Medications (MSK, Neuro, CVP)

Question 1

ACE Inhibitors

Answer 1

ACE: prevent conversion of angiotensin I to II
-pril
well tolerated

side effects:
- persistent dry cough
- OH

Question 2

Alpha Adrenergic Antagonists

Answer 2

-zosin
reduces peripheral vascular tone
arteriole and venous dilation
decreases BP

side effects: OH, dizziness, palpitations, drowsiness

doxazosin, prazosin, terazosin

Question 3

Angiotensin II Receptor Antagonist (ARBs)

Answer 3

ARBs: block angiotensin II
limits vasoconstriction and stimulation of vascular tissue

side effects: dizziness, back and leg pain, angina pectoris

-sartan

Question 4

Nitrates

Answer 4

vasodilation
- veins: decrease cardiac preload

sublingual tablet/spray, or patch

side effects:
- OH
- headache, dizziness
- nausea
- reflex tachycardia

Question 5

Antiarrhythmics
Class 1. sodium channel blocker
Class 2. beta blocker
Class 3. potassium channel blocker
Class 4. calcium channel blocker

Answer 5

side effects: exacerbation of cardiac arrhythmias, dizziness, hypotension

Question 6

Calcium Channel Blockers

Answer 6

-dipine
diminish myocardial contraction, vasodilation, decreased oxygen demand of heart

side effects: dizziness, headache, hypotension, peripheral edema

Question 7

Anticoagulant

Answer 7

prevent clot formation and platelet aggregation

side effects: increased risk of bleeding

heparin, coumadin (warfarin)

Question 8

Antiplatelet (antithrombotic)

Answer 8

inhibits platelet activation to prevent clotting
aspirin (could be used acutely)
clopidogrel (plavix) stronger antiplatelet
- important after stent placement

side effects: hemorrhage, thrombocytopenia, liver toxicity

Question 9

Beta Blockers

Answer 9

-olol

acts on beta 1 receptors (located on the heart)
reduces HR and contractility to decrease CO

side effects:
- cannot use HR as a guide to exercise (use RPE)
- OH

Question 10

Diuretic

Answer 10

-thiazide

act on kidneys to increase sodium and water excretion
- decreased blood volumes = decreased CO

side effects:
- electrolyte imbalance
- fluid depletion –> can lead to OH (increases fall risk)

thiazide: end in thiazide
loop: furosemide (lasix)
potassium sparing: spironolactone (aldactone)

Question 11

Antihyperlipidemia agents (Statins)

Answer 11

break down LDL, decrease triglycerides, increase HDLs

side effects:
myalgia
GI distress
headache
nausea

Question 12

Positive Inotropic

Answer 12

increase force and velocity of myocardial contraction
slow HR
decrease conduction through AV node
decrease activation of SympNS

side effects: arrhythmias, GI distress, blurred vision, dizziness

Question 13

Thrombolytic

Answer 13

facilitate clot dissolution by converting plasminogen to plasmin
plasmin: breaks down clots and allows occluded vessels to reopen to maintain blood flow

side effects: hemorrhage, allergic reaction, arrhythmia

kinlytic (urokinase), activate (alteplase)

Question 14

Antihistamine

Answer 14

block effects of histamine resulting in a decrease in nasal congestion, mucosal irritation, and symptoms of common cold and allergies

side effects: postural hypotension, arrhythmias, GI distress, dizziness, thickening of bronchial secretions

Question 15

Anti-inflammatory

corticosteroid
leukotriene modifiers
mast cell stabilizers

Answer 15

help prevent inflammatory-mediated bronchoconstriction by inhibiting the production of inflammatory cells
suppressing the release of inflammatory mediators
reversing capillary permeability, in turn reducing airway edema

side effects
corticosteroids: OP, skin breakdown, damage of supporting tissues, nasal irritation and dryness, bloody mucus, sneezing
leukotriene: liver dysfunction
mast cells: bronchospasm, throat and nasal irritation, GI distress

Question 16

Bronchodilator

Answer 16

relieve bronchospasm by stimulating the receptors that cause bronchial smooth muscle relaxation
blocking receptors that trigger bronchoconstriction

side effects:
dry mouth, GI distress, chest pain, palpitations, tremor, nervousness

anticholinergic: atrovent
sympathomimetic: albuterol
xanthine derivative: aminophylline

Question 17

Expectorant

Answer 17

increase respiratory secretions which helps loosen mucus
reduces the viscosity of secretions and increases sputum volume improves efficiency of cough

side effects:
GI distress, drowsiness

mucinex

Question 18

Mucolytic

Answer 18

decreases viscosity of mucus secretions by altering their composition and consistency, making them easier to expectorate
administered via nebulizer

side effects:
pharyngitis, oral mucosa inflammation, rhinitis, chest pain

pulmozyme, mucosil/mucomyst

Question 19

Antiepileptic

Answer 19

reduce or eliminate seizure activity within the brain by attempting to inhibit firing of certain cerebral neurons through various effects on CNS

side effects: ataxia, behavioral changes, headaches, blurred vision, GI distress, weight gain

secobarbital, clonazepam, gabapentin (neurontin), carbamazepine

Question 20

Antispasticity

Answer 20

promote relaxation in a spastic muscle through agents binding selectively within CNS or within skeletal muscle cells to reduce spasticity

side effects: drowsiness, confusion, headache, dizziness, muscle weakness, tolerance, dependence, hepatotoxicity

baclofen, diazepam, dantrolene, tizanidine

Question 21

Cholinergic

Answer 21

direct: mimic ACh and bind directly to the cholinergic receptor to activate and create a response at the cellular level
- duvoid, pilocar

indirect: increase cholinergic synapse activity through the inhibition of acetylcholinesterase (which destroys ACh)
- aricept, tensilon, prostigmin, cognex

side effects: GI distress, impaired visual accommodation, bronchoconstriction, bradycardia, flushing, other parasympathetic effects

Question 22

Dopamine Replacement

Answer 22

assist in relieving the symptoms of Parkinson’s disease 2/2 decrease in endogenous dopamine

side effects: arrhythmias, GI distress, OH, dyskinesia, mood and behavioral changes, tolerance

levodopa, amantadine

Question 23

Muscle Relaxant

Answer 23

promote relaxation in muscles that typically present with spasm that is a continuous, tonic contraction

side effects: sedation, drowsiness, dizziness, n/v, headaches, tolerance, dependence