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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

A

DHP

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

A

DHP

25
Q

DHP drugs

A

All end in -pine

Amlodipine, nifedipine

26
Q

How often are CCBs dosed

A

QD except for Isradipine and nicardipine (BID for both)

27
Q

Adverse ffects of CCBs

A

Reflex tachycardia, flushing, dizziness

28
Q

Warnings for CCB

A

increase risk of angina/MI in pts with obstructive coronary disease due to reflex tachycardia

29
Q

Patients with additional benefits for non DHP CCBs

A

Supraventriculat tachycardia
A fib
pts with Angina who can not tolerate BB

30
Q

How do non DHP CCBs affect AV node conduction and HR

A

Decrease both

31
Q

NON DHP CCBs drug names

A

Verapamil and diltiazem

32
Q

How often are diltiazem and verapamil dosed

A

QD or BID

33
Q

Adverse effects of NON DHP CCBs

A

Bradycardia, H/A, Dizziness, AV node block, (Constipation in verapamil)

34
Q

If a CCB is needed for HF choose

A

Amlodipine

35
Q

Amlodipine side effects

A

Might cause swollen ankles (decrease dose to combat this)
COmpression stockings could help

36
Q

WHich CCB helps with both BP and Angina

A

NON-DHP CCBs (diltiazem and verapamil)

37
Q

Compelling indication for the use of B blockers

A

Stacle ischemic heart disease
HFrEF

38
Q

Important counseling point for BB

A

AVOID abrupt cessation

39
Q

What are some cardioselective B blockers

A

Atenolol, Betaxolol, Bisoprolol, Metoprolol tartrate and metorpolol succinate, Nebivolol

40
Q

WHich cardioselective B blocker is short acting and is dosed BID

A

Metorprolol tartrate

All others dosed QD

41
Q

How does nebivolol differ from other B blockers

A

It induces NO, causes vasodilation

42
Q

Non-selective B blockers

A

Nadolol
Propanolol IR
Propanolol LA

43
Q

Which non selective B blocker is dosed BID

A

Propanolol IR

44
Q

What type of patients should never use NON selective B blockers

A

bronchospastic airway disease pts (Asthma, COPD)

45
Q

B blockers with intrinsic sympathomimetic activity (ISA) drugs

A

Acebutolol-BID
Penbutolol- QD
Pindolol- BID

46
Q

IMPORTANT What type of pts should never use ISA BB

A

Pts with HF and ischemic heart disease

47
Q

Bixed alpha/beta drugs

A

Carvedilol
Labetalol

48
Q

How are mixed a/b blockers dosed

A

BID

49
Q

B blocker adverse effects

A

Bronchospasm, bradycardia, fatigue, exercise intolerance, depression

Can also mask symptoms of hypoglycemia

50
Q

what BB is preferred in PAD (peripheral artery disease)

A

Carvedilol

51
Q

What BB is preferred in airway diseases

A

Selective BB

52
Q

contraindications of BBs

A

2nd and 3rd degree heart block
Bradycardia
HF
Post MI of ISA BBs

Therapeutics P2 (41 decks)

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