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Final- Old Stuff Flashcards

1
Q

Dixogin

A

MOA-

  • inhibits Na/ K/ ATPase pump.
    • Intracellular Na+ & Ca+ increases.
      • Increase Ca+→ increased contractility (+ inotrope).
  • Increase vagal efferent efferent
    • redueces SA firing→ decreased HR,
    • slows conduction velocity in AV mode

Renal clearnace

DDI- quinidine, verapamil, amioarone

Hypokalemia can cause toxicity (watch for duretic use)

  • GI- nausea/ vomitting
  • confusion/ neurological changes
  • visual changes cardiac toxicity
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2
Q

Lidocaine

A

Anti-arrhythmic Class 1b- Na channel blockers- short refractory period

Ventricular arrhythmia ONLY

ONLY IV

CNS toxicity- paresthesia, confusion, seizure, tremor

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3
Q

Hydrocholorothiazide

A

Thiazide diuretic- inhibt Nacl luminal synporter

Inital therapy for hypertention not goog for renal disease but good for kidney stones caused by hypercalciuria

ADR- Hypokalemia, hypercalcemia, hypomagnesemia, hyperuricemia

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4
Q

Glyburide

A

Sulfonylureas (oral)- first generation

MOA- initally bind to high affinity 140-kDa SU receptor and block K channel in beta cell in increase insulin release , works on pancreas in the K channels in the beta cells

Works independent of glucose load- insulin porduced even if glucose is not present so take with food

ADR- Hypoglycemia (highest in class), weight gain

Use in caution in older patients and those with renal impairment

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5
Q

Esmolol

A

Class 2- Beta blockers

MOA- supression of abnormal pacemaker activity by cloking sympathetic (beta 1- receptor) activity in SA/ AV node

IV- short acting acute arrhythmia

Preferred for rate control

ADR

  • Bronchospasm, AV block, Hypotension, exercise intolerance, sexual dysfunction, masking hyperglycemia
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6
Q

Nateglinide

A

Glinide

MOA- initally bind to high affinity 140-kDa SU receptor and block K channel in beta cell in increase insulin release , works on pancreas in the K channels in the beta cells

Works independent of glucose load- insulin porduced even if glucose is not present so take with food

Rapid onset of action best for post prandial glucose- take before meal

ADR- Hypoglycemia, weight gain (both less then SU)

Use in caution in older patients and those with renal impairment

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7
Q

Metformin

A

Biguanide

MOA- Activatio of AMP- Kinase (supress hepatic glucose production (gluconeogenesis)- mean mechanism, increase insulin sensitivity of peripheral tissue (increase number of Glut-4 receptor), works on liver, muscle adipose tissue (AMP-K), Glut-4

ADR- Diarrhea, anorexia, metallic taste, GI (titrate to minimize GI effect), increse plasma lactate( lactic acidosis), less B12 absorption

NO hypoglycemia with monotherapy

causes weight loss or neutral

Renal consideration- eGFR < 30 no not use

Titrate- 500 mg BID with meals to start then increase 500 mg increment every 5-6 days

MAX dose- 2000 mg daily

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8
Q

Ethacrynic Acid

A

Loop diuretic- inhibits luminal Na/K/2Cl

DOC diuretic class for renal disease, can be used in sulfa allergy

ADR- Hypokalemia, hypocalemia, hypomagnesemia, hyperuricemia

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9
Q

Nisoldipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

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10
Q

Chlorthalidone

A

Thiazide diuretic- inhibt Nacl luminal synporter

Inital therapy for hypertention not goog for renal disease but good for kidney stones caused by hypercalciuria

ADR- Hypokalemia,hypercalcemia,hypomagnesemia, hyperuricemia

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11
Q

Lispro U-100

A

Rapid- Acting Insulin

MOA- stablized in hexamer

Less hypoglycemia then short acting

used in insulin pump

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12
Q

Lixisenatide

A

GLP-1 receptor agonist- incretin mimetic (injectable)

MOA-

  • slows gastic empty which reduces post-pradial rise in blood glucoe (feels fuller longer)
  • Decreases in appetitie- WEIGHT LOSS
  • Increase insulin secretion by activating beta cells
    • glucose dependent (safer then SU)
  • Supresses glucagon release

ADR- Nausea (less nausea with weely formulations),mide hypoglycemia, pancretitis, weight loss

