FINAL Flashcards
what loop has the best absopriton
bumetanide
WHICH LOOP HAS THE LONGES HALF LIFE
TORSEMIDE
what do you need to monitor with loop
hypoK Cr Mg WEIGHT
No more than 1 lb a day
only loop without a sulfa structure
ethacrynic acid
where do thiazides work
inhibit NaCl reabsorption in the DCT
which SE do Thiazides have that loops don’t
inhances Ca reabsoription which can lead to Ca renal stones
thiazide aDE
high serum glucose
high lipedemia
hyperCa
hyperurecemia
Which Thiazde does not cause hyperlipedemia
indapidmide
which diuretic can be used for osteoporosis
thiazides
which hyprlipid drug is CI in pts with a TG>400
bile
which BAS has the least drug binding
colesevelam
what is the limiting dose for Niacin
2g
what kind of drug is chlorthalidone
Thiazide diuretic
Aldosterone antagonist should nto be taken with
NSAIDS will lose effect
ACEI ARB or renin inhibitor : hyperkalemia
less steroid effects are seen with this aldosterone antagonis
eplerenone
mannitol is only given
IV
which diuretic would we use for a pt with Cr<30
LOOP
how does trimterene work?
distal tubule Na reasorbtion inhibitor and K sparing
what are the ADE of trimeterene
RENAL STONES
hyper K
metrabolic acidosis
what do you need to do inorder to use mannitol
make sure you have good renal function and give test dose in pts with pulmonary edema
two aDH agonists and how they are used
vasopression and desmopression
bed wetting
diabetes insipidous
esophageal variceal bleeding
MOA of ADH agonists
causes vasoconstriction and increases H20 permeability
name the ADH antagonists and how they are used
Conivaptan -IV ONLY
tolvaptan - PO ONLY
used for euvolemic pts with hyponatremia
how do SLG2 inhibitors work for HTN
block NA glucose transporter
indicated for DM
increased UTI
what is CI w/ nitrates
PDE5 inhibitors
best beta blocker for HTN and HF or angina prophylaxis
metorpolol succinate
atenelol is also cardioselective
carvedilol
which CCB result in greatest amount of vasodilation
pines
amlodopine
nidfedipine
which CCB can be used in HF
diltizem and verapimil
b/c of the negative inotropic effects
ADE of CCB
pereferal edema seen more in pines than verabimil
when would you use ranolazine
when you ranolazine out of options for angina
reduced late Na current that facilitates Ca entry via Na/C exchanger leading to decreaed contractility
main ADR w/ ranaolazine
QT prolongation
qt watch
when would you want to avoid spironolactone or eplerenone in HF
sCR>2
or in a pt with K >5
how do ACE’s work and what is their suffex
what a PRIL
they inhibit ACE in the lungs inhibiting the conversion of angeostensin 2
reduces cardiac remodeling
inhibit the breakdown of bradykinen leading to cough
indications for ACE
CHF
DM
HTN-risk ofr stepp BP drop
All ACEs are prodrugs except for
lisinopril
captopril
ACE CI in
pregnancy!!!
bilateral stenosis
ACE should be used with caution in
renal issues,
SBP<80
how should ACE be taken
not with food unless it’s enalipril or lisinopril
caution with lisinipril
liver function
why would we use a ACE over ARB
ACE>ARB in decreasing mortality
if you can’t get well join the dark side (sartan)
name all the ARBS
cadesartan
irbesartan
lorsartan
valsartan
how long should you wait after stopping ACEI before tarting ARB
6 weeks
how do ARBS work
selectively block angiotensin type II
when are ARBS CI
2nd and 3rd trimester pregnancy
caution in SB<80, Low Na, and poor renal funx
what would you want to monitor on a pt taking an ARB
BP, Cr, K
neprolysin inhibitor/ARB
sacubitril/valsartan
ERNESTO
HFrEF
after using
ACE/ARB/ BB and MRA (aldosterone antagonist) wait 36 hrs before using ernesto \
CI with ACEO
what is hydralizine used for
HFrEF
as an add on
works as a vasodilator for systolic dysfunction
digoxins effect on AP
shortens duration
effect os erythromyocin and tetracyclin on digoxin
decrease bioavilability
effects of cyclosporin on digoxin
increases
dig levels should be
<2ng/ml
if greater than 6 than mortality is high
normal half life od digoxin
1.6-2 sayd
alpha 1 adrenergic antagonists what are they and what are the indications
doxazosin, terazosin and prazosin
not 1st line because showed higher risk for CVD HF than thiazides
ZOSIN
why would you want to steer clear of a alpha 1 adrenergic agonist zosin in elderly women
because they cause stress incontinence
floppy iris syndrome?
what are we worried about with prazosin specifically
first dose can cause syncope especially with BB
avoid at night
can induce HF
what are the ADE of hydralizine
reflex tachy fluid retention lupus syndrome makes anginea worse HA flushing
what is minidroxil indicated for ?
rogaine!
mainly for severe HTN with severe renal insufficiency because this drug is hepatically eleminated
usually used with a diuretic
who should we avoid minidroxil in?
makes angina worse avoid in CAD
can also induce pericardial effusion
what is the suffex for SGLT2 inhibitors
FLOZIN
what BB is recommended for HTN in pregnant pts
labetalol
What are some ADE sepecific to dihydropyridines
gingival hyperplasia
pedal edema
what CCB can be used in hypertensive emergencies
clevidipine IV
clevidipine IS CI in
soy or egg allergy or dyslipidemia
this drug inhibits funny currents prolonging diastole and reducing HR
ivabradine
funny IVA
ADE of ivabradine
prolonged QT
afibb
heart block
brady
DRUGS for decompensated HF
nitroprusside
dobutamine
dopamine
nesiritde
potent vasodialator that can be used in HTN emergencies of in decomp HF
nitroprusside
cyanide toxicity is associated with this cardio med
nitroprusside
what do you have to monitor with a pt on nitroprusside
thiocynate levels
B1 agonists
dobutamine
used for decompensated HF
increased contractility, HR, and CO, but also increases oxygen demand so can only be used short term
how does dopamine work for decompensated HF
activates D2 receptros which leads to dilation
activates B1 in the heart
can be used to increase renal blood flow or for SHOCK
how does nesiritide help pts with decompensated HF
binds to vascular smooth muscle and leads to increased cGMP and smooth muscle relaxation
when would we use nesirited
onlu in pts with acute decompensated HF who were unresponsive to nitro
may increase mortality and should be last line
ADR os nesiritide
hypotension
hypersensitiviy
renal damage
what is aliskrin
direct renin inhibitor
when is aliskrin CI
in pregnant pts
in pts with DM
in pts taking ACE or ARB
drugs for HTN emergencies
nitroprusside
fenoldopam
phentolamine
nitroglycerin
how does fenoldopam work
selective D1 agonist and alpha2 agonist: vasodilator and increases renal blood flow
could be good for renal insufficiency
phentolamine MOA and indications
used for HTN emergencies
