More drugs Flashcards by Jennifer Watson

Effects of reserpine: (4)

decreased TPR
decreased CO
decreased renin
decreased BP

How well did you know this?

Not at all

Perfectly

Side effects of reserpine:

sedation
depression
increased incidence of ulcers

How well did you know this?

Not at all

Perfectly

Effects of
prazosin (minipress)
terazosin (hytrin)

(alpha-1 blocker, so:)
decrease TPR
decreased BP
increase HDL
decrease LDL
beneficial effect on insulin resistance

How well did you know this?

Not at all

Perfectly

Used in older men with HTN and BPH:

terazosin (hytrin)

How well did you know this?

Not at all

Perfectly

Effects of BB: (5)

decrease HR + contractility (thus CO)
decrease renin/ATII
   *no Na/H2O retention
with chronic use: decrease TPR
decreased production of aq. humor
   *glaucoma
treats stage fright

How well did you know this?

Not at all

Perfectly

Pindolol does NOT affect levels of ___ like other BB

renin/ATII

How well did you know this?

Not at all

Perfectly

BB are useful in patients with HTN and:

CHF
MI or ischemic heart disease
hyperthyroidism
migraines

How well did you know this?

Not at all

Perfectly

Beta-1 cardioselective drugs

metoprolol

atenolol

How well did you know this?

Not at all

Perfectly

Partial beta-agonists; less effective than other BB:

pindolol

How well did you know this?

Not at all

Perfectly

Side effects of BB: (7)

cold extremities (due to alpha action)
bradycardia 
bronchospasm
CNS (bad dreams, depression)
drug withdrawal syndrome
block glycogenolysis
increase LDL/decrease HDL

How well did you know this?

Not at all

Perfectly

Should not be given with verapamil or diltiazem (non-DHP)

beta blockers

How well did you know this?

Not at all

Perfectly

Nonselective beta and alpha 1 antagonists

labetalol

carvedilol (coreg)

How well did you know this?

Not at all

Perfectly

Effects of nebivolol (bystolic)

promotes NO vasodilation
very beta-1 selective = 
   decreases BP
   decreases HR
   decreases TPR

How well did you know this?

Not at all

Perfectly

Effects of ACEI:

decrease BP
decrease TPR
vasodilation

How well did you know this?

Not at all

Perfectly

What patients have a greater response to ACEI?

those with elevated renin or Na depletion

greater decrease in BP

How well did you know this?

Not at all

Perfectly

Renoprotective: delays renal disease in type I diabetics

captopril

lisinopril

How well did you know this?

Not at all

Perfectly

increases synthesis of prostaglandins (vasodilation) in vascular and renal endothelium

captopril

How well did you know this?

Not at all

Perfectly

ACEI activated by deesterification

ramipril

How well did you know this?

Not at all

Perfectly

Side effects of ACEI’s:

angioedema
fetal toxicity (not for 2nd/3rd trimester)
dry cough
hyperkalemia
hypotension (if hypovolemic +/or Na depleted), possibly 1st dose

How well did you know this?

Not at all

Perfectly

ATII receptor antagonists end in the suffix…

-sartan

How well did you know this?

Not at all

Perfectly

Effects of ARBs

vasodilation
increased Na/water excretion
decrease TPR
decrease BP/CO

How well did you know this?

Not at all

Perfectly

What do you do if one anti-HTN med causes a dry cough?

switch patient to ARBs

How well did you know this?

Not at all

Perfectly

ARBs block the action of ATII on _____ receptors

AT type 1

How well did you know this?

Not at all

Perfectly

What beta blocker is likely to have drug-drug interactions?

carvedilol

How well did you know this?

Not at all

Perfectly

Competitive TXA2 receptor antagonist

losartan

Attenuates platelet aggregation

losartan

increases uric acid excretion

losartan

ARB that inhibits CYP

losartan

Side effects of ARBs

1. hyperkalemia 2. fetal toxicity 3. hypotension (hypovolemic +/or Na depleted patients)

ARB that causes hepatic dysfunction

losartan

Effect of renin inhibitors | aliskiren

decrease BP **dose-dependent

(CCBs) phenylalkylamines are ~selective for: dihydropyridines selectively block:

L-type Ca channels in myocardium | L-type Ca channels in blood vessels

Effects of dihydropyridines:

decrease systemic vascular resistance decrease arterial pressure NO/MILD changes in HR (except short acting dihy's)

CCBs most effectively control BP in what type of patient?

patients with low renin HTN | this is more common in AA and elderly

Side effects of dihydropyridines:

peripheral edema hypotension constipation

Reflex tachy occurs in patients taking what dihydropyridine?

nifedipine (procardia), short acting

Side effects of hydralazine?