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13
Q

Clevidipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

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14
Q

Adenosine

A

Adenosine receptors found in AV nodal tissue and vascular smooth mucle

  • Slows AV nodal conduction

ADR-

  • Vasodilation→ flushing hypotension
  • Chest pain
  • Dyspnea
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15
Q

Chlorothiazide

A

Thiazide diuretic- inhibt Nacl luminal synporter

Inital therapy for hypertention can use for renal disease (only one in class) but good for kidney stones caused by hypercalciuria

ADR- Hypokalemia,hypercalcemia,hypomagnesemia, hyperuricemia

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16
Q

Repaglinide

A

Glinide

MOA- initally bind to high affinity 140-kDa SU receptor and block K channel in beta cell in increase insulin release , works on pancreas in the K channels in the beta cells

Works independent of glucose load- insulin porduced even if glucose is not present so take with food

Rapid onset of action best for post prandial glucose- take before meal

ADR- Hypoglycemia, weight gain (both less then SU)

Use in caution in older patients and those with renal impairment

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17
Q

Linaglipton

A

DPP-4 Inhibitor

MOA- inhibits the action of the DPP-4 enzyme which inhibits the breakdown of endogenous GLP-1. Inhibits incretin breakdown

Useful in patients with low levels of incretin/ GLP-1

ADR- Headache, nasopharyngitis, rash, URI, joint aches

Renal adjustment NOT required- only one in class

Not replacing incretin- just inhibiting the thing thats breaking down incretin (DPP-4)

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18
Q

Verapamil

A

Class 4- Ca+ channel blockers (non DHP- CCB)

MOA- slows conduction in AV node by blocking Ca channels (phase 2),

Good for asthma and COPD patients for rate control

DO NOT USE IN HF

ADR- Constipation, hypotension, AV block,

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19
Q

Ramipril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

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20
Q

Disopyramide

A

Anti-arrhythmic Class 1A- Na channel blockers

MOA- blocks Na+ channel moderately and K+

Negative inotrope

Antimuscarinic effects (Hot, dry fast crazy), exacerbates, heart failure, increases digoxin toxicity

All 1a drugs can precipitate new arrhythmia

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21
Q

Benzepril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

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22
Q

Eprosartan

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

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23
Q

Canagliflozin

A

SGLT-2 inhibitor

MOA-inhibitrs SGLT-2 transporter in kidney to decrease reabsorption of glucose thus increasing urinary glucose excretion

ADR- Polyuria, increased risk of genital myoctic infection and UTI, increased LDL, volume depletion ( with diuretis double the risk), increased risk of amputations

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24
Q

NPH- Humulin, Novolin

A

Intermediate acting

MOA- recombinant human insulin complexed with zinc and protamine to delay absorption and extend action

Often combined with rapid acting insulin

Highest rate of hypogylcemia

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25
Q

Dulaglitide

A

GLP-1 receptor agonist- incretin mimetic (injectable)

MOA-

  • slows gastic empty which reduces post-pradial rise in blood glucoe (feels fuller longer)
  • Decreases in appetitie- WEIGHT LOSS
  • Increase insulin secretion by activating beta cells
    • glucose dependent (safer then SU)
  • Supresses glucagon release

ADR- Nausea (less nausea with weely formulations),mide hypoglycemia, pancretitis, weight loss

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26
Q

Novolin

A

Short- Acting (regular insulin)

MOA- hexamer complex with zinc

IV in-patient for diabetics for DKA

Higer risk of hyopglycemia then rapid acting

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27
Q

Glipizide

A

Sulfonylureas (oral)- second generation

MOA- initally bind to high affinity 140-kDa SU receptor and block K channel in beta cell in increase insulin release , works on pancreas in the K channels in the beta cells

Works independent of glucose load- insulin porduced even if glucose is not present so take with food

ADR- Hypoglycemia, weight gain

Use in caution in older patients and those with renal impairment

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28
Q

Captopril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia,AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

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29
Q

Metolazone

A

Thiazide diuretic- inhibt Nacl luminal synporter

Inital therapy for hypertention can use for renal disease (only one in class) but good for kidney stones caused by hypercalciuria

