Exam 2 Review Flashcards
1
Q
Ganglionic synapse
A
A synapse outside of the CNS
2
Q
Preganglionic neurons
A
nerves carrying impulses exiting the spinal cord
3
Q
Postganglionic neurons
A
Nerves on the other side of the ganglionic synapse, waiting to receive impulses
4
Q
What are the two primary neurotransmitters of the ANS?
A
Acetylcholine (Ach) and norepinephrine (NE)
5
Q
Two types of cholinergic nerves
A
Nicotinic receptors and muscarinic receptors
6
Q
Nicotinic receptors
A
Receptors located at the ganglionic synapse in both the parasympathetic and sympathetic NS. Nicotine binds to these receptors
7
Q
Muscarinic receptors
A
Receptors are located on target tissues affected by postganglionic neurons in the parasympathetic nervous system. Muscarine (a substance obtained by poisonous mushrooms), binds to these receptors
8
Q
Activation of cholinergic receptors causes which physiological reactions
A
Tachycardia
Hypertension
Increased tone and motility in the digestive tract
9
Q
What two classes of drugs stimulate the parasympathetic nervous system
A
Cholinergic
Parasympathomimetics
10
Q
What two classes of drugs inhibit the parasympathetic nervous system
A
Cholinergic blocking
Anticholinergic
11
Q
Parasympathomimetics
A
Drugs that mimic action of the parasympathetic nervous system. Induce the rest-and-digest response
12
Q
Which neurotransmitter is a parasympathomimetic
A
Acetylcholine (Ach)
13
Q
Prototype drug Bethanechol (Urecholine) therapeutic class
A
Nonobstructive urinary retention drug
14
Q
Prototype drug Bethanechol (Urecholine) Pharmacologic class
A
Muscarinic cholinergic receptor drug
15
Q
Prototype drug Bethanechol (Urecholine) common indications and uses
A
Nonobstructive urinary retention in patients with atony (lack of muscle tone) of the bladder
16
Q
Prototype drug Bethanechol (Urecholine) mechanism of action
A
Direct-acting parasympathomimetic that interacts with muscarinic receptors to cause actions typical of parasympathetic stimulation
17
Q
Prototype drug Bethanechol (Urecholine) effects
A
Most noted in the digestive and urinary tracts, where it stimulates smooth-muscle contraction.
18
Q
Prototype drug Bethanechol (Urecholine) administration standards
A
PO
Subcutaneous
19
Q
Prototype drug Bethanechol (Urecholine) adverse effects
A
Increased salivation
Sweating
Abdominal cramping
Hypotension
20
Q
Prototype drug Bethanechol (Urecholine) contraindications
A
Patients with asthma epilepsy parkinsonism hyperthyroidism peptic ulcer disease bradycardia
21
Q
Cholinergic crisis
A
may develop when given too much cholinergic medication. Signs include: hypersalivation, small pupils, muscle twitching, unusual paleness, sweating muscle weakness, and difficulty breathing.
22
Q
Prototype drug Physostigmine (Antilirium) therapeutic class
A
Antidote for anticholinergic toxicity
23
Q
Prototype drug Physostigmine (Antilirium) Pharmacologic class
A
Acetylcholinesterase inhibitor
24
Q
Prototype drug Physostigmine (Antilirium) mechanism of action
A
Indirect-acting parasympathomimetic that inhibits the destruction of Ach by AchE. Effects occur at the neuromuscular junction and at central and peripheral locations where Ach is the neurotransmitter.
25
Prototype drug Physostigmine (Antilirium) indications
Reverses toxic and life-threatening delirium caused by atropine, diphenhydramine, dimenhydrinate, Atropa belladonna (deadly nightshade), or jimson weed.
26
Prototype drug Physostigmine (Antilirium) administration alerts
Administer slowly over 5 minutes to avoid seizures and respiratory distress.
