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Pharmacology > Pharm 2 (GI, antihyperlipidemics, Cardiovascular) > Flashcards

Pharm 2 (GI, antihyperlipidemics, Cardiovascular) Flashcards

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1
Q

Sodium Bicarbonate
Aluminum Hydroxide
Calcium Carbonate
Magnesium hydroxide

A

Antacids

Tx - GERD, peptic ulcers, dyspepsia

AE - Hypokalemia & can affect absorption, bioavailability, or urinary excretion of other drugs

  • AH - Constipation, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures
  • CC - Hypercalcemia, acid rebound, gas/bloating
  • SB - metabolic acidosis, excess NaCl absorption, gas
  • MH - Diarrhea, hyporeflexia, HoTN, cardiac arrest
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2
Q

Cimetidine
Ranitidine
Famotidine
Nizatidine

A

H2 blockers = reversibly block histamine H2-receptors = ↓H+ secretion by parietal cells

Tx - GERD, peptic ulcer, dyspepsia, gastritis

AE - C = potent inhibitor of cytochrome P-450, antiandrogenic effects (prolactin release, gynocomastia, impotence, ↓ libido in males), crosses BBB (confusion, dizziness, headaches) & placenta
- C&R = ↓ renal excretion of creatinine

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3
Q 
Omeprazole
Lansoprazole
Esomeprazole
Pantoprazole
Dexlansoprazole
Rabeprazole
A

Proton Pump Inhibitors = Irreversibly inhibit H+/K+ ATPase in stomach parietal cells

Tx - GERD, peptic ulcer, dyspepsia, gastritis, hyper-secretory disease (Zollinger-Ellison), NSAID & H. pylori associated ulcers

AE - ↑ risk of C. dif infection, pneumonia, hip fractures;
- ↓ serum Mg w/ long-term use

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4
Q

Bismuth

Sucralfate

A

Mucosal protective agent - bind to ulcer base, provide physical protection & allow HCO3- secretion to reestablish pH gradient in the mucous layer

Tx - ↑ ulcer healing, travelers’ diarrhea (bismuth)

AE - Bismuth - Blackening of stool & tongue

Bismuth subsalicylate also usee as antidiarrheal

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5
Q

Misoprostol

A

Mucosal protective agent - PGE1 analog = ↑ production & secretion of gastric mucous barrier, ↓ acid production

Tx - Prevent NSAID-induced peptic ulcers

 - maintenance of a PDA
 - also used to induce labor (ripens cervix)

AE - Diarrhea, cramping
CI - women of childbearing potential (abortifacient)

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6
Q

Octreotide

A

Somatostatin receptor agonist (long-acting) = ↓ gut motility

Tx - acute variceal bleeds

 - acromegaly, VIPoma, carcinoid tumors
 - secretory diarrhea

AE - Nausea, cramps, steatorrhea

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7
Q

Magnesium hydroxide
Magnesium citrate
Polyethylene glycol
Lactulose

A

Osmotic laxatives - provide osmotic load to draw water out (into the intestinal lumen)

Tx - Constipation

AE - Diarrhea, dehydration (may be abused by bulimics)

Lactulose also Tx - hepatic encephalopathy since gut flora degrade it into metabolites (lactic & acetic acid) that promote nitrogen excretion as NH4+

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8
Q

Infliximab

A

Monoclonal Ab (mouse/human chimeric) to TNF-α

Tx - Moderate to severe IBD (UC, CD), RA, ankylosing spondylitis, psoriasis

AE - Infection (including reactivation of latent TB), fever, HoTN

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9
Q

Sulfasalazine

Balsalazine

A

Sulfapyridine (antibacterial) & 5-ASA (anti-inflammatory), activated by colonic bacteria

Tx - UC & CD

AE - Malaise, nausea, sulfonamide toxicity, reversible oligospermia

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10
Q

Ondansetron

A

Antiemetic (central acting) - 5-HT3 antagonist; ↓ vagal stimulation;

Tx - control vomiting Post-op & in chemotherapy

AE - headache, constipation
- Prolonged QT

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11
Q

Metoclopramide

A

Prokinetic & antiemetic - D2 receptor antagonist; ↑ resting tone, contractility, LES tone, motility (does not influence colon transport time)

Tx - Diabetic & post-op gastroparesis, antiemetic

AE - ↑ parkinsonian effects (restlessness, drowsiness, fatigue, depression, nausea, diarrhea)
CI - Small bowel obstruction, Parkinson disease
RxI - digoxin & diabetic agents

