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Pharm II > FINAL > Flashcards

FINAL Flashcards

1
Q

what loop has the best absopriton

A

bumetanide

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2
Q

WHICH LOOP HAS THE LONGES HALF LIFE

A

TORSEMIDE

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3
Q

what do you need to monitor with loop

A

hypoK Cr Mg WEIGHT

No more than 1 lb a day

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4
Q

only loop without a sulfa structure

A

ethacrynic acid

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5
Q

where do thiazides work

A

inhibit NaCl reabsorption in the DCT

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6
Q

which SE do Thiazides have that loops don’t

A

inhances Ca reabsoription which can lead to Ca renal stones

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7
Q

thiazide aDE

A

high serum glucose
high lipedemia
hyperCa
hyperurecemia

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8
Q

Which Thiazde does not cause hyperlipedemia

A

indapidmide

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9
Q

which diuretic can be used for osteoporosis

A

thiazides

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10
Q

which hyprlipid drug is CI in pts with a TG>400

A

bile

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11
Q

which BAS has the least drug binding

A

colesevelam

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12
Q

what is the limiting dose for Niacin

A

2g

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13
Q

what kind of drug is chlorthalidone

A

Thiazide diuretic

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14
Q

Aldosterone antagonist should nto be taken with

A

NSAIDS will lose effect

ACEI ARB or renin inhibitor : hyperkalemia

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15
Q

less steroid effects are seen with this aldosterone antagonis

A

eplerenone

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16
Q

mannitol is only given

A

IV

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17
Q

which diuretic would we use for a pt with Cr<30

A

LOOP

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18
Q

how does trimterene work?

A

distal tubule Na reasorbtion inhibitor and K sparing

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19
Q

what are the ADE of trimeterene

A

RENAL STONES
hyper K
metrabolic acidosis

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20
Q

what do you need to do inorder to use mannitol

A

make sure you have good renal function and give test dose in pts with pulmonary edema

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21
Q

two aDH agonists and how they are used

A

vasopression and desmopression

bed wetting
diabetes insipidous
esophageal variceal bleeding

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22
Q

MOA of ADH agonists

A

causes vasoconstriction and increases H20 permeability

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23
Q

name the ADH antagonists and how they are used

A

Conivaptan -IV ONLY
tolvaptan - PO ONLY

used for euvolemic pts with hyponatremia

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24
Q

how do SLG2 inhibitors work for HTN

A

block NA glucose transporter
indicated for DM
increased UTI

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25
Q

what is CI w/ nitrates

A

PDE5 inhibitors

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26
Q

best beta blocker for HTN and HF or angina prophylaxis

A

metorpolol succinate
atenelol is also cardioselective
carvedilol

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27
Q

which CCB result in greatest amount of vasodilation

A

pines
amlodopine
nidfedipine

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28
Q

which CCB can be used in HF

A

diltizem and verapimil

b/c of the negative inotropic effects

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29
Q

ADE of CCB

A

pereferal edema seen more in pines than verabimil

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30
Q

when would you use ranolazine

A

when you ranolazine out of options for angina

reduced late Na current that facilitates Ca entry via Na/C exchanger leading to decreaed contractility

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31
Q

main ADR w/ ranaolazine

A

QT prolongation

qt watch

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32
Q

when would you want to avoid spironolactone or eplerenone in HF

A

sCR>2

or in a pt with K >5

33
Q

how do ACE’s work and what is their suffex

A

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

34
Q

indications for ACE

A

CHF
DM
HTN-risk ofr stepp BP drop

35
Q

All ACEs are prodrugs except for

A

lisinopril

captopril

36
Q

ACE CI in

A

pregnancy!!!

bilateral stenosis

37
Q

ACE should be used with caution in

A

renal issues,

SBP<80

38
Q

how should ACE be taken

A

not with food unless it’s enalipril or lisinopril

39
Q

caution with lisinipril

A

liver function

40
Q

why would we use a ACE over ARB

A

ACE>ARB in decreasing mortality

if you can’t get well join the dark side (sartan)