Never to be continuously infused
Monitor BP, pulse, respirations
27
Prototype drug Physostigmine (Antilirium) adverse effects
```
Bradycardia
Asystole
Restlessness
Nervousness
Seizures
Salivation
Urinary frequency
Muscle twitching
Respiratory paralysis
```
28
Prototype drug Physostigmine (Antilirium) Contraindications
```
Asthma
Epilepsy
Diabetes
Cardiovascular disease
Bradycardia
```
29
Cholinergic-blocking drugs
Inhibit parasympathetic impulses. Suppressing the parasympathetic division induces symptoms of the fight or flight response
30
Drugs that block the action of Ach
Anticholinergics
Cholinergic blockers
Muscarinic antagonists
Parasympatholytics
31
Therapeutic uses of anticholinergics
```
GI disorders
Ophthalmic procedures
Cardiac rhythm abnormalities
Anesthesia adjuncts
Asthma and COPD
Overactive bladder
Parkinson's disease
```
32
Prototype drug Atropine (Atro-pen) therapeutic class
Antidote for anticholinesterase poisoning
33
Prototype drug Atropine (Atro-pen) Pharmacologic class
Muscarinic cholinergic receptor blocker
34
Prototype drug Atropine (Atro-pen) mechanism of action
Occupies muscarinic receptors and blocks the parasympathetic actions of Ach and induces symptoms of the fight-or-flight response
35
Prototype drug Atropine (Atro-pen) indications
Hypermotility diseases of the GI tract such as irritable bowel syndrome
To suppress secretions during surgical procedures
To increase the heart rate in patients with bradycardia
To dilate the pupil during eye examinations
Reflexive bradycardia in infants
Infantile hypertrophic pyloric stenosis
36
Prototype drug Atropine (Atro-pen) adverse effects
```
Dry mouth
Constipation
Urinary retention
Increased heart rate
Initial CNS excitement may progress to delirium and coma
```
37
Prototype drug Atropine (Atro-pen) contraindications
```
glaucoma, because the drug may increase pressure within the eye.
Obstructive disorders of the GI tract
Paralytic ileus
Bladder neck obstruction
Benign prostatic hyperplasia
Myasthenia gravis
Cardiac insufficiency
Acute hemorrhage
```
38
Catecholamines
Class of agents secreted in response to stress that include epinephrine, norepinephrine, and dopamine
39
Adrenergic
relating to nerves that release norepinephrine or epinephrine
40
What are the two basic types of adrenergic receptors
alpha and beta receptors
41
Primary location and response when NE binds with the adrenergic Alpha1 receptor
All sympathetic target organs except the heart.
| Constriction of blood vessels and dilation of pupils
42
Primary location and response when NE binds with the adrenergic Alpha2 receptor
Presynaptic adrenergic nerve terminals
| Inhibition of release of NE
43
Primary location and response when NE binds with the adrenergic Beta1 receptor
Heart and kidneys
| Increased heart rate and force of contraction, release of renin
44
Primary location and response when NE binds with the adrenergic Beta2 receptor
All sympathetic target organs except the heart
| Inhibition of smooth muscle
45
Primary location and response when NE binds with the adrenergic Beta3 receptor
Adipose tissue and urinary bladder.
| Lipolysis and relaxation of the detrusor muscle.
46
Monoamine oxidase inhibitors (MAOIs)
Enzyme that destroys norepinephrine in the nerve terminal
47
Catecholamine-O-methyl transferase (COMT)
Destroys NE at the synaptic cleft
48
Site most responsible for the release of epinephrine
Adrenal gland
49
Adrenergic drugs
Adrenergic agonists or sympathomimetics. Stimulate the sympathetic nervous system and induce symptoms characteristic of the fight-or-flight response
50
Adrenergic Alpha1 receptor therapeutic uses
Treatment of nasal congestion or hypotension; causes dilation of the pupil during ophthalmic examinations
51
Adrenergic Alpha2 receptor therapeutic uses
Treatment of hypertension through a centrally acting mechanism.
Reduce the release of NE within the axon terminal
52
Adrenergic Beta2 receptor therapeutic uses
Treatment of asthma and premature labor contractions
53
Adrenergic Beta3 receptor therapeutic uses
Treatment of overactive bladder
54
Adrenergic antagonists (sympatholytics)
drugs that act by directly blocking adrenergic receptors. Specific to either alpha or beta blockade.
55
What is the most common adverse effect of alpha blockers
Orthostatic hypotension
56
Pheochromocytoma
A rare, catecholamine-secreting tumor on the adrenal gland that may precipitate life-threatening hypertension.
57
Prototype drug Phenylephrine (Neo-Synephrine) therapeutic class
Nasal decongestant
mydriatic drug
antihypotensive
58
Prototype drug Phenylephrine (Neo-Synephrine) pharmacologic class
Adrenergic drug (sympathomimetic)
59
Prototype drug Phenylephrine (Neo-Synephrine) mechanism of action
Selective alpha-adrenergic agonist. Sympathetic stimulation
60
Prototype drug Phenylephrine (Neo-Synephrine) adverse effects
Side effects uncommon when used topically or intranasally.