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12
Q

Bethanechol

A

Prokinetic agent - Muscarinic receptor (M3) agonist

Tx - GERD, gastroparesis

AE - cholinergic side effects

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13
Q

Neostigmine

A

Prokinetic agent - AChE inhibitor

Tx - non-obstructive urinary retention, abdominal distension

AE - Cholinergic side effects

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14
Q

Erythromycin

A

Prokinetic agent - Motilin receptor agonist

Tx - gastroparesis

AE - Erythromycin mediated side effects

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15
Q

Methylcellulose

Psyllium

A

Bulk-forming laxative (fiber) - adds fecal bulk & retains water (must take w/ water)

Tx - constipation, minimize straining, prior to surgical/endoscopical procedures

AE - gas/bloating

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16
Q

Glycerin

Mineral oil

A

Surfactant/Stool-softening Laxative = coat stool w/ oil & penetrate w/ water & lipids

Tx - constipation, minimize straining, prior to surgical/endoscopical procedures

AE - nutrient malabsorption

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17
Q

Senna
Castor Oil
Phenophthalein

A

Stimulant Laxative = stimulate ENS, induce leaky mucosa, inhibit sodium uptake by the gut

Tx - constipation, minimize straining, prior to surgical/endoscopical procedures

AE - GI irritation

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18
Q

Lubiprostone

A

Laxative - Chloride Channel Activator (Prostaglandin derivative)

Tx - Chronic constipation

AE - N,V,D

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19
Q

Loperamide

A

Anti-diarrheal, opioid agonist = ↑ segmental contractions & ↓ peristaltic contractions (↑ absorption ↓ movement)

Tx - Diarrhea (IBS)

AE - Constipation
low to no ability to cross BBB

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20
Q

Diphenoxylate

A

Anti-diarrheal, opioid agonist = ↓ GI perception of GI distension

Tx - diarrhea

AE - CNS effects, Atropine-like effects

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21
Q

Kaolin & Pectin

A

Antidiarrheal; Add fecal bulk & absorb toxins
Kaolin = Magnesium aluminum silicate
Pectin = non-digestible sugar

Tx - Diarrhea

AE - constipation

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22
Q

Bismuth subsalicylate

A

Antidiarrheal agent - Absorb toxins & inhibit prostaglandin synthesis in intestines

