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Nursing N368 Pharmacology I > N368 test 2 drugs for lipid disorders and HTN > Flashcards

N368 test 2 drugs for lipid disorders and HTN Flashcards

1
Q

dyslipidemia

A

in presynaptic nerve terminal from choline andacetyl coenzyme A

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2
Q

pannel for lipid disorder

A

total cholesterol, triglyceride, HDL, LDL

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3
Q

Therapeutic Prevention of CVD

A

start pharmacotherapy for lipid control and lifestyle medication

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4
Q

three different lipids

A

triglycerides = 90% of fat in body 3 fatty acids + 1 glycerol, phospholipids = essential in building the bilayer phospholipid membrane, and steroids = hormones, cholesterol

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5
Q

cholesterol important for

A

Vitamin D production, Bile acids, cortisol, estrogen, testosterone.

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6
Q

Lipoproteins

A

carriers of lipid of molecules

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7
Q

HDL

A

High Density Lipoprotein

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8
Q

LDL

A

Low Density Lipoprotein - carriers cholesterol; transfers cholesterol from liver to tissues and organs; known as bad cholesterol because too much can accumulate in the vessels causing atherosclerosis. Lowering LDL can decrease risk for CVD

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9
Q

VLDL

A

Very Low Density Lipoprotein: is a major carrier for triglycerides = so if high you can say high triglycerides

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10
Q

HDL

A

Opposite to LDL; good cholesterol; assists in transportation of cholesterol away from body tissues and back to liver; good cholesterol.

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11
Q

lifestyle changes for lipid disorder

A

monitor blood-lipid levels; maintain weight, exercise; reduce dietary saturated fat and cholesterol; incr soluble fiber diet, reduce or cease tobacco and alcohol

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12
Q

pharmacotherapies for lipid disorders

A

statins - try to inhibit the prod of cholesterol
Bile-acid-binding resins - try to use up cholesterol to form bile which is excreted.
fibric acid derivatives
Nicotinic acid
cholesterol absorption

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13
Q

major side effect of statins

A

muscle or joint pain; must monitor liver enzymes every 6 months

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14
Q

bile-acid resin

A

bind with bile-acids in small intestines

*prototype drug cholestyramine

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15
Q

bile-acid resin major adverse effect

A

GI tract, gas,

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16
Q

nicotinic acid

A

decrease adipose tissue lipolysis which in turn reduces circulating free fatty acids; resulting reduction in VLDL and increase HDL

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17
Q

fibric-acid agents

A

mechanism unknown
prototype gemfibrozil
tx: severe hypertriglyceridemia

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18
Q

fibric-acid agents adverse effects

A

GI distress, watch for bleeding with clients on anticoagulants

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19
Q

Do not use with Bile acid binding resins, which interrupt the absorption of this lipid disorder controlling drug

A

Cholesterol Absorption Inhibitor

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20
Q

Adverse effects of nicotinic acid

A

_Adverse effects: cutaneous flushing with pruritis, hot flushes, nausea, excess gas, liver toxicity

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21
Q

Prototype drug for nicotinic acid

A

Prototype drug: niacin

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22
Q

Mechanism of action of nicotinic acid and primary use

A

_Mechanism of action: to decrease VLDL levels

Primary use: to reduce triglycerides; increase HDL levels

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23
Q

Prehypertension requires what therapy

A

lifestyle modifications: diet, exercise, stop smoking, reduce cholesterol, lower sodium intake