Intranasal use: burning of the mucosa and rebound congestion if used for prolonged periods.
Ophthalmic: narrow-angle glaucoma
Reflex bradycardia
61
Prototype drug Phenylephrine (Neo-Synephrine) black box warning
Severe reactions, including death, may occur with IV infusion even when appropriate dilution is used to avoid rapid diffusion. Therefore IV use for situations in which other routes are not feasible.
62
Prototype drug Phenylephrine (Neo-Synephrine) contraindications
Acute pancreatitis
Heart disease
Hepatitis
Narrow-angle glaucoma
63
Beta-adrenergic antagonists block what type of receptors?
Either beta1, beta2, or both
64
Effects of Beta-adrenergic antagonists on the cardiovascular system
Decrease the rate and force of contraction of the heart and slow electrical conduction through the AV node.
65
Prototype drug Prazosin (Minipress) therapeutic class
Antihypertensive
66
Prototype drug Prazosin (Minipress) pharmacologic class
Adrenergic-blocking drug
67
Prototype drug Prazosin (Minipress) mechanism of action
Selective alpha-adrenergic antagonist that competes with NE at its receptors on vascular smooth muscle in arterioles and veins.
68
Prototype drug Prazosin (Minipress) effects
Major action is a rapid decrease in peripheral resistance that reduces blood pressure.
69
Prototype drug Prazosin (Minipress) indications
Hypertension
70
Prototype drug Prazosin (Minipress) adverse effects
```
Orthostatic hyptotension due to alpha1 inhibition in vascular smooth muscle.
Dizziness
Drowsiness
Reflex tachycardia
Nasal congestion
Inhibition of ejaculation
```
71
Structures of the upper respiratory tract
Nose, nasal cavity, pharynx, and paranasal sinuses.
72
What are the effects of sympathetic NS activation on the upper respiratory system?
Constricts arterioles in the nose, reducing thickness of the mucosal layer.
73
Allergic rhinitis (hay fever)
Inflammation of the nasal mucosa due to exposure to allergens.
74
Immediate hypersensitivity response
Histamine response and other inflammatory mediators from the mast cells and basophils, producing sneezing, itchy nasal membranes and watery eyes.
75
Delayed hypersensitivity response
Occurs 4-8 hours after initial exposure, causing continuous inflammation of the mucosa and adding to the chronic nasal congestion
76
H1-Receptor antagonists
Antihistamines
Block the actions of histamine at the H1 receptor.
Widely used OTC remedies for relief of allergy symptoms, motion sickness, and insomnia.
77
H1 receptors
Histamine receptors responsible for allergic symptoms
78
H2 receptors
Found in the gastric mucosa and responsible for peptic ulcers
79
When are antihistamines most effective?
When taken prophylactically to PREVENT allergic symptoms. Effectiveness in reversing allergic symptoms is limited
80
In addition to allergic rhinitis, what other disorders are treated with antihistamines
Vertigo and motion sickness
Parkinson's disease
Insomnia
Urticaria and other skin rashes
81
Prototype drug Diphenhydramine (Benadryl, others) therapeutic class
Drug to treat allergies
82
Prototype drug Diphenhydramine (Benadryl, others) pharmacologic class
H1-receptor antagonist; antihistamine
83
Prototype drug Diphenhydramine (Benadryl, others) indications
```
Minor symptoms of allergies and common cold
Rashes
Parkinson's disease
Motion sickness
Insomnia
```
84
Prototype drug Diphenhydramine (Benadryl, others) administration alerts
Increased risk of anaphylactic shock when administered parenterally
85
Prototype drug Diphenhydramine (Benadryl, others) adverse effects
Drowsiness
Occasionally, paradoxical CNS stimulation and excitability
Anticholinergic effects such as dry mouth, tachycardia and mild hypotension
Photosensitivity
86
Prototype drug Diphenhydramine (Benadryl, others) contraindications
```
Hypersensitivity to the drug
benign prostatic hypertrophy
narrow-angle glaucoma
GI obstruction
Use cautiously in patients with asthma or hyperthyroidism
```
87
Most decongestants are which class of drug?
