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Cardiovascular > Mechanism of Action / Class > Flashcards

Mechanism of Action / Class Flashcards

1
Q

Altoprev

A

Lovastatin
HMG-CoA Reductase inhibitor which prevents the conversion of HMG-CoA to mevalonate

Rate limiting step of cholesterol synthesis

decreases LDL by 20 - 55%

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2
Q

Pravachol

A

Pravastatin
HMG-CoA Reductase inhibitor which prevents the conversion of HMG-CoA to mevalonate

Rate limiting step of cholesterol synthesis

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3
Q

Zocor

A

Simvastatin
HMG-CoA Reductase inhibitor which prevents the conversion of HMG-CoA to mevalonate

rate limiting step of cholesterol synthesis

decreases LDL by 20-55%

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4
Q

Zetia

A

Ezetimibe
inhibits ABSORPTION of cholesterol in the small instestine

decreases LDL by 18-23%

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5
Q

Praluent

A

Alirocumab
PSK9 inhibitor that blocks the defradation of LDL receptor

decreases LDL by 60%

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6
Q

Repatha

A

Evolocumab
PSK9 inhibitor that blocks the degradation of LDL receptor

decreases LDL by 60%!!!

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7
Q

Welchol

A

Colesevelam
Bile Acid Sequestrant

prevent the reabsorption of bile acids

decreases LDL by 10-30%
INCREASES TG :(

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8
Q

Cholestyramine

A

Bile Acid Sequestrant

prevent the reabsorption of bile acids

decreases LDL by 10-30%
INCREASES TG :(

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9
Q

Antara

A

Fenofibrate
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG

decrease TG by 20-50%

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10
Q

Lopid

A

Gemfibrozil
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG

decrease TG by 20-50%

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11
Q

Tricor

A

Fenofibrate
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG

decrease TG by 20-50%

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12
Q

Trilipix

A

Fenofibrate
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG

decrease TG by 20-50%

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13
Q

Niacin

A

decreases hepatic synthesis of VLDL and LDL

*increases HDL by 15-35%

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14
Q

Lovaza

A

Omega-3 acid ethyl ester

fish oil that decreases TG
***can increase LDL :(

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15
Q

Vascepa

A

Icosapent ethyl

fish oil that decreases TG
**can increase LDL

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16
Q

Zestoretic

A

Lisinopril / HTCZ

-ACE inhibitor block conversion of angiotensin I to II to decrease vasoconstriction and aldosterone secretion

  • Thiazide inhibit sodium reabsorption in the distal convoluted tubule
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17
Q

Exforge

A

Valsartan / Amlodipine

-ARB block angiotensin II from binding to its receptor and preventing vasoconstriction

  • DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
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18
Q

Benicar HCT

A

Olmesartan / HTCZ

-ARB block angiotensin II from binding to its receptor and preventing vasoconstriction

  • Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
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19
Q

Diovan HCT

A

Valsartan / HTCZ

-ARB block angiotensin II from binding to its receptor and preventing vasoconstriction

  • Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
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20
Q

Ziac

A

Bisoprolol / HCTZ
- Beta- 1 selective beta blockers causes decrease in HR
**preferred in HF patients

  • Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
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21
Q

Maxzide, Dyazide

A

Triamterene / HTCZ
- Potassium sparing diuretic

  • Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
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22
Q

Tenoretic

A

Atenolol / Chlorthalidone
- beta 1 selective beta blockers cause decrease HR

  • Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
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23
Q

Lotrel

A

Benazepril / Amlodipine
-ACE inhibitor block conversion of angiotensin I to II to decrease vasoconstriction and aldosterone secretion

  • DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
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24
Q

Norvasc

A

Amlodipine
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure

25
Q

Cardene IV

A

Nicardipine
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure

26
Q

Procardia XL

A

Nifedipine ER
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure

27
Q

Adalat CC

A

Nifedipine ER
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure

28
Q

Tiazac

A

Diltiazem
non DHP CCB control HR

**negative inotropic (contraction) effects too

moderate pgp and CYP3A4 inhibitors LOWER the doses of simvastatin and lovastatin!!!

