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Therapeutics P2 > Exam 6 lecture 2 > Flashcards

Exam 6 lecture 2 Flashcards

1
Q

ACEi inhibits conversion of

A

ANG I to ANG II

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2
Q

How do ARBs work

A

Block the effects of ANG II by binding to target receptors

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3
Q

Renin inhibitors MOA

A

Inhibit Antiotensinogen to ANG I conversion

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4
Q

All ACe I drugs end with

A

-pril

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5
Q

ACE i dosing

A

Most are dosed once a day
captoptril is dosed 2-3 times a day

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6
Q

Dosing strategy for ACE i drugs

A

Never start on a max dose, always start on lowest possibel dose

Dose at night for BP dip overnight

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7
Q

adverse effects of ANg i

A

Angioedema, cough, hyperkalemia, acute renal failure

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8
Q

CI of ACE i

A

Hx of angioedema on an ACE i
concomitant use of aliskiren in pts with DM
Pregnant/nursing

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9
Q

if hx of angioedema/cough of ACE we use

A

ARB

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10
Q

ARBs all end with

A

-sartan

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11
Q

Dosing of ARBs

A

Losartan and Eprosartan only doses given twice

All other once

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12
Q

adverse effects of ARBs

A

Angioedema, hyperkalemia, acute renal failure

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13
Q

CI of ARBs

A

Angioedema on ARBs
Concomitant use of aliskiren in pts with DM
Pregnancy/nursing

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14
Q

ACEi/ARB monitoring

A

check baseline for K and renal function
Check BMP within 1 week for elderly

In low risk pts or ots with K<4.5 wait 3-4 weeks before initial assesment

check 3-4 weeks after initiation if elevated Scr or K at 1-2 weeks

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15
Q

When to hold or reduce ACI/ARB dose

A

if K>5.5
Scr>30%

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16
Q

direct renin inhibitor drug name

A

Aliskiren

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17
Q

CI of aliskiren

A

Concomitant use with ACE or ARB in DM pts

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18
Q

Dosing of Aliskiren

A

QD

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19
Q

Monitoring parameters for aliskiren

A

K, BUN, SCr

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20
Q

Adverse effects of Alsikiren

A

NO cough

Diarrhea, h/a, hyperkalemia, renal insufficiency, dizziness

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21
Q

CCB MOA

A

inhibit influx of Ca across cardiac and smoth muscle causing vasoddilation

22
Q

Which CCB has more vasidilation

23
Q

What patient population would have additional benefits for CCBs

A

Reynauds syndrome
elderly pts with isolated systolic HTN

24
Q

Which CCB can cause baroreceptor mediated tachycardia

25
DHP drugs
All end in -pine Amlodipine, nifedipine
26
How often are CCBs dosed
QD except for Isradipine and nicardipine (BID for both)
27
Adverse ffects of CCBs
Reflex tachycardia, flushing, dizziness
28
Warnings for CCB
increase risk of angina/MI in pts with obstructive coronary disease due to reflex tachycardia
29
Patients with additional benefits for non DHP CCBs
Supraventriculat tachycardia A fib pts with Angina who can not tolerate BB
30
How do non DHP CCBs affect AV node conduction and HR
Decrease both
31
NON DHP CCBs drug names
Verapamil and diltiazem
32
How often are diltiazem and verapamil dosed
QD or BID
33
Adverse effects of NON DHP CCBs
Bradycardia, H/A, Dizziness, AV node block, (Constipation in verapamil)
34
If a CCB is needed for HF choose
Amlodipine
35
Amlodipine side effects
Might cause swollen ankles (decrease dose to combat this) COmpression stockings could help
36
WHich CCB helps with both BP and Angina
NON-DHP CCBs (diltiazem and verapamil)
37
Compelling indication for the use of B blockers
Stacle ischemic heart disease HFrEF
38
Important counseling point for BB
AVOID abrupt cessation
39
What are some cardioselective B blockers
Atenolol, Betaxolol, Bisoprolol, Metoprolol tartrate and metorpolol succinate, Nebivolol
40
WHich cardioselective B blocker is short acting and is dosed BID
Metorprolol tartrate All others dosed QD
41
How does nebivolol differ from other B blockers
It induces NO, causes vasodilation
42
Non-selective B blockers
Nadolol Propanolol IR Propanolol LA
43
Which non selective B blocker is dosed BID
Propanolol IR
44
What type of patients should never use NON selective B blockers
bronchospastic airway disease pts (Asthma, COPD)
45
B blockers with intrinsic sympathomimetic activity (ISA) drugs
Acebutolol-BID Penbutolol- QD Pindolol- BID
46
IMPORTANT What type of pts should never use ISA BB
Pts with HF and ischemic heart disease
47
Bixed alpha/beta drugs
Carvedilol Labetalol
48
How are mixed a/b blockers dosed
BID
49
B blocker adverse effects
Bronchospasm, bradycardia, fatigue, exercise intolerance, depression Can also mask symptoms of hypoglycemia
50
what BB is preferred in PAD (peripheral artery disease)
Carvedilol
51
What BB is preferred in airway diseases
Selective BB
52
contraindications of BBs
2nd and 3rd degree heart block Bradycardia HF Post MI of ISA BBs

Therapeutics P2 (41 decks)

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