Tx - nonspecific & travelers’ diarrhea

AE - Salicylate toxicity

Also used as a mucosal protective agent

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23
Q

Scopolamine

A

Antiemetic - Muscarinic (M1) antagonist

Tx - Motion sickness

AE - Antimuscarinic effects

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24
Q

Dimenhydrinate

A

Antiemetic - Histamine (H1) antagonist

Tx - Motion Sickness

AE - Drowsiness

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25
Aprepitant
Antiemetic - NK1 antagonist Tx - Chemotherapy related nausea/vomiting - 2nd/3rd choice due to AE AE - Fatigue, dizziness, diarrhea **CYP3A4 interactions**
26
Prochlorperazine
Antiemetic - M1D2H1 antagonist Tx - Severe nausea & vomiting - 2nd/3rd choice due to AE AE - Extrapyramidal (D), Drowsiness (H), Anticholinergic (M)
27
Lorazepam
Antiemetic - GABA agonist Tx - Anxiety/chemotherapy AE - drowsiness
28
Nabilone
Antiemetic - Cannabinoid agonist Tx - chemotherapy AE - dysphoria, sedation, increased appetite (can be beneficial if trying to ↑ caloric intake)
29
Dexamethasone
Antiemetic - Glucocorticoid agonist Tx - Post-op & chemotherapy - ↑ effectiveness of 5-HT antagonists (ondansetron, Alosetron etc.)
30
Tegaserod
Laxative - 5-HT4 agonist Tx - chronic idiopathic constipation - IBS-constipation predominant AE - GI, cardiovascular, CNS - not available for general use
31
Alosetron
5-HT3 antagonist = relieve pain & ↓ motility Tx - IBS-diarrhea prodominant in Women** AE - constipation, ischemic colitis (fatal)
32
Mesalamine- - Pentasa - Asacol - Rowasa 7 Canasa
5-ASA (aminosalicylate) = inhibit IL-1, TNF-α, NF-kB, COX; free radical scavenger Tx - Ulcerative colitis
33
Prednisone Prednisolone Hydrocortisone
Glucocorticoids - suppress inflammatory cytokines (TNF-α, IL-1), chemokines (IL-8), adhesion molecules & signal transduction molecules (NOS, PLA2, COX-2, NF-kB) Tx - Moderate to severe active IBD AE - Glucocorticoid Adverse Effects
34
Azathioprine | 6-mercaptopurine
Antimetabolites - Inhibition of purine synthesis = ↓ proliferation of immune cells Tx - Maintenance of remission of IBD AE - N,V, bone marrow suppression
35
Methotrexate
Antimetabolite - Inhibit DHFR = impair immune cell proliferation Tx - Maintenance of remission of Crohn's disease AE - Bone marrow depression (uncommon at low doses)
36
``` Lovastatin Pravastatin Simvastatin Atorvastatin Rosuvastatin ```
Inhibit HMG-CoA reductase = inhibit conversion of HMG-CoA to mevalonate (a cholesterol precursor) = ↓ de novo cholesterol synthesis = cells upregulate LDLr & ↑ uptake of LDL = ↓↓↓ LDL, ↓ Triglycerides, ↑ HDL Tx - Familial combined hyperlipoproteinemia - Familial hypercholesterolemia - Familial ligand-defective apoB AE - GI effects, hepatotoxicity (↑ LFTs) - rhabdomyolysis (esp. w/ fibrates & niacin)
37
Cholestyramine Colestipol Colesevelam
Bile acid resins - Prevent cholesterol absorption at small intestine brush border = ↑ liver bile acid synthesis = ↓ plasma cholesterol (↓ LDL, slightly ↑ HDL & Trig) Tx - Familial hypercholesterolemia - impaired bile-salt absorption mediated diarrhea AE - Tastes bad & causes GI discomfort (Pt hate it) - Cholesterol gallstones, ↓ ADEK absorption
38
Niacin (Vit B3)
Inhibits lipolysis in adipose tissue; reduces hepatic VLDL synthesis (↓↓ LDL (&VLDL), ↑↑ HDL, ↓ Trig) ``` Tx - all hypercholesterolemias & hypertriglyceridemias Primary chylomicronemia Familial hypertriglyceridemia Familial dysbetalipoproteinemia Familial combined hyperlipoprotemia Familial hypercholesterolemia Familial ligand-defective apoB ``` AE - Cutaneous flust (↓ by aspirin or long-term use), hyperglycemia (acanthosis nigricans), hyperuricemia (exacerbates gout)
39
Gemfibrosil Clofibrate Fenofibrate Bezafibrate
Fibrates = Upregulate LPL to ↑ Trig clearance; + PPAR to induce HDL synthesis ( ↓ LDL, ↑ HDL, ↓↓↓ Trig) Tx - Primary chylomicronemia, Familial combined hyperlipoproteinemia, Familial hypertriglyceridemia, Familial dysbetalipoproteinemia AE - Myositis (↑ risk w/ statins), Hepatotoxicity (↑ LFTs), cholesterol gallstones (esp. w/ bile acid resins)
40
Ezetimibe
