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Pharm 2 Module 1.1-1.2 > More drug's unique properties > Flashcards

More drug's unique properties Flashcards

1
Q

Neprilysin inhibitor / ARB

Combo drug

A

Sacubitril/valsartan Entresto

Neprilysin is an enzyme that contributes to the breakdown of the biologically active natriuretic peptides. By blocking the enzyme we increase our endogenous ANP, BNP, and CNP

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2
Q

alpha1, alpha 2 antagonist Not used for long term treatment

A

phentolamine

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3
Q

Hypos - calc, mag, K, H = met. alkalosis, ototoxicity (avoid aminogylcosides)

A

furosemide

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4
Q

Treat Severe pulmonary arterial HTN

A

bosentan

Endothelin (ET) receptor antagonist

ambrisentan

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5
Q

HF with renal dysfunction who cannot tolerate ACEI. HTN emergencies in pregnancy

A

hydralazine

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6
Q

Dilation of coronary arteries, systemic (peripheral) arterioles

Dihydropyridine - bind to inactivated L-type

A

nifedipine

amlodipine

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7
Q

Aldosterone/mineralocorticoid receptor antagonist - potassium sparing metabolized by liver

A

spironolactone

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8
Q

alpha1, alpha 2 antagonist Irreversible

A

phenoxybenzamine

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9
Q

Teratogenic, Hyperkalemia

A

ARBs

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10
Q

Decreases systemic vascular resistance AND Na absorption by the kidney (by blocking formation of ATII)

A

aliskiren tekturna

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11
Q

No effect on bradykinin - minimal incidence of cough and angioedema. K sparing diuretics contraindicated

A

ARBs

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12
Q

Natriuretic peptide 6 actions

A

promote vasodilation

relax smooth muscle

increased capillary endothelial permeability

promote natriuresis increased renal Na excretion

promote increase in GFR

suppress SNS outflow

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13
Q

ARB what channel?
What type of receptor is it?

A

AT1
GQ

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14
Q

diuretic that leads to

Hyperglycemia, hypokalemia, metabolic alkalosis

A

Hydrochlorothiaze

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15
Q

Low dose - D1 - vasodilation, decreased SVR (afterload), increases renal blood flow and ANP/BNP; intermediate dose - Beta1 - increased contractility and HR; high dose - alpha1 - vasoconstriction

A

dopamine

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16
Q

longer half life than prazosin

A

terazosin

doxazosin

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17
Q

Hyperkalemia, met. Acidosis. Blocks androgen receptors (impotence and gynecomastia)

A

spironolactone

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18
Q

Initial treatment of HTN

A

propranolol

metoprolol

atenolol

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19
Q

Pro-drug - metabolized to release NO in the body. Requires mitochondrial aldehyde dehydrogenase (ALDH2) (sometimes missing in Chinese population)

A

nitroglycerin, glyceryl trinitrate

isosorbide dinitrate

isosorbide 5-mononitrate

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20
Q

Ventricular arrhythmias, thrombocytopenia (low blood platelet count)

A

milrinone

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21
Q

Prolong NMB, headache, dizziness, Peripheral edema, negative chronotropy/inotropy, overdose pulmonary edema

A

CCB

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22
Q

Renin inhibitor

A

aliskiren Tekturna

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23
Q

eNOS inhibitor

A

methylene blue

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24
Q

Short term severely decompensated HF and severely failing circulation. Bridge to cardiac transplantation

A

milrinone

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25
Q

Reversible lupus erythematosus-like syndrome (primarily in slow acetylators)

A

hydralazine

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26
Q

MAO and dopamine B-hydroxylase (caution in patients with MAOIs)

A

dopamine

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27
Q

Reduces systemic vascular resistance (afterload), increases RENAL blood flow

A

fenoldopam corlopam D1 agonist

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28
Q

Treatment of BPH

A

terazosin Hytrin alpha1 antagonist

29
Q

Greater effect in arterioles over veins. Anesthetic induced vasodilation may be exacerbated

A

prazosin

Minipress

30
Q

dyspnea, chest pain, hemolysis

A

methylene blue

31
Q

AV block, bradyarrthymia, bronchospasm. Avoid in diabetics - decreases glycogenolysis and gluconeogenesis

32
Q

Pulmonary edema-initial increase in plasma volume due to oncotic pressure - increases preload

33
Q

Venous dilation equal to arteriolar dilation (balanced vasodilator). Short term administration (cyanide released during metabolism - avoid infusion rates above 2 mcg/kg/min)

A

sodium nitroprusside

34
Q

HoTN, renal failure, teratogenic

A

aliskiren Tekturna

35
Q

First line agent in HTN diabetics

A

captopril

lisinopril

ARBs

36
Q

contraindicated in patient bilateral artery stenosis?