41
Q

name all the ARBS

A

cadesartan
irbesartan
lorsartan
valsartan

42
Q

how long should you wait after stopping ACEI before tarting ARB

A

6 weeks

43
Q

how do ARBS work

A

selectively block angiotensin type II

44
Q

when are ARBS CI

A

2nd and 3rd trimester pregnancy

caution in SB<80, Low Na, and poor renal funx

45
Q

what would you want to monitor on a pt taking an ARB

A

BP, Cr, K

46
Q

neprolysin inhibitor/ARB

A

sacubitril/valsartan

ERNESTO
HFrEF

after using
ACE/ARB/ BB and MRA (aldosterone antagonist) wait 36 hrs before using ernesto \
CI with ACEO

47
Q

what is hydralizine used for

A

HFrEF
as an add on

works as a vasodilator for systolic dysfunction

48
Q

digoxins effect on AP

A

shortens duration

49
Q

effect os erythromyocin and tetracyclin on digoxin

A

decrease bioavilability

50
Q

effects of cyclosporin on digoxin

A

increases

51
Q

dig levels should be

A

<2ng/ml

if greater than 6 than mortality is high

52
Q

normal half life od digoxin

A

1.6-2 sayd

53
Q

alpha 1 adrenergic antagonists what are they and what are the indications

A

doxazosin, terazosin and prazosin

not 1st line because showed higher risk for CVD HF than thiazides

ZOSIN

54
Q

why would you want to steer clear of a alpha 1 adrenergic agonist zosin in elderly women

A

because they cause stress incontinence

floppy iris syndrome?

55
Q

what are we worried about with prazosin specifically

A

first dose can cause syncope especially with BB
avoid at night
can induce HF

56
Q

what are the ADE of hydralizine

A 
reflex tachy
fluid retention
lupus syndrome
makes anginea worse
HA 
flushing
57
Q

what is minidroxil indicated for ?

A

rogaine!

mainly for severe HTN with severe renal insufficiency because this drug is hepatically eleminated

usually used with a diuretic

58
Q

who should we avoid minidroxil in?

A

makes angina worse avoid in CAD

can also induce pericardial effusion

59
Q

what is the suffex for SGLT2 inhibitors

A

FLOZIN

60
Q

what BB is recommended for HTN in pregnant pts

A

labetalol

61
Q

What are some ADE sepecific to dihydropyridines

A

gingival hyperplasia

pedal edema

62
Q

what CCB can be used in hypertensive emergencies

A

clevidipine IV

63
Q

clevidipine IS CI in

A

soy or egg allergy or dyslipidemia

64
Q

this drug inhibits funny currents prolonging diastole and reducing HR

A

ivabradine

funny IVA

65
Q

ADE of ivabradine

A

prolonged QT
afibb
heart block
brady

66
Q

DRUGS for decompensated HF

A

nitroprusside
dobutamine
dopamine
nesiritde

67
Q

potent vasodialator that can be used in HTN emergencies of in decomp HF

A

nitroprusside

68
Q

cyanide toxicity is associated with this cardio med

A

nitroprusside

69
Q

what do you have to monitor with a pt on nitroprusside

A

thiocynate levels

70
Q

B1 agonists

A

dobutamine

used for decompensated HF
increased contractility, HR, and CO, but also increases oxygen demand so can only be used short term

71
Q

how does dopamine work for decompensated HF

A

activates D2 receptros which leads to dilation
activates B1 in the heart

can be used to increase renal blood flow or for SHOCK

72
Q

how does nesiritide help pts with decompensated HF

A

binds to vascular smooth muscle and leads to increased cGMP and smooth muscle relaxation

73
Q

when would we use nesirited

A

onlu in pts with acute decompensated HF who were unresponsive to nitro

may increase mortality and should be last line

74
Q

ADR os nesiritide

A

hypotension
hypersensitiviy
renal damage

75
Q

what is aliskrin

A

direct renin inhibitor

76
Q

when is aliskrin CI

A

in pregnant pts
in pts with DM
in pts taking ACE or ARB

77
Q

drugs for HTN emergencies

A

nitroprusside

fenoldopam

phentolamine

nitroglycerin

78
Q

how does fenoldopam work

A

selective D1 agonist and alpha2 agonist: vasodilator and increases renal blood flow

could be good for renal insufficiency

79
Q

phentolamine MOA and indications

A

used for HTN emergencies

Pharm II (16 decks)

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