Prevent cholesterol absorption at small intestine brush border = ↓↓ LDL & total cholesterol Tx - Familial combined hyperlipoproteinemia, Familial hypercholesterolemia, Familial ligand-defective apoB AE - rare ↑ LFTs, diarrhea
41
Class I Antiarrhytmics
Na+ channel blockers - Slow or block (↓) conduction (esp. in depolarized cells) - ↓ slope of phase 0 depol - ↑ threshold for firing in abnormal pacemaker cells Are state dependent = selectively depress tissue that is frequently depolarized (e.g. tachycardia) Hyperkalemia causes ↑ toxicity for all class I drugs
42
Quinidine Procainamide Disopyramide
Class IA antiarrhytmics - Na+ channel blockers (moderate) ↑ AP duration, ↑ ERP, ↑ QT interval Tx - Atrial & ventricular arrhytmias; especially re-entrant & ectopic SVT & VT AE - Torsades de pointes; thrombocytopenia - Cinchonism (headache, tinnitis) - Quinidine - reversible SLE-like syndrome - procainamide - Heart failure - Disopyramide
43
Lidocaine Mexiletine -Phenytoin can fall into this category
Class IB antiarrhythmics - Na+ channel blockers (mild) ↓ AP duration; preferentially affect ischemic or depolarized Purkinje & ventricular tissue Tx - Acute ventricular arrhythmias (esp. post-MI) - digitalis-induced arrhythmias AE - CNS stimulation/depression, CV depression IB is Best post-mi
44
Flecainide | Propafenone
Class IC antiarrhythmics - Na+ channel blockers (strong) Significantly prolongs refractory period in AV node (minimal effect on AP duration) Tx - SVTs, including atrial fibrillation - only as last resort in refractory VT AE - Proarrhythmic, especially post-MI CI - structural & ischemic heart disease
45
``` Metoprolol Propranolol Esmolol Atenolol Timolol Carvedilol ```
Class II antiarrhythmics - β-blockers ↓ SA & AV node activity (by ↓ cAMP, ↓ Ca+ currents); Suppress abnormal pacemakers by ↓ slope of phase 4 Tx - SVT, slows ventricular rate during A Fib & Flutter AE - Impotence, exacerbation of COPD & asthma - CV (bradycardia, AV block, CHF) - CNS effects (sedation, sleep alterations) - may mask the signs of hypoglycemia - Dyslipidemia (metoprolol) - propranolol can exacerbate vasospasm in Prinzmetal agina CI - cocaine users (risk of unopposed α-adrenergic receptor agonist activity) Treat overdose w/ glucagon *ONLY antiarrhytmic drugs found to be clearly effective in preventing sudden cardiac deaths in Pt w/ prior MI
46
Amiodarone, (Dronedarone) Ibutilide Dofetilide, Sotalol
Class III antiarrhytmics, K+ channel blockers ↑ AP duration, ↑ ERP, ↑ QT interval Tx - A Fib & Flutter, Ventricular Tachycardia (A, S) - used when other antiarrhytmics fail AE - Sotalol - TdP, excessive β-blockade - Ibutilide - TdP - Amiodarone - *pulmonary fibrosis (lethal interstitial pneumonitis), hepatotoxicity, hypo/hyperthyroidism, corneal deposits, Blue/gray skin deposits, photodermatitis, neurologic effects, constipation, Cardiovascular (bradycardia, heart block, CHF) - Remembert ro checn PFTs, LFTs, & TFTs Amiodarone has Class I, II, III & IV effects, and alters the lipid membrane
47
Verapamil | Diltiazem
Class IV antiarrhythmic - Ca2+ channel blocker ↓ conduction velocity, ↑ ERP, ↑ PR, ↓ SA automaticity Tx - Prevention of nodal arrhytmias (e.g. SVT), rate control in atrial fibrillation AE - Constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression)
48
Adenosine
Other antiarrhythmic - ↑ K+ out of cells = hyperpolarize the cell and ↓ Ica = ↓ firing rate -Very short acting (~15 seconds) Tx - DoC in Dx/abolishment of SVT AE - flushing, HoTN, chest pain Effects blocked by theophylline & caffeine
49
Magnesium
Other antiarrhythmic Effective in TdP & digoxin toxicity
50
Hydralazine
Arterial Vasodilator - ↑ cGMP = smooth muscle relaxation Vasodilates arterioles > veins = afterload reduction Tx - Severe HTN, CHF - 1st line tx for HTN in pregnancy (w/ methyldopa) - frequently coadministered w/ a β-blocker to prevent reflex tachycardia AE - Compensatory tachycardia = CI in angina/CAD - fluid retention, nausea, headache, angina - Lupus-like syndrome
51
Sodium Nitroprusside
Short acting for Hypertensive emergency ↑ cGMP via direct release of NO = ↓ preload & afterload Can cause cyanide toxicity (releases cyanide)