Sympathomimetics (Drugs that activate the sympathetic nervous system)
88
Rebound congestion
Condition characterized by hypersecretion of mucus and worsening nasal congestion once the drug effects wear off
89
Prototype Drug Fluticasone (Flonase, Veramyst, others) therapeutic class
Drug for allergic rhinitis
90
Prototype Drug Fluticasone (Flonase, Veramyst, others) pharmacologic class
Intranasal corticosteroid
91
Prototype Drug Fluticasone (Flonase, Veramyst, others) indications
Typical intranasal corticosteroid used to treat seasonal allergic rhinitis
92
Prototype Drug Fluticasone (Flonase, Veramyst, others) adverse effects
Swallowing large amounts increases the potential for systemic corticosteroid adverse effects
93
Prototype drug Oxymetazoline (Afrin, others) Therapeutic class
Nasal decongestant
94
Prototype drug Oxymetazoline (Afrin, others) Pharmacologic class
Sympathomimetic
95
Prototype drug Oxymetazoline (Afrin, others) mechanism of action
Activates alpha-adrenergic receptors in the sympathetic nervous system. This causes arterioles in the nasal passages to constrict, thus drying the mucous membranes.
96
Prototype drug Oxymetazoline (Afrin, others) adverse effects
Rebound congestion is common when used for longer than 3 to 5 days.
Minor stinging and dryness in the nasal mucosa
97
Prototype drug Oxymetazoline (Afrin, others) contraindications
Patients with thyroid disorders
Hypertension
Diabetes
Heart disease
98
What are the most effective antitussives?
Opioids. Act by raising the cough threshold in the CNS
99
Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) therapeutic class
Cough suppressant
100
Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) pharmacologic class
Drug for increasing cough threshold
101
Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) mechanism of action
Acts in the medulla to raise the cough reflex threshold
102
Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) adverse effects
Adverse effects at therapeutic doses are rare.
Dizziness
Drowsiness
GI upset
Abuse situations: CNS toxicity, slurred speech, ataxia, hyperexcitability, stupor, respiratory depression, seizures, coma, and toxic psychosis.
103
Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) Contraindications
Treatment of chronic cough due to bronchial secretions, such as asthma, smoking, and emphysema.
Children under 6
104
Expectorants
Drugs that reduce the thickness or viscosity of bronchial secretions, thus increasing mucus flow that can then be removed more easily by coughing.
105
Mucolytics
Break down the chemical structure of the mucus molecules. The mucus becomes thinner and can be removed more easily by coughing
106
Ventilation
The process of moving air into and out of the lungs.
107
Perfusion
Blood flow through the lungs
108
What receptors does the sympathetic NS activate in the lower respiratory tract?
Beta2-adrenergic receptors, which causes bronchiolar smooth muscle to relax, the airway diameter to increase, and bronchodilation to occur.
109
What effects does the parasympathetic NS have on the lower respiratory tract?
Causes bronchiolar smooth muscle to contract, the airway diameter to narrow, and bronchoconstriction to occur
110
Aerosol
suspension of minute liquid droplets or fine solid particles suspended in a gas
111
Advantage of aerosol therapy
Delivers pulmonary drugs to their immediate site of action, thus reducing systemic side effects
112
Bronchospasm
An acute condition during which the bronchiolar smooth muscle rapidly contracts, leaving the patient gasping for breath.
113
Asthma
Characterized by acute bronchospasm.
Can cause intense breathlessness, coughing, and gasping for air.
Acute inflammatory response stimulates the secretion of histamine and other inflammatory mediators, which increases mucus and edema in the airways.
114
Status asthmaticus
A severe, prolonged form of asthma unresponsive to drug treatment that may lead to respiratory failure.
115
Nonselective bronchodilators
Beta agonists that activate both beta1 and beta2 receptors
116
Selective bronchodilators
Beta agonists that activate only the the beta2 receptors
117
Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) therapeutic class
Bronchodilator
118
Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) pharmacologic class
Beta2-adrenergic agonist
119
Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) Indications
To relieve the bronchospasm of asthma.
120
Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) mechanism of action
Short-acting beta agonist (SABA). Relax smooth muscle, thus widening the airway and making breathing easier.