ADR- Hypokalemia,hypercalcemia,hypomagnesemia, hyperuricemia

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30
Q

Propranolol

A

Class 2- Beta blockers

MOA- supression of abnormal pacemaker activity by cloking sympathetic (beta 1- receptor) activity in SA/ AV node

thyrotoxicosis induce arrhythmia

Preferred for rate control

ADR

  • Bronchospasm, AV block, Hypotension, exercise intolerance, sexual dysfunction, masking hyperglycemia
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31
Q

Telmisartan

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

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32
Q

Sacubitril; Valsartan (entresto)

A

Neprilysin inhibitor- stops the breakdown down of vasodilators

ADR- hyperkalemia, cough/angioedema/ ARF/ AKI/ hypotension (more then enalapril)

Demonstrated superiority to enalapril

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33
Q

Dronedarone

A

Class 3- K+ channel blocker

MOA- block K+ channelsto delay repolarization (phase 3) (increase AP duration, Increase the refractory period), Na+, Ca+

Strong CYP 34A interactions

ADR

  • GI intolerence,
  • lacks pulmonary, thyroid, or hepatic effects vs amiodarone

LESS ADRs then amiodarone but not as effective

CANNOT USE IN HF

All Class 3 drugs can increase the risk of subsequent arrhythmias, most notably torsades (QTc prolongation)

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34
Q

Olmesartan

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

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35
Q

Afrezza

A

Inhaled insulin- rapid acting

MOA- absorb onto technosphere microparticles for pulmonary administation, dissoves in neutral pH

Good for people who dont want to inject themselves, bad for asthma/ COPD

less hypoglyemia then aspart

ADR- cough, sore throat, hypoglycemia, bronchitis, weight gain

Monitor- PFT- ar baseline, 6 months and anually

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36
Q

Alogliptin

A

DPP-4 Inhibitor

MOA- inhibits the action of the DPP-4 enzyme which inhibits the breakdown of endogenous GLP-1. Inhibits incretin breakdown

Useful in patients with low levels of incretin/ GLP-1

ADR- Headache, nasopharyngitis, rash, URI, joint aches

Increased HF admissions with someone already with HF

Renal adjustment required

Not replacing incretin- just inhibiting the thing thats breaking down incretin (DPP-4)

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37
Q

Empagliflozin

A

SGLT-2 inhibitor

MOA-inhibitrs SGLT-2 transporter in kidney to decrease reabsorption of glucose thus increasing urinary glucose excretion

ADR- Polyuria, increased risk of genital myoctic infection and UTI, increased LDL, volume depletion ( with diuretis double the risk),

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38
Q

Indapamide

A

Thiazide diuretic- inhibt Nacl luminal synporter

Inital therapy for hypertention can use for renal disease (only one in class) but good for kidney stones caused by hypercalciuria

ADR- Hypokalemia,hypercalcemia,hypomagnesemia, hyperuricemia

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39
Q

Flecainide

A

Anti-arrhythmic Class 1c- Na channel blockers

Dizziness

Metallic taste

NORMAL HEARTS ONLY

40
Q

Saxagliptin

A

DPP-4 Inhibitor

MOA- inhibits the action of the DPP-4 enzyme which inhibits the breakdown of endogenous GLP-1. Inhibits incretin breakdown

Useful in patients with low levels of incretin/ GLP-1

ADR- Headache, nasopharyngitis, rash, URI, joint aches

Increased HF admissions with someone already with HF

Renal adjustment required

CYP 3A4 interacts CYP 3A4 inhibitors

Not replacing incretin- just inhibiting the thing thats breaking down incretin (DPP-4)

41
Q

Bromocriptine

A

Prefferable for Parkinson and Diabetes

42
Q

Pramlintide

A

Amylin Analog

MOA- supression of high postprandial hyperglycemia, slows gastic emptying, and increased satiety

Indicated for use with mealtime insulin but must reduce inulin dose by 50% to avoid hypoglycemia (BLACK BOX WARNING)

ADR- Nausea, vomiting, anorexia, increased risk of insulin-induced hypoglycemia

Used in Type 1 DM

43
Q

Procainamide

A

Anti-arrhythmic Class 1A- Na channel blockers

MOA- blocks Na+ channel moderately and K+

IV

Hypotension, lupus-like syndrome, arganulocytosis, nasuea, diarrhea

Cleared though kidneys

All 1a drugs can precipitate new arrhythmia

Most likely to cause torsades

44
Q

Valsartan

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

45
Q

Mexilteine

A

Anti-arrhythmic Class 1b- Na channel blockers- short refractory period

Ventricular arrhythmia ONLY

IV and PO

Longer duration of action

CNS toxicity- paresthesia, confusion, seizure, tremor (sign of toxicity), GI upset