52
Fenoldopam
Dopamine D1 receptor agonist =coronary, peripheral, renal & splanchnic vasodilation Tx - hypertensive emergency - ↓ BP & ↑ natriuresis
53
Nitroglycerin Isosorbide dinitrate Isosorbide mononitrate
Vasodilate by ↑ NO in vascular smooth muscle = ↑ cGMP & smooth muscle relaxation Dilate veins >> arteries = ↓ preload Tx - angina, acute coronary syndrome, pulmonary edema AE - reflex tachycardia (tx w/ β-blocker), HoTN, flushing, headache "Monday disease" in industrial exposure = development of tolerance during the week & loss of tolerance over weekend = tachycardia, dizziness & headache upon reexposure
54
Digoxin
Direct inhibition of Na/K ATPase leads to indirect inhibition of Na/ca exchanger = ↑ Ca = positive inotropy -also stimulates vagus nerve = ↓ HR Tx - CHF (↑ contractility); A Fib (↓ conduction at AV node & depression of SA node) AE - Cholinergic (N,V,D, blurry yellow vision) - ECG = ↑ PR, ↓ QT, ST scooping, T-wave inversion, arrhythmia, AV block - Can lead to hyperkalemia, which indicates poor Px Antidote = Slowly normalize K+, cardiac pacer, anti-digoxin Fab fragments, Mg2+
55
-Minoxidil
Arterial Vasodilator - Katp channel opener = relaxes arteriole smooth muscle cells (NO effect on veins) Tx - oral use only for severe, refractory HTN - in combo w/ diuretics & B-blockers AE - Fluid & salt retention; Reflex ↑ myocardial activity; hypertrihosis CV effects = ↓ BP, ↑ CO, ↑ blood flow to renal, heart, skin, skeletal muscle, GI, CNS
56
-Aliskiren
Binds directly to catalytic site of renin = inhibits conversion of angiotensinogen in ANG1 Tx - Mono- or combotherapy for HTN - demonstrated efficacy in lowering BP when used in combo w/ thiazide, ACEI, ARB or CCB AE - hyperkalemia CI - Pregnancy
57
-Reserpine
Rauwolfia Alkaloids = blocks transport of NE into storage granules = depletes NE at sympathetic nerve endings Tx - most effective w/ thiazide diuretic (mitigate Na/H2O retention) - rarely used in HTN because of perceived side affects AE - sedation, depression, ↓ CO, orthostatic HoTN - ↑ parasympathetic activity = nasal stuffiness, ↑ gastric acid secretion, diarrhea, bradycardia
58
- Inamrinone | - Milrinone
Phosphodiesterase Inhibitors - Inhibit PDE3 = ↑ cAMP (due to ↓ degradation) = ↑ myocardial contractility, accelerate myocardial relaxation; balance arterial & venous dilation; ↓TPR, PVR, LV &RV filling pressure = ↑CO Tx - short-term circulation support in advanced CHF short T1/2 = must be given IV
59
- Propanolol - Metaprolol - Pindolol - Labetalol
β-adrenergic receptor antagonists = ↓ BP, varying degrees of ↓ HR, may ↓ renin Tx - 1st line for compelling indications of CAD, Left ventricular dysfunction w/ HTN - Addon for uncomplicated HTN & HTN w/ diabetes + w/ migraine, tachyarrhythmia, high-normal HR/tachycardia, hyperthyroidism (symptoms), essential tremor, Pre-op HTN AE - can ↑ bronchospasm
60
- Spironolactone | - Eplerenone
Aldosterone receptor antagonists - competitively inhibit aldosterone binding MRs = ↓ Na uptake, ↓ K loss Tx - Add-on for RHTN, & HTN w/ CAD, L ventricle dysfunction + Low-normal K - used in combo w/ thiazide to balance K, chronic kidney disease (early stages) - high-normal K (including end stage kidney disease)
61
- Prozosin - Doxasin - Terazosin
α1-adrenergic receptor antagonists Tx - HTN monotherapy, or w/ diuretic + ↓ LDL, TG & total cholesterol AE -mild reflex tach, sexual dysfunction, orthostatic HoTN - mild tolerance develops to antihypertensive effect
62
- Clonidine | - α-methyldopa
α2 selective agonists = ↓ central sympathetic outflow = ↓ BP Tx - transdermal formulation useful for labile HTN, Pt prone to early morning BP surges, hospitalized Pt who can't take medication by mouth - optimally used w/ diuretic to diminish fluid retention - limited by anticholinergic effects & can cause rebound HTN when stopped α-methyldopa - used in gestational HTN & chronic HTN in pregnancy = fewer anticholinergic side effects but hepatotoxicity & + direct Coomb's test
63
Mannitol