121
Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) adverse effects
```
Serious adverse effects are uncommon
Palpitations
Headaches
Throat irritation
Tremor
Nervousness
Restlessness
Tachycardia
```
122
Prototype drug Ipratropium (Atrovent) therapeutic class
Bronchodilator
123
Prototype drug Ipratropium (Atrovent) Pharmacologic class
Anticholinergic
124
Prototype drug Ipratropium (Atrovent) Indications
Inhalation: To relieve and prevent the bronchospasm that is characteristic of asthma and COPD
Nasal spray: Symptomatic relief of runny nose associated with the common cold and allergic rhinitis
125
Methylxanthines (theophylline and aminophylline)
Bronchodilators chemically related to caffeine. Infrequently prescribed because they have a narrow safety margin, especially with prolonged use
126
Prototype Drug Beclomethsone (Qvar) therapeutic class
Anti-inflammatory drug for asthma and allergic rhinitis
127
Prototype Drug Beclomethsone (Qvar) pharmacologic class
Inhaled corticosteroid
128
Prototype Drug Beclomethsone (Qvar) indications
Aerosol for asthma, nasal spray for allergic rhinits
129
Prototype Drug Beclomethsone (Qvar) administration alerts
Don't use if experiencing an acute asthma attack
130
Prototype Drug Montelukast (Singulair) therapeutic class
Anti-inflammatory drug for asthma prophylaxis
131
Prototype Drug Montelukast (Singulair) pharmacologic class
Leukotriene modifier
132
Prototype Drug Montelukast (Singulair) indications
Prophylaxis of persistent, chronic asthma, exercise-induced bronchospasm, and allergic rhinitis.
133
Prototype Drug Montelukast (Singulair) mechanism of action
Prevents airway edema and inflammation by blocking leukotriene receptors in the airways.
134
Leukotrienes
Mediators of the immune response that are involved in allergic and asthmatic reactions. When released in the airway, leukotrienes promote edema, inflammation, and bronchoconstriction
135
Two primary COPD conditions
Chronic bronchitis and empysema
136
Chronic bronchitis
excess mucus is produced in the lower respiratory tract due to the inflammation and irritation from cigarette smoke or pollutants. The airway becomes partially obstructed with mucus, thus resulting in the classic signs of dyspnea and coughing
137
Emphysema
Terminal stage of COPD
After years of chronic inflammation, the bronchioles lose their elasticity, and the alveoli dilate to maximum size to allow more air into the lungs. Patient suffers extreme dyspnea from even the slightest physical activity.
138
Patients with COPD should not receive what type of drugs?
Drugs that have beta-adrenergic antagonist activity or that cause bronchoconstriction
139
What are the three primary types of lipids important to human nutrition?
Triglycerides, phospholipids, steroids
140
Triglycerides
Neutral fats, account for 90% of total lipids in the body.
| Major storage form of fat in the body and the only type of lipid that serves as an important energy source.
141
Phospholipids
Essential to building plasma membranes. Best known are lecithins, which are found in high concentration in egg yolks and soybeans
142
Steroids
Diverse group of substances having a common chemical structure called the sterol nucleus, or ring structure.
143
Lipoproteins
Consist of various amounts of cholesterol, triglycerides, and phospholipids, along with a protein carrier.
144
High-density lipoprotein (HDL)
contains the most apoprotein, up to 50% by weight. Manufactured in the liver and small intestine and assists in the transport of cholesterol away from the body tissues and back to the liver. Cholesterol component then broken down to unite with bile that is subsequently excreted in the feces.
145
Low-density lipoprotein (LDL)
Carries the highest amount of cholesterol. Often called "bad cholesterol." Transports cholesterol from the liver to the tissues and organs, to build plasma membranes. Increased levels a risk factor for CAD
146
Important things to remember about cholesterol
Vital for plasma membranes
Role in atherosclerosis
Building block for vitamin D, bile acids, cortisol, estrogen, and testosterone.
Body only needs very small amounts
No need for dietary cholesterol because synthesized by liver
147
Very low-density lipoproteins (VLDL)
Contains highest amount of triglycerides. Becomes LDL after it is reduced in size
148
Hyperlipidemia
Elevated levels of lipids in the blood
149
Hypercholesterolemia
Elevated levels of cholesterol in the blood
150
Dyslipidemia
Abnormal levels of lipoproteins in the blood
151
What are the two causes of hyperlipidemia?