palpitations (tachy, may lead to angina) Autoimmune reactions (not a s/e, but causes water retention)

What drugs are direct vasodilators?

minoxidil | nitroprusside

Side effects of minoxidil:

increases renin | hirsutism

How does minoxidil affect BP?

opens K-ATP channels, which causes relaxation of arteriolar smooth muscle **dilates arterioles NOT veins

Effects of nitroprusside:

forms NO, causing vasodil (arteries/veins) Decreases TPR Decreases CO in normal

Side effects of nitroprusside:

1. excessive hypotension 2. palpitations/tachycardia 3. metabolized to cyanide (cyanate/thiocyanate toxicity: give small dose for small period)

Nitroprusside is used to treat:

HTN emergencies in patients with ventricular failure | **why does this seem to contradict??

clonidine acts on what receptors?

postsynaptic alpha-2A adrenoreceptors in the rostral ventrolateral medulla (decreases symp impulses from RVLM to heart and vessels)

Effects of clonidine

decrease peripheral vasc resistance | decrease HR

Because it releases endogenous opiates, this drug is used as an analgesic in neuropathic pain

clonidine

Treats ADHD

clonidine

Side effects of clonidine

sedation contact dermatitis, if patch form clonidine withdrawal (HTN)

Effects of bosentan: | What is this indicated for?

vasodilation (by blocking endothelin 1 and 2 receptors) pulmonary HTN

_____ (alone or with beta-blockers) decrease mortality in patients with HTN

duiretics

Which drug class has the advantage of decreasing HTN wile improving lipid profile and insulin resistance?

alpha 1 blockers

Offers secondary protection in CAD (plus anti-HTN)

beta blockers

_____ should not be stopped abruptly--taper down doses

beta blockers

ACEI are the 1st choice drug for patients with:

high renin diabetes nephropathy CHF-propensity

Angina is treated by: (approaches)

1. increase blood blow 2. decrease oxygen consumption 3. prevent platelet aggregation (**Aspirin)

(Nitrates) Venodilation causes reduced preload, which results in:

1. decreased ventricular pressure in diastole 2. decreased oxygen demand 3. increased subendocardial blood flow

(Nitrates) Coronary vasodilation results in:

1. blood flow to ischemic areas 2. selective dilation of epicardial/collateral coronary vessels 3. prevention/reversal of vasospasm

(Nitrates) Overall effects on hemodynamics:

decreased pulmonary vascular resistance | slightly reduced CO

Adverse effects of nitrates:

hypotension (due to arterial vasodil) Orthostatic hypotension (reduced preload) headache (dilation of meningeal arteries)

Drug reactions with nitrates

viagra and other type V PDE inhibitors | causes hypotension and MI

Nitrates are abosorbed (quickly/slowly) and metabolized (quickly/slowly)

``` quickly quickly (via 1st pass**) ```

Side effect of abrupt discontinuation of nitrates

vasospasm

What type of CCBs target smooth muscle cells? Cardiac cells?

DHPs | non-DHPs

How do non-dihydropyridine CCB's treat angina?

decrease oxygen demands by decreasing HR, contractility and afterload ~coronary vasodilation prevents or reverses vasospasm

How do dihydropyridine CCB's treat angina?

reduces oxygen demand by reducing afterload ***coronary vasodilation (causes reflex cardiac stimulation)

Side effects of DHP CCB's?

GI irritation peripheral edema exacerbation of angina (coronary steal)

Side effects of non-DHP CCB's?

bradycardia asystole AV block constipation DO NOT USE IN CHF

How do beta blockers treat angina?

1. decrease HR and contractility in response to exercise | 2. decreases afterload

Why combine nitrates or DHP CCB's with beta blockers treat angina?

BB prevent reflex tachycardia and contractility

4 drugs used in combo for unstable angina

BB nitrates ASA heparin

BB are useless in what type of angina?

vasospastic

When would you use CCB's instead of BB in angina?

DHP: valvular insuff (reduce afterload) sinus brady/AV block non-DHP: depression asthma DM with variable glu levels

Expensive, late Na-current inhibitor that increases oxygen utilization in heart

ranolazone/renexa

Drugs that reduce CHD event

beta blockers

Reduces CHD, reinfarction and stroke after MI or unstable angina

ASA

Improves survival post MI in patients with LV dysfunction

ACEI

Reduces HR Reduces contractiliy Indirectly reduces afterload (via decr renin)

beta blockers

coronary vasodilation reduced preload reduced afterload

nitrates

coronary vasodilation | reduced afterload

nifedipine

coronary vasodilation reduced HR reduced contractility reduced afterload

verapamil | diltiazem

More drugs Flashcards

Anti-HTN Anti-Anginal