Osmotic diuretic = ↑ tubular fluid osmolarity, producing ↑ urine flow, ↓ intracranial/intraocular pressure Tx - Drug overdose - ↑ intracranial/intraocular pressure - prophylaxis for acute renal failure AE - pulmonary edema, dehydration CI - anuria, CHF
64
Acetazolamide
Carbonic anhydrase Inhibitor - causes self-limited NaHCO3 diuresis & ↓ total-body HCO3- stores Tx - Glaucoma - urinary alkalinization, metabolic alkalosis, altitude sickness, pseudotumor cerebri AE - hypercholoremic metabolic acidosis, parasthesias, NH3 toxicity, sulfa allergy, renal stones CI - cirrhosis
65
Furosemide | Bumetamide
Sulfonamide Loop diuretic - inhibit NKCC in thick ascending loop; abolish hypertonicity of medulla, preventing concentration of urine. Stimulates PGE release; ↑ Ca excretion (loops lose calcium) Tx - Edematous states (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), HTN, hypercalcemia AE - Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout (OH DANG!)
66
Ethacrynic acid
Phenoxyacetic acid derivative loop diuretic - essentially same action as furosemide Tx - diuresis in patients allergic to sulfa drugs AE - OH DANG; can cause hyperuricemia = never use to treat gout
67
Hydrochlorothiazide Chlorthalidone Metolazone Indapamide
Thiazide diuretics - Inhibit NCC in early distal tubule. ↓ diluting capacity of the nephron; ↓ Ca excretion Tx - HTN, CHF, idiopathic hypercalciuria, nephrogenic diabetes insipidus, osteoporosis AE - hypokalemic metabolic alkalosis, hyponatremia - hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia (hyperGLUC) - sulfa allergy
68
Amiloride | Triamterene
Block Na channels in late distal tubule & collecting ducts =K+ sparing agents Tx - hyperaldosteronism, K+ depletion, CHF, HTN - in combo w/ loop diuretics/thizides to prevent hypokalemia AE - Hyperkalemia (can lead to arrhythmias), glucose tolerance & photosensitization
69
Spironolactone | Eplerenone
Competitive aldosterone receptor antagonists in cortical collecting tubule = ↓ Na uptake = natriuresis = K+ sparing agents Tx - Hyperaldosteronism, K+ depletion, CHF, HTN - prevention of L. ventricular remodeling & fibrosis, prevention of sudden cardiac death... AE - Hyperkalemia (can lead to arrhythmias), - spironolactone = endocrine effects (gynocomastia, antiandrogen effects...)
70
Captopril Lisinopril Fosinopril Enalapril
ACEI - ↓ AngII = ↓ GFR by preventing constriction of efferent arterioles. Levels of renin ↑ as a result of loss of feedback inhibition. Inhibition of ACE also prevents inactivation of bradykinin (a potent vasodilator) Tx - HTN, CHF, proteinuria, diabetic nephropathy - prevent unfavorable heart remodeling as a result of chronic HTN - 1st line/add=on for uncomplicated HTN - 1st line tx for diabetes, chronic kidney disease, CAD, LV dysfunction & ischemic shock AE - Cough, Angeioedema, Teratogen, ↑ Creatinine (↓gfr), Hyperkalemia & Hypotension (Captopril's CATCHH) CI - bilateral renal stenosis (because ACEI will further ↓ GFR = renal failure)
71
Losartan Valsartan Candesartan
ARB (Angiotensin Receptor 1 blockers) = block AT1R = ↓ ANGII effects = ↓ vasoconstriction, aldosterone & Na/H2O retention Tx - 1st line/add-on in uncomplicated HTN - 1st line Tx for diabetes, chronic kidney disease, CAD, LV dysfunction - commonly used as an alternative for pt w/ intolerance to ACEI + Low-normal K, prediabetes - High-normal K, hyperkalemia, volume depletion CI - pregnancy & bilateral renal artery stenosis
72
Nifedipine Amlodipine Felodipine Nimodipine
Dihydropyridine Ca channel blockers - Block voltage-dependent L-type Ca channels w/ vasodilation to negative ionotropy = 10:1 Tx - HTN, angina (incl. Prinzmetal), Raynaud phenomenon - nimodipine = subarachnoid hemorrhage (prevents cerebral vasospasm) AE - Cardiac depression, AV block, peripheral edema, flushing, dizziness, hyperprolactinemia & constipation
73
Verapamil | Diltiazem
NDHP Ca channel blockers - block voltage-dependent L-type Ca channels w/ 1:1 vasodilation to negative ionotropy Tx - Hypertension, angina, A fib/flutter AE - Cardiac depression, AV block, peripheral edema, flushing, dizziness, hyperprolactinemia & constipation

Pharmacology (6 decks)

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