Heredity and lifestyle
152
Lifestyle changes that may affect lipid levels are:
```
Healthy body weight
Reduce increase of fats and cholesterol
Increase fiber
Exercise
Limit/eliminate tobacco use
Monitor blood lipid levels
```
153
Sources of plant lipids
Wheat, corn, rye, oats, rice, nuts, and olive oil
154
Total cholesterol blood levels should be less than
200 mg/dL
155
LDL blood level should be less than
100 mg/dL
156
HDL blood level should be greater than
60 mg/dL
157
Triglyceride blood level should be less than
150 mg/dL
158
What is the most accurate risk predictor for cardiovascular disease
Measurement of LDL and HDL. The goal is to maintain higher levels of HDL and lower levels of LDL
159
What is the goal for LDL-to-HDL ratios for males?
Less than 5.0. 5 times for LDL than HDL
160
What is the goal for LDL-to-HDL ratios for females?
Less than 4.5
161
HMG-CoA reductase enzyme
primary regulatory mechanism for cholesterol synthesis
162
Statins
Developed in a lab from fungi
Can produce a 20-40% reduction in LDL, VLDL, and triglyceride cholesterol levels.
Raise the levels of HDL
163
Prototype drug Atorvastatin Calcium (Lipitor) pharmacologic class
Antilipemic; HMG-coA; Reductase inhibitor (statin
164
Prototype drug Atorvastatin Calcium (Lipitor) therapeutic class
Antilipemic
| Statin
165
Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) Pharmacologic classification
Antilipemic
| Bile acid sequestrant
166
Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) therapeutic class
Cholesterol-lowering
167
Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) mechanism of action
Absorbs and combines with intestinal bile acids in exchange for chloride ions to form an insoluble, nonabsorbable complex that is excreted in the feces.
168
Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) indications
As adjunct to diet therapy in management of patients iwth primary hypercholesterolemia (type IIa hyperlipidemia) with a significant risk of atherosclerotic heart disease and MI
Relief of pruritus secondary to partial biliary stasis.
169
Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) contraindications
Complete biliary obstruction or biliary cirrhosis
Cholelithiasis
GI obstruction
Hypersensitivity to bile acid sequestrants
Coagulopathy
Lactation
170
Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) adverse effects
Constipation, fecal impaction, hemorrhoids, abdominal pain and distension, flatulence, bloating, nausea/vomiting, heartburn, anorexia, diarrhea, steatorrhea
171
Primary effect of niacin
To decrease VLDL levels, and subsequently LDL levels
172
Prototype drug Gemfibrozil (Lopid) pharmacologic classification
Antilipemic, fibrate
173
Prototype drug Gemfibrozil (Lopid) therapeutic class
Cholesterol-lowering
174
Prototype drug Gemfibrozil (Lopid) mechanism of action
Blocks lipolysis of stored triglycerides in adipose tissue and inhibits hepatic uptake of fatty acids.
175
Prototype drug Gemfibrozil (Lopid) indications
Patients with very high serum triglyceride levels who have not responded to intensive diet restriction and are at risk of pancreatitis and abdominal pain.
176
Prototype drug Gemfibrozil (Lopid) contraindications
Gallbladder disease, biliary cirrhosis, hepatic or severe renal dysfunction.
177
Prototype drug Gemfibrozil (Lopid) adverse effects
```
Abdominal pain
Diarrhea
Epigastric pain
Headache
Dizziness
Blurred vision
```
178
Prototype drug ezetimibe (Zetia) mechanism of action
Involves blocking up to 50% of the absorption of cholesterol in the small intestine.
179
Prototype drug ezetimibe (Zetia) adverse effects
Nausea
Cholecystitis
Cholelithiasis
180
Prototype drug ezetimibe (Zetia) pharmacologic class
Cholesterol absorption inhibitors
181
Prototype drug ezetimibe (Zetia) contraindications
Patients who currently take bild acid resins
Liver disease
Pregnant
182
Thiazide and Thiazide-like diuretics
Cause kidneys to decrease reabsorption of sodium, drawing more water into the urine to be excreted.
Can cause decrease in potassium level, hyperglycemia and hyperuricemia
183
Potassium-sparing diuretics
Less diureses than thiazides
| Use caution if also taking ACE inhibitor or angiotensin
184
Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) pharmocologic class
Calcium channel blocker, antianginal, antihypertensive
185
Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) therapeutic class
antihypertensive
| Antianginal
186
Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) mechanism of action
Act to limit the contraction of muscles by preventing calcium from entering cells.
