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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

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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
Q

HTN stage 2 requires what therapy

A

two ant-HTN drugs

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26
Q

secondary HTN

A

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.

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27
Q

essential HTN

A

SNS hyperactivity
Renin-Angiotensin System hyperactivity
Increase cellular sodium/calcium level

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28
Q

untreated HTN can lead to?

A

CVD, hemorrhagic stroke, kidney failures, visual impairment because high vascular pressure behind eye

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29
Q

mechanisms controlling blood pressure

A

blood volumes (ADH & Aldosterone), peripheral resistance from diameter of arterioles (sns activity, RAS, increase in blood viscosity), cardiac output (stroke volume, HR)

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30
Q

Cholesterol Absorption Inhibitor prototype drug

A

ezetimibe (Vytorin)

31
Q

primary use of cholesterol absorption inhibitors

A

modest reduction in LDL (20%)

32
Q

adverse effects of cholesterol absorption inhibitor

A

no significant adverse effects

33
Q

fibrinic-acid agents mechanism

A

_Mechanism of action: unknown

34
Q

polycythemia

A

too many RBCs; continual production of RBCs

35
Q

prototype for Bile-Acid Resins

A

Prototype drug: cholestyramine (Questran)

36
Q

mechanism for Bile-Acid Resins

A

Mechanism: bind with bile acids (containing cholesterol) in small intestine, forming insoluble complexes that are excreted in feces.

37
Q

Cardiac Output formula

A

Stroke Volume x Heart Rate

38
Q

Primary use of Statins

A

Primary use: Reduces serum-lipid levels (esp. decrease in cholesterol level)

39
Q

Statin mechanism of action

A

Mechanism of action: inhibits HMG-CoA reductase _ inhibit synthesis of cholesterol

40
Q

Prototype Drug for Statins

A

Prototype drug: atorvastatin (Lipitor)

41
Q

Major Adverse effect of Nicotinic Acid = Niacin

A

_Adverse effects: cutaneous flushing with pruritis

42
Q

Beta 1 agonists do what to HR

A

increase heart rate

43
Q

how many SNS receptors for NE

A

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
Q

Greater resistance in the arteries yields higher?

A

BP

45
Q

brain center for regulating BP

A

medulla oblongata

46
Q

Baroreceptors and Chemoreceptors in carotid arteries

A 
baroreceptors = pressure
chemoreceptors = levels of O2 and CO2 or pH
47
Q

ADH does what to BP

A

BP by raising systemic blood volumes

48
Q

Aldosterone does what to BP

A

increases the reabsorption of water and sodium and therefore increases bp

49
Q

Epinephrine and norepinephrine do what to BP

A

increase BP

50
Q

Non-pharmacologic Management of BP

A

_Losing weight
_Limiting foods high in fat and sodium
_Limiting use of tobacco and alcohol
_Beginning an exercise program

51
Q

Pharmacotherapy of HTN:

Primary Antihypertensive Agents

A 
_Diuretics
_Angiotensin-converting enzyme (ACE) inhibitors
_Angiotensin II receptor blockers (ARB)
_Beta-adrenergic antagonists (BB)
_Calcium channel blockers (CCB)
52
Q

Secondary Antihypertensive

Agents

A

_Alpha1-adrenergic antagonist
_Alpha2-adrenergic agonists
_Direct-acting vasodilators

53
Q

Beta Blocker

A

reduce HR and contractility therefore lower cardiac output and BP goes down

54
Q

ACE inhibitor

A

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
Q

Angiotensin Receptor Blockers

A

prevent angiotensin II from reaching its receptors, causing vasodilation.

56
Q

Calcium Channel Blockers

A

Block Calcium ion channels in arterials, smooth muscles causing vasodilation

57
Q

alpha 1 blocker

A

inhibit sympathetic activation in arterioles; can result in orthostatic hypotension as adverse effect

58
Q

alpha 2 agonist

A

directly causes vasodilation

59
Q

Primary HTN: Diuretics

A

Mechanism of Action: by increasing urine output & decrease fluid volume

60
Q

Thiazide Diuretics

A

Chlorothiazide (Diuril) and hydrochlorothiazide (HydroDiuril).

61
Q

primary HTN: Diuretics loop diuretics

A

_Loop diuretics
_Bumetanide (Bumex)
_Furosemide (Lasix)*
can cause HYPOKYLEMIA

62
Q

primary diurectics: potassium-sparing

A

_Potassium-sparing diuretics
_Spironolactone (Aldactone)*
can cause HYPERKYLEMIA

63
Q

BB mechanism blcok

A

beta1 and beta 2 adrenergic

64
Q

Adverse effects of Beta Blockers

A

bronchoconstriction, sedation

65
Q

Mechanism of action of calcium channel blcokers

A

reduce BP by blocking calcium ion channels in arterial smooth muscle, causing vasodilation

66
Q

contraindication for calcium channel blocker

A

CHF or other cardiac problem

67
Q

nonselective calcium channel blockers

A

Non-selective drugs- affecting both heart and vessels
_Verapamil (Calan, Isoptin, Covera)*
_Diltiazem (Cardizem, Tiazac)*

68
Q

adverse effects of calcium channel blocking

A

dizziness, headache, flushing, constipation; can cause CHF (especially with non-selective CCB) **

69
Q

ACEI Adverse effect

A

persistent cough and hypotension

70
Q

if PT gets cough or hypotension you switch them to

A

ARB - Affecting Renin-Angiotensin System2: ARB

can cause hypotension but not the dry cough associated with ACEI

71
Q

Secondary HTN drug: Clonidine is what class

A

alpha-2 agonist; major side effect DIZZINESS

72
Q

If protein in urine means

A

means kidney impairment because destruction of the kidney tissues, something that must be monitored with drugs with HTN

73
Q

furosemide (Lasix) is what

A

Primary HTN: Diuretic for treatment of HTN

Nursing N368 Pharmacology I (16 decks)

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