29
Q

Calan SR

A

Verapamil
non DHP CCB control HR

**negative inotropic (contraction)

moderate pgp and CYP3A4 inhibitors LOWER the doses of simvastatin and lovastatin!!!

30
Q

Altace

A

Ramipril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release

31
Q

Vasotec

A

Enalapril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release

32
Q

Lotensin

A

Benazepril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release

33
Q

Prinivil

A

Lisinopril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release

34
Q

Accupril

A

Quinipril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release

35
Q

Avapro

A

Irbesartan
ARB block angio II from receptor to prevent vasoconstriction

36
Q

Benicar

A

Olmesartan
ARB block angio II from receptor to prevent vasoconstriction

37
Q

Cozaar

A

Losartan
ARB block angio II from receptor to prevent vasoconstriction

38
Q

Diovan

A

Valsartan
ARB block angio II from receptor to prevent vasoconstriction

39
Q

Aliskiren

A

Direct renin inhibitor

40
Q

Aldactone

A

Spironolactone
Aldosterone antagonist (non-selective) will also block androgen

41
Q

Eplerenone

A

Selective aldosterone antagtonist

(no endocrine side effects)

42
Q

Triamterene

A

Potassium sparing diuretic

43
Q

Lopressor

A

Metoprolol
Beta 1 selective blocker

44
Q

Bystolic

A

Nebivolol
Beta 1 selective blocker with Nitric Oxide (NO) vasodilation

45
Q

Inderal

A

Propanolol
Beta 1 and 2 blocker

***HIGHLY lipid solubility that passes BBB

46
Q

Corgard

A

Nadolol
Beta 1 and 2 blocker

***HIGHLY lipid soluble that passes BBB

47
Q

Coreg

A

Carvediol
Beta 1, 2 and Alpha 1 blocker

48
Q

Labetalol

A

Beta 1,3, and alpha 1 blocker

49
Q

Catapres

A

Clonidine
central acting alpha 2 agonist that stimulating sympathetic outflow of NE to decrease SVR and HR

***patch formulation for patients who cannot swallow!!!

remember it is Kapvay for ADHD

50
Q

Methyldopa

A

centrally acting alpha 2 agonist that stimulates NE to decrease SVR and HR

***DILE drug

51
Q

Guanfacine

A

Centrally acting alpha 2 agonist

** Intuniv brand name for ADHD

52
Q

Hydralazine

A

direct vasodilator of arteries

***DILE drug

53
Q

Sacubitril

A

Neprilysin inhibitor that increases Natriuretic Peptide that are VASODILATORY

***1st line in HFrEF

54
Q

What are the first line agents for Heart Failure patients?

A

Beta blockers
ACE inhibitors (Entresto)
Loop diuretics

55
Q

What HF medications decrease mortality?

A

Aldosterone Antagonists
SGLT2 inhibitors
Beta blockers
ACE/ARBs
Hydralazine/Nitrate

56
Q

What benefit does Lanoxin provide in heart failure patients?

A

increase cardiac output and decreases cardiac hospitalizations

MOA: inhibits Na-K-ATPase causing a positive inotropic effect (increasing cardiac output) and negative chronotropic effect (decrease HR)

SE: bradycardia, hypokalemia, hypomagnesium, hypercalcemia, mental disturbances

PGP and CYP substrate (lower dose by 50% with amiodarone)

57
Q

What are the requirements for starting ivabradine in a heart failure candidate?

A
  • must be at target dose on all mortality decreasing HF medications
  • be in sinus rhythm with HR >/= 70 bpm

SE: bradycardia, QTc prolongation, afib

**do not use with strong CYP3A4 inhibitors

58
Q

Vericiguat can be used to treat what?

A

Heart failure
soluble cGC stimulator

BW: pregnancy - need contraception during use!

59
Q

What supplementation might be needed for HF patients?

A

Potassium (Klor-Con, Micro-K, K-Tab)

Oral solution 10% (20mEq/15mL) mix with 6 oz of water

Capsules: Klor-Con Sprinkle, Micro-K can be opened

ER tablets: K-Tab, Klor-Con 10 swallow whole

Klor Con M - can be split it half

SE; abdominal pain/cramping, DIARRHEA, nausea, flatuence

Cardiovascular (6 decks)

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