46
Q

Perindopril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

47
Q

Sotalol

A

Class 3- K+ channel blocker

MOA- block K+ channelsto delay repolarization (phase 3) (increase AP duration, Increase the refractory period), K+and Beta receptors

Treatment of ventricular arrhythmias and afib

Do not use if LVEF <25%

Renally cleared

All Class 3 drugs can increase the risk of subsequent arrhythmias, most notably torsades (QTc prolongation)

48
Q

Liraglutide

A

GLP-1 receptor agonist- incretin mimetic (injectable)

MOA-

  • slows gastic empty which reduces post-pradial rise in blood glucoe (feels fuller longer)
  • Decreases in appetitie- WEIGHT LOSS
  • Increase insulin secretion by activating beta cells
    • glucose dependent (safer then SU)
  • Supresses glucagon release

ADR- Nausea, mide hypoglycemia, pancretitis, weight loss

Requires dose titration to reduce nausea

49
Q

Quinapril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia,AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

50
Q

Quinidine

A

Anti-arrhythmic Class 1A- Na channel blockers

MOA- blocks Na+ channel moderately and K+

Most toxic in the class

HA, vertigo, tinnitus, GI distrubance, thrombocytopena, hemolyic anemia, hepatitis

All 1a drugs can precipitate new arrhythmia

51
Q

Losartan

A

ARB- Blocks recepotrs for angiotension II

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (lower then ACE ), Angioedema, Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

52
Q

Amlopdipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

53
Q

Moexipril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

54
Q

Felodipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

55
Q

Nifedipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

56
Q

Spironolactone

A

K- sparring diuretic- collecting duct- Na excretion and K reabsorbtion

Aldosterone antagonist- can be used for acne, Increases the expression of Na channels

DO not use with diabetics with protein in their urine, can use in sulfa allergy

least likely to cause gout​

ADR- Hyperkalemia, gynecomastia (adrogen recepotor blockade),

57
Q

Lisinopril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics) and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia,AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

58
Q

Acarbose

A

Alpha- Glucosidase Inhibitor

MOA- inhibits enzymes in small intestine that hydrolyze polysaccharides (starches) into simple sugars→ delays the absorption of dietary CHO→ reduced post parandial glucose

Taken at the start of each meal- before meal because drug must be available in the intestine

ADR- poor absorption, flatulence, bloating, abdominal pain

59
Q

Humulin

A

Short- Acting (regular insulin)

MOA- hexamer complex with zinc

IV in-patient for diabetics for DKA

Higer risk of hyopglycemia then rapid acting

60
Q

Fosinopril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

61
Q

Pioglitazone

A

Thiazolidinediones (TZD)

MOA- Activate PPAR- gamma in muscle, liver and fat

  • increase GLUT1 and GLUT4 transpsporter expression
    • Increases insulin sensitivity
    • Decrease gluconeogenesis
    • Decrease TG in ciruclation (increase lipoprotein lipase)

ADR- WEIGHT GAIN, edema→ exacerbate CHF, increased LFTs, increase bone fracture, anemia

Delayed clinical effect- 8-12 weeks combine with metformin

Increased risk of bladder cancer if use over 1 year

62
Q

Degludec

A

Ultra- Long acting

MOA- forms multihexamer upon injection, resulting in a large depot. Gradual remocal of zinc leads to slow dissociaion into dimers and monomers

63
Q

Glargine

A

Ultra- Long acting

MOA- same as insulin glargine U-100; given at one thrid of volume

64
Q

Diltiazem

A

Class 4- Ca+ channel blockers (non DHP CCB)

MOA- slows conduction in AV node by blocking Ca channels

Good for asthma and COPD patients for rate control

DO NOT USE IN HF

ADR- Constipation, Flushing hypotension, AV block

65
Q

Colesvelam

A

Approved for pregnancy weight lowering

66
Q

Amiodarone

A

Class 3- K+ channel blocker

MOA- has class 1, 2 & 4 electrophysiologix properties

Lowest risk of torsades in class 3

Long half life

DDI (MANY)- digoxin, warfarin, etc

Lipophilic

Monitor- TFTs, LFTs, PFTs/ CXR (yearly)