Peripheral resistance decreases
Force of heart contractions decreases and heart rate slows
Reduction in afterload
187
Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) indications
Vasospastic "variant" or Prinzmetal's angina and chronic stable angina.
Mild to moderate hypertension
188
Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) contraindications
```
Hypersensitivity to nifedipine
Unstable angina
Acute MI
Cardiogenic shock
Aortic stenosis
GI obstruction
```
189
Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) adverse effects
Dizziness, Headache, flushing, heat sensation, peripheral edema, diarrhea
190
Prototype drug Enalapril Maleate (Vasotec) pharmocologic class
Angiotensin-converting enzyme (ACE) inhibitor
| Antihypertensive
191
Prototype drug Enalapril Maleate (Vasotec) mechanism of action
Block the formation of angiotensin II, preventing vasoconstriction of arterioles and decreasing peripheral resistance
Block the effects of angiotensin II on the secretion of aldosterone, decreasing blood volume and increasing the effects of thiazides.
192
Prototype drug Enalapril Maleate (Vasotec) adverse effects
Persistent, dry cough
Orthostatic hypotension
Hyperkalemia
Angioedema
193
Angiotensin II receptor blockers (ARBs)
decrease blood pressure by blocking the action of angiotensin II in the smooth muscle wall of arteries and in the adrenal gland, decreasing peripheral resistance
194
Direct renin inhibitor
Type of RAAS blocker
| Blocks renin, preventing the conversion of an inactive peptide called angiotensinogen to angiotensin I, lowering BP.
195
Prototype drug Hydralazine Hydrochloride pharmacologic class
Non-nitrate vasodilator
| Antihypertensive
196
Prototype drug Hydralazine Hydrochloride mechanism of action
Acts directly on vascular smooth muscles of arterial-resistance vessels, resulting in vasodilation
197
Prototype drug Hydralazine Hydrochloride contraindications
Monotherapy for CHF
Mitral valvular rheumatic heart disease
MI
Tachycardia
198
Prototype drug Hydralazine Hydrochloride adverse effects
Sodium and water retention
Reflex tachycardia
Headache
199
Prototype drug Hydralazine Hydrochloride Contraindications
Angina, history of MI, underlying tachycardia
200
Risk factors for hypertension
Family history, Age, race, diet, obesity, insulin resistance, excess alcohol consumption, stress
201
What are the three factors responsible for blood pressure?
Cardiac output
Peripheral resistance
Blood volume
202
Vasomotor system
Located in the brain
Receives info from receptors in the aorta and carotid arteries
Either constricts arterial walls to increase BP or vasodilate arterial walls to decrease BP
203
Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) pharmacologic class
Electrolytic and water balance agent
Loop diuretic
Antihypertensive
204
Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) therapeutic class
Loop diuretic
| Antihypertensive
205
Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) MOA
Inhibits reabsorption of sodium and chloride primarily in the loop of Henle nad also in the proximal and distal renal tubules
206
Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) indications
Edema associated with CHF
Cirrhosis of liver
Kidney disease
Nephrotic syndrome
207
Negative chronotropic effect
a decrease in heart rate
208
Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) pharmacologic class
Cardioselective
Beta-adrenergic antagonist
Antihypertensive
Antiaginal
209
Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) MOA
Beta-adrenergic antagonist with preferential effect on beta1 receptors located primarily on cardiac muscle
210
Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) indications
Management of mild to severe hypertension
Long-term treatment of angina pectoris
Stable angina pectoris reduce the risk of mortality after an MI
211
Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) contraindications
Cardiogenic shock, sinus bradycardia, advanced AV block w/out pacemaker, bradycardia, sick sinus syndrome,
212
Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) adverse effects
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Dizziness
Fatigue
Insomnia
Bradycardia
Heartburn
Shortness of breath
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213
Prototype drug Digoxin (Lanoxicaps, Lanoxin) pharmacologic class
Cardiac glycoside
| Inotropic
214
Prototype drug Digoxin (Lanoxicaps, Lanoxin) therapeutic class
Cardiac glycoside
| Antiarrythmic
215
Prototype drug Digoxin (Lanoxicaps, Lanoxin) MOA
Acts by increasing
216
Phosphodiesterase III inhibitors
An enzyme found in cardiac and smooth muscle. When blocked, there is an increase in the calcium available for muscle contraction.
Causes inotropic action and vasodilation
Given intravenously