A

captopril
lisinopril
patients dependent on angiotensin 2 to maintain GFR

37
Q

COMT (caution in COMT Inhibitor patients - Parkinsons)

A

dobutamine

38
Q

combo drug used for HF

A

Sacubitril/valsartan Entresto

39
Q

May precipitate - kidney stones

A

triamterene

40
Q

Low dose - Beta1 - positive inotrope, lusitrope, chronotrope, and dromotrope, also vasodilation in SKM; High dose - alpha1 - generalized peripheral vasoconstriction increasing afterload

41
Q

hepatic metabolism, vasopressin receptor agonist

A

Vasopressin

42
Q

four drugs for HTN crisis

A

Labetalol-b1/b2-a1

fenoldopam-D1 receptor agonist

sodium nitroprusside-no donor

furosemide-loop diuretic

43
Q

Beta1 - Positive inotrope, chronotrope, lusitrope. Beta2 - peripheral vasodilation and hypotension. No activity on alpha

A

isoproterenol

renal metabolism

44
Q

Teratogenic, Hyperkalemia, dry cough, angioedema, first dose HoTN - acute renal failure. May precipitate profound refractory HoTN in presence of vasodilating anesthetics - use V1 agonists

A

captopril

lisinopril

45
Q

Contraindicated with PVD and COPD/asthma

A

propranolol

46
Q

Headache, flushing, peripheral edema, reflex tachycardia

47
Q

metabolized by renal OAT

A

Hydrochlorothiazide

chlorothiazide

48
Q

Renal metabolism

verapamil decreases ______clearance by blocking the P-glycoprotein energy dependent efflux transporter (renal secretion)

49
Q

More selective than spironolactone - less anti-androgenic side effects

A

eplerenone Inspra

50
Q

good for treating intraoperative hypotension exacerbated in a patient taking ace inhibitors receiving anesthesia VIA

A

terlipressin

51
Q

Arteriolar smooth muscle relaxation, increases renal blood flow - NOT coronary arteries or venous smooth muscle.

A

hydralazine

52
Q

Positive inotrope (improves diastolic dysfunction), vasodilation. Blocks metabolism of cAMP (inotropic effects), cGMP (vasodilatory effects)

53
Q

Contradications - ACE, ARBs, renal insufficiency with hyperkalemia

A

Spironolactone

eplerenone

amiloride

triamterene

54
Q

Low dose - Beta1 - positive inotrope, lusitrope, chronotrope, and dromotrope, also alpha1 - vasoconstriction with increased afterload. Little effect on Beta2

55
Q

Inhibits pulmonary vasoconstriction and may cause V/Q mismatch, rebound hypertension, coronary steal, cyanide toxicity

A

sodium nitroprusside

56
Q

Liddle’s syndrome (super ENaC Na channel)

A

amilrode midamor

triamtrene dyrenium

57
Q

More effective with frequent channel openings - SA, AV, cardiac myocytes

Non-dihydropyridine -bind to open conformation L-type

A

diltiazem

verapamil

58
Q

Decrease ATII and increase bradykinin levels. Vasodilatory effects - RENAL PROTECTIVE. Avoid K sparing diuretics, NSAIDs. Contraindicated in patients with bilateral renal artery stenosis - dependent on ATII to maintain GFR by constriction of efferent arteriole

A

captopril

lisinopril

59
Q

V2 selective agonist. Relieves PDPH, DOC for central DI, treatment of bleeding disorders

A

desmopressin

60
Q

No reflex tachycardia

61
Q

What happens when the AT1 receptor is activated?

7

A
  1. aldosterone secretion from adrenal cortex
  2. Na reabsorption from renal PCT
  3. Renal vasoconstriction-efferent arteriole
  4. direct vasoconstriction
  5. SNS discharge
  6. Release of catecholamines from adrenal medulla
  7. release of ADH (vasopressin) from pos pituitary
62
Q

Low dose - Vasodilate VEINS and coronary arteries. High dose - decrease arteriolar resistance. Prefers epicardial coronary arteries and minimizes coronary steal

A

nitroglycerin, glyceryl trinitrate

isosorbide dinitrate

isosorbide 5-mononitrate

63
Q

HTN emergencies and severe HF, Controlled hypotension during anesthesia to reduce bleeding

A

sodium nitroprusside

64
Q

Prevent vasoplegic syndrome in CP bypass. Treatment for methemoglobinemia

A

methylene blue

65
Q

To correct drug-induced kaliuresis and hypokalemia. Secondary HTN to hyperaldosteronism

A

Spironolactone

66
Q

Inhibits Na/K ATPase on sarcoplasmic reticulum - less Na extracellular means less Na available for the Na/Ca exchanger = more Ca available to be stored and released intracellularly. Positive inotrope (from Ca), negative chronotropy, dromotropy

67
Q

HTN primarily, adjunct in HF; first line agent for African American patients

A

hydrochlorothiazide

68
Q

HTN emergencies

69
Q

Opens ATP modulated K channels (inhibits influx of Ca through VGCC). Acts primarily on arterial smooth muscle cells - no effect on venous system

Pharm 2 Module 1.1-1.2 (5 decks)

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