ADR

  • Pumonary fibrosis, hepatic dsyfunction, grey-blue skin, corneal deposits, hypo/hyperthyroidism (iodine based)

All Class 3 drugs can increase the risk of subsequent arrhythmias, most notably torsades (QTc prolongation)

67
Q

Aliskiren

A

Direct Renin Inhibitor- prevents the generation of angiotension I

DO NOT COMBINE WITH ACE/ARB

ADR- hypotension, hyperkalemia, AKI/AKF, rare angioedema, teratogenic

68
Q

Propafenone

A

Anti-arrhythmic Class 1c- Na channel blockers

Mild Beta blocking properties

NORMAL HEARTS ONLY

69
Q

Furosemide

A

Loop diuretic- inhibits luminal Na/K/2Cl

DOC diuretic class for renal disease

ADR- Hypokalemia, hypocalemia, hypomagnesemia, hyperuricemia

70
Q

Amiloride

A

K- sparring diuretic- collecting duct- Sodium channel blockers Na excretion and K reabsorbtion

DO not use with diabetics with protein in their urine, can use in sulfa allergy

ADR- Hyperkalemia,

71
Q

Miglitol

A

Alpha- Glucosidase Inhibitor

MOA- inhibits enzymes in small intestine that hydrolyze polysaccharides (starches) into simple sugars→ delays the absorption of dietary CHO→ reduced post parandial glucose

Taken at the start of each meal- before meal because drug must be available in the intestine

ADR- poor absorption, flatulence,bloating, abdominal pain

72
Q

Glulisine

A

Short- Acting (regular insulin)

MOA- hexamer complex with zinc

IV in-patient for diabetics for DKA

Higer risk of hyopglycemia then rapid acting

73
Q

Azilsartan

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

74
Q

Glargine

A

Long acting

MOA- soluable at & injected as an acidic solution (pH-4). After injection the acidic solution is neutralized leading to formation of mcroprepitates. Small amount of glargine are slowly released from assportion

75
Q

Asoart

A

Short- Acting (regular insulin)

MOA- hexamer complex with zinc

IV in-patient for diabetics for DKA

Higer risk of hyopglycemia then rapid acting

76
Q

Torsemide

A

Loop diuretic- inhibits luminal Na/K/2Cl

DOC diuretic class for renal disease

ADR- Hypokalemia, hypocalemia, hypomagnesemia, hyperuricemia

77
Q

Rosiglitazone

A

Thiazolidinediones (TZD)

MOA- Activate PPAR- gamma in muscle, liver and fat

  • increase GLUT1 and GLUT4 transpsporter expression
    • Increases insulin sensitivity
    • Decrease gluconeogenesis
    • Decrease TG in ciruclation (increase lipoprotein lipase)

ADR- WEIGHT GAIN, edema→ exacerbate CHF, increased LFTs, increase bone fracture, anemia

Delayed clinical effect- 8-12 weeks combine with metformin

78
Q

Nimodipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

79
Q

Ibutilide

A

Class 3- K+ channel blocker

MOA- block K+ channels to delay repolarization (phase 3) (increase AP duration, Increase the refractory period), Na+ and Beta receptors

Treatment of acute afib- most effective when given within seven days of onset

All Class 3 drugs can increase the risk of subsequent arrhythmias, most notably torsades (QTc prolongation)

80
Q

Nicardipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

81
Q

Defetilide

A

Class 3- K+ channel blocker

MOA- block K+ channelsto delay repolarization (phase 3) (increase AP duration, Increase the refractory period)

Must be strated inpatient; provider must be registered to perscribe& pharmacy to dispense

DDI- HCTZ, verapamil

All Class 3 drugs can increase the risk of subsequent arrhythmias, most notably torsades (QTc prolongation)

82
Q

Metoprolol

A

Class 2- Beta blockers

MOA- supression of abnormal pacemaker activity by cloking sympathetic (beta 1- receptor) activity in SA/ AV node

Preferred for rate control

ADR

  • Bronchospasm, AV block, Hypotension, exercise intolerance, sexual dysfunction, masking hyperglycemia
83
Q

Isradipine

A

DHP CCB

Can be used in HF but only treats the hypertension in HF

Potenial reflex tachycardia so combine with Beta blockers (beta 1- antagonist)

ADR- Peripheral edema (dose- related), flushing (dose-related), palpitations (dose- related), reflex tachycardia (give with beta blocker)

