hypertension with an ACE-I and CCB but his blood pressure is still not controlled, what should you consider adding?

A

BB

56
Q

What is the use of alpha agonists?

A
  • Treats refractory HTN

- Reduce sympathetic vasoconstriction and total peripheral vascular resistance

57
Q

What kind of drugs are clonidine and Methyldopa?

A

Central acting alpha agonists

*** Methyldopa is safe in pregnancy

58
Q

What are the side effects of alpha agonists?

A

-Sedation, xerostomia, Orthostatic hypotension

59
Q

What should you monitor in a patient taking Methyldopa?

A

CBC, liver enzymes, and Coombs test

60
Q

What is the most appropriate pharmacologic treatment for stable angina?

A

Sublingual nitro PRN

61
Q

What are the side effects of nitro?

A

Orthostatic Hypotension, tachycardia, throbbing headache

62
Q

What is the dosage of SL nitro?

A

Take 1 dose ever 5 minutes for up to 3 doses, and if it does not improve call EMS

63
Q

What is the use of antianginals?

A
  • Decrease cardiac workload, decrease preload and afterload

- treat acute angina or prophylactically

64
Q

What kind of drug is Isosorbide Dinitrate?

A

A long acting nitrate used in the long term management of chronic stable angina

65
Q

What are the contraindications to nitrates?

A

Do not use within 24 hours of sildenafil

-HCM or RV infarction

Pharm 3 (20 decks)

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