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24
Q

hypertension stage 1 requires what therapy

A

anti-HTN mediction: thiazide diuretic

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25
HTN stage 2 requires what therapy
two ant-HTN drugs
26
secondary HTN
chronic renal disease, cushing's syndrome, clampsia (r/t pregnancy) - siezures, strokes, or blinding may result if not treated; drug use can cause HTN too.
27
essential HTN
SNS hyperactivity Renin-Angiotensin System hyperactivity Increase cellular sodium/calcium level
28
untreated HTN can lead to?
CVD, hemorrhagic stroke, kidney failures, visual impairment because high vascular pressure behind eye
29
mechanisms controlling blood pressure
blood volumes (ADH & Aldosterone), peripheral resistance from diameter of arterioles (sns activity, RAS, increase in blood viscosity), cardiac output (stroke volume, HR)
30
Cholesterol Absorption Inhibitor prototype drug
ezetimibe (Vytorin)
31
primary use of cholesterol absorption inhibitors
modest reduction in LDL (20%)
32
adverse effects of cholesterol absorption inhibitor
no significant adverse effects
33
fibrinic-acid agents mechanism
_Mechanism of action: unknown
34
polycythemia
too many RBCs; continual production of RBCs
35
prototype for Bile-Acid Resins
Prototype drug: cholestyramine (Questran)
36
mechanism for Bile-Acid Resins
Mechanism: bind with bile acids (containing cholesterol) in small intestine, forming insoluble complexes that are excreted in feces.
37
Cardiac Output formula
Stroke Volume x Heart Rate
38
Primary use of Statins
Primary use: Reduces serum-lipid levels (esp. decrease in cholesterol level)
39
Statin mechanism of action
Mechanism of action: inhibits HMG-CoA reductase _ inhibit synthesis of cholesterol
40
Prototype Drug for Statins
Prototype drug: atorvastatin (Lipitor)
41
Major Adverse effect of Nicotinic Acid = Niacin
_Adverse effects: cutaneous flushing with pruritis
42
Beta 1 agonists do what to HR
increase heart rate
43
how many SNS receptors for NE
alpha 1 - arterioles = vasoconstriction - TX = shock alpha 2 - arterioles = vasodilation - TX = HTN Beta 1 - Heart = Increase HR - TX cardiac arrest Beta 2 - Bronchi = bronchodilation - TX = asthma
44
Greater resistance in the arteries yields higher?
BP
45
brain center for regulating BP
medulla oblongata
46
Baroreceptors and Chemoreceptors in carotid arteries
``` baroreceptors = pressure chemoreceptors = levels of O2 and CO2 or pH ```
47
ADH does what to BP
BP by raising systemic blood volumes
48
Aldosterone does what to BP
increases the reabsorption of water and sodium and therefore increases bp
49
Epinephrine and norepinephrine do what to BP
increase BP
50
Non-pharmacologic Management of BP
_Losing weight _Limiting foods high in fat and sodium _Limiting use of tobacco and alcohol _Beginning an exercise program
51
Pharmacotherapy of HTN: | Primary Antihypertensive Agents
``` _Diuretics _Angiotensin-converting enzyme (ACE) inhibitors _Angiotensin II receptor blockers (ARB) _Beta-adrenergic antagonists (BB) _Calcium channel blockers (CCB) ```
52
Secondary Antihypertensive | Agents
_Alpha1-adrenergic antagonist _Alpha2-adrenergic agonists _Direct-acting vasodilators
53
Beta Blocker
reduce HR and contractility therefore lower cardiac output and BP goes down
54
ACE inhibitor
blocking angiotensin II which is a vasoconstrictor, so reduces blood pressure, and block aldosterone which can result in HYPOKYLEMIA - so must monitor for this.
55
Angiotensin Receptor Blockers
prevent angiotensin II from reaching its receptors, causing vasodilation.
56
Calcium Channel Blockers
Block Calcium ion channels in arterials, smooth muscles causing vasodilation
57
alpha 1 blocker
inhibit sympathetic activation in arterioles; can result in orthostatic hypotension as adverse effect
58
alpha 2 agonist
directly causes vasodilation
59
Primary HTN: Diuretics
Mechanism of Action: by increasing urine output & decrease fluid volume
60
Thiazide Diuretics
Chlorothiazide (Diuril) and hydrochlorothiazide (HydroDiuril).
61
primary HTN: Diuretics loop diuretics
_Loop diuretics _Bumetanide (Bumex) _Furosemide (Lasix)* can cause HYPOKYLEMIA
62
primary diurectics: potassium-sparing
_Potassium-sparing diuretics _Spironolactone (Aldactone)* can cause HYPERKYLEMIA
63
BB mechanism blcok
beta1 and beta 2 adrenergic
64
Adverse effects of Beta Blockers
bronchoconstriction, sedation
65
Mechanism of action of calcium channel blcokers
reduce BP by blocking calcium ion channels in arterial smooth muscle, causing vasodilation
66
contraindication for calcium channel blocker
CHF or other cardiac problem
67
nonselective calcium channel blockers
Non-selective drugs- affecting both heart and vessels _Verapamil (Calan, Isoptin, Covera)* _Diltiazem (Cardizem, Tiazac)*
68
adverse effects of calcium channel blocking
dizziness, headache, flushing, constipation; can cause CHF (especially with non-selective CCB) **
69
ACEI Adverse effect
persistent cough and hypotension
70
if PT gets cough or hypotension you switch them to
ARB - Affecting Renin-Angiotensin System2: ARB | can cause hypotension but not the dry cough associated with ACEI
71
Secondary HTN drug: Clonidine is what class
alpha-2 agonist; major side effect DIZZINESS
72
If protein in urine means
means kidney impairment because destruction of the kidney tissues, something that must be monitored with drugs with HTN
73
furosemide (Lasix) is what
Primary HTN: Diuretic for treatment of HTN

Nursing N368 Pharmacology I (16 decks)

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