84
Q

Enalapril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia,AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

85
Q

Semaglutide

A

GLP-1 receptor agonist- incretin mimetic (injectable)

MOA-

  • slows gastic empty which reduces post-pradial rise in blood glucoe (feels fuller longer)
  • Decreases in appetitie- WEIGHT LOSS
  • Increase insulin secretion by activating beta cells
    • glucose dependent (safer then SU)
  • Supresses glucagon release

ADR- Nausea (less nausea with weely formulations),mide hypoglycemia, pancretitis, weight loss

86
Q

Trandolapril

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

87
Q

Exenatide

A

GLP-1 receptor agonist- incretin mimetic (injectable)

MOA-

  • slows gastic empty which reduces post-pradial rise in blood glucoe (feels fuller longer)
  • Decreases in appetitie- WEIGHT LOSS
  • Increase insulin secretion by activating beta cells
    • glucose dependent (safer then SU)
  • Supresses glucagon release

ADR- Nausea (less nausea with weely formulations), mide hypoglycemia, pancretitis, weight loss

88
Q

Eplerenone

A

K- sparring diuretic- collecting duct- Na excretion and K reabsorbtion

Aldosterone antagonist- can be used for acne, Increases the expression of Na channels

DO not use with diabetics with protein in their urine, can use in sulfa allergy

least likely to cause gout

ADR- Hyperkalemia, gynecomastia (adrogen recepotor blockade)

89
Q

Sitagliptin

A

DPP-4 Inhibitor

MOA- inhibits the action of the DPP-4 enzyme which inhibits the breakdown of endogenous GLP-1. Inhibits incretin breakdown

Useful in patients with low levels of incretin/ GLP-1

ADR- Headache, nasopharyngitis, rash, URI, joint aches

Renal adjustments

Not replacing incretin- just inhibiting the thing thats breaking down incretin (DPP-4)

90
Q

Chlorpropamide

A

Sulfonylureas (oral)- first generation

MOA- initally bind to high affinity 140-kDa SU receptor and block K channel in beta cell in increase insulin release, works on pancreas in the K channels in the beta cells

Works independent of glucose load- insulin porduced even if glucose is not present so take with food

ADR- Hypoglycemia , weight gain

Use in caution in older patients and those with renal impairment

91
Q

Candesartan

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

92
Q

Glimeperide

A

Sulfonylureas (oral)- second generation

MOA- initally bind to high affinity 140-kDa SU receptor and block K channel in beta cell in increase insulin release , works on pancreas in the K channels in the beta cells

Works independent of glucose load- insulin porduced even if glucose is not present so take with food

ADR- Hypoglycemia, weight gain

Use in caution in older patients and those with renal impairment

93
Q

Detemir

A

Long- Acting

MOA- Neurtral pH. Has stron molecular association once injected, 98% bound to albumin once in circulation to slow distrubution into tissue

In hypoalbuminemia causes hypoglycemia becase there is more free drug

94
Q

Irbesartan

A

ACE- inhibits the conversion of angiotension I to II, increase bradykinin (dry cough)

Diminish proteinura (good for diabetics)and stabilize renal funtion

Uses- hypertension, post MI, LV systolic dysfunction, systolic heart failure, CKD,

Potential increase in SCr initially then declines- CAN CAUSE AKI

ADR- Dry cough (change to ARB), Angioedema (cannot switch to ARB), Hyperkalemia, AKF, tetratogenic, Redued efficiacy in African Americans (use HCTZ)

95
Q

Bumetanide

A

Loop diuretic- inhibits luminal Na/K/2Cl

DOC diuretic class for renal disease

ADR- Hypokalemia, hypocalemia, hypomagnesemia, hyperuricemia

96
Q

Dapagliflozin

A

SGLT-2 inhibitor

MOA-inhibitrs SGLT-2 transporter in kidney to decrease reabsorption of glucose thus increasing urinary glucose excretion

ADR- Polyuria, increased risk of genital myoctic infection and UTI, increased LDL, volume depletion ( with diuretis double the risk), increased risk of amputations

97
Q

Triamterene

A

K- sparring diuretic- collecting duct- Sodium channel blockers Na excretion and K reabsorbtion

DO not use with diabetics with protein in their urine, can use in sulfa allergy

ADR- Hyperkalemia,

Pharm (9 decks)

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