Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

year 2 > Pharm 3 Cardio > Flashcards

Pharm 3 Cardio Flashcards

1
Q

Numodipine

A

Calcium Blocker

  • Most lipid soluble
  • Cerebral Vasodilator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diltiazem

Benzothiazipine

A

Calcium Blocker

  • Less tachycardia
  • Depress SA & AV
  • ↓ contractility
  • Bradycardia
  • C/I SA &AV node abnormalities/CHF
  • Aterioles>Veins
  • INHIBIT INSULIN; Interfere plate agg
  • ↑ plasma Digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Captopril

A
  • ACE inhibitor (peptidyl dipeptidase)
  • Increases Angioten I & Bradykinin
  • Bradykinin → ↑ PG syn → vasodilation
  • No reflex sympathetic
  • Young Caucausians (mono therapy ok)
  • DOC: DM, chronic renal, LV hypertropy
  • Synergistic with diuretics
  • Cough, hyperkalemia, angioedema, acute renal failure w/ B/L stenosis, hypotension
  • C/I Pregnancy, K+ diuretics, NSAIDS (block bradykinin
  • active drug (all other ACEI are prodrugs)

**ACEI don’t compromise HEART, KIDNEY, or BRAIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Verapamil

Papaverine

A

Calcium Blocker

  • strongest Cardiac Effect
  • Less tachycardia
  • Depress SA & AV
  • Constipation
  • Bradycardia
  • Aterioles>Veins
  • INHIBIT INSULIN; Interfere Plate Agg
  • ↑ plasma Digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nifedipine

Dihydropyridines

A
  • Calcium Blocker
  • Strongest Vaodilator
  • ↓ afterload ↑o2 supply
  • Reflex tachycardia
  • Vascular Side Effects
  • Gingival hyperplasia
  • Less SA AV effect
  • INHIBIT INSULIN; Interfere -Plate Agg
  • ↑ plasma Digoxin
  • Slow release HPT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Losartan

A
  • Inhibit AT1 (ATII receptor) → ↑ ATII
  • No bradykinin effect
  • SE: hyperkalemia, acute renal failure w/ B/L stenosis (?), hypotension
  • Fetal Toxicity
  • Does not cause cough/angioedema
  • More effective lowering mortality Atenolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ranolazine

A
  • Partial fatty-acid oxidation inhibitor
  • ↓ left ventricular wall stiffness
  • Oral
  • Inhibits late sodium
  • Metabolized by CYP3A= drug interactions
  • C/I: hypokalemia, Heart rhythym abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nitroglycerin

A
  • ↑ cGMP
  • ↓ preload ↓afterload
  • Can ↑ workload by reflex tachycard
  • ↓ O2 requirement & redistribute bf to ischemic
  • ↓ platelet aggregation
  • Acute hypotension, THROBBING headaches
  • Tolerance, “Monday Disease”
  • High first pass effect
  • Sublingual avoids hepatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aliskiren

A

-Renin Antagonist block ang I
-Hypertension
Hepatobiliary clearance
Headache
Dizziness
GI events
C/I Pregnancy 2nd 3rd Trimesters Categ D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sildenafil

A

-Selective inhibior of cGMP phosphodiesterase
-PDE5
-Helps with Impotence
-Treats pulm hypertension
-PDE6 less potent EYE
-Metabol CYP 3A4
Adv Effect
-Nasal congestion, UTI,
-Visual Impairment
-C/I: pregnant/children, NITRATES, alpha blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Verdenafil

A
  • Like sildenafil
  • More selective for PDE5>6
  • Faster onset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dorzolamide

Brinzolamide

A
  • Inhibit Carbonic Anhydrase

- Topically for Glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Furosemide

A
  • Loop Diuretic/ Inhibit NaK2Cl thick asc
  • ↑ excr Mg & Ca
  • TREAT: CHF, Edema, HyperCalc, excess K
  • HYPOKALEMIA & ALKALOSIS
  • ↑ PG synthesis, Relieve PULM Congestion
  • Hyperuricemia
  • OTOTOXICITY w/ aminioglycosides
  • Thrombocytopenia, Allergies
  • DI: Aminoglyc, Lithium, Digoxin
  • C/I Sulfonamide, hep cirrhosis, renal fail, dangerous in CHF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ethacrynic Acid

A
  • Loop Diuretic
  • Same Adverse Effects
  • Not a sulfonamide
  • Higher risk of OTOTOXICITY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hydrochlorothiazide

A

-Inhibit Na/Cl resorption distal tubule
-Depends on PG synthesis (inhib by NSAID)
Uses
-HPTN, CHF, Nephrolithiasis, **Nephrogemoc DI
Effects
-↑ K opening, Lower BP, enhance antihyperten drugs
-Hypokalemia, Hyperuricemia, ↓ Ca excre, ↑Mg. Br, Iodine loss, Hyperglycemia ↓insulin
-↑ Lipids Blood, Dyscrasia, Necrotizing vasculitis, aggravate jaundice infants, Lithium Toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Metolazone

A
  • Similar to Thiazide,

- Produce diuresis in patients with reduced GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indapamide

A
  • Direct vasodilators
  • Thiazide Like
  • Hepatic metabolism
  • No increase in Lipids
  • PRONOUNCED Vasodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Spironolactone

A

-Competitive inhibitor of aldosterone
-Binds to glucocorticoid and sex hor receptors @ high doses
Toxicities
-GI, Impotence, GYNECOMASTIA,
-Hyperkalemia, Acidosis
-CAREFUL: w/ ACE inhib and ARB’s
-Most Effective in Hyperaldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Eplerenone

A

Selective Aldosterone Receptor Antagonist

  • Simular to spironolactone, NO ENDOCRINE EFFECTS ↓ affinits gluco, androgen receptors
  • REDUCE all cause mortality with M.I.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Triamterene

A

-Independent of aldosterone,
-Inhibits Dihydrofolate reductase
-Inhibit sodium potassium exchange distal tube
-NO CAUSE OF HYPERURICEMIA
Toxicity
-Hyperkalemia
-Nausea vomiting
Use
-Combo with K losing diuretics
-Edema w/ CHF,Cirrhosis, Nephrotic synd
-Hirutism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Amiloride

A

-Independent of aldosterone,
-Inhibit sodium potassium exchange distal tube
-NO CAUSE OF HYPERURICEMIA
Toxicity
-Hyperkalemia
-Nausea vomiting
Use
-Combo with K losing diuretics
-Edema w/ CHF,Cirrhosis, Nephrotic synd
-Hirutism.
DOC: lithium induce Diab Inipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Mannitol

A

Osmotic Diuretic
-Freely Filtered @ glomerulus
-Pharmacologically inactive
-Inhibits water resorption at prox and loh
-DOC: less irritable, less likely thrombophlebitis
USES:
-↓ intraocular, ↓ intercranial, ↓ CSF, protect kidney form toxic agents, prophylaxis renal
Toxic - ↑ cerebral bf, dehydration, ECF expansion,
pulm edema CHF, headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vasopressin

A
  • Exogenous form of ADH
  • Parenteral
  • Prevent or control poly-uria/dipsia & dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Desmopressin

A

-Synthetic analog of ADH
-Long acting
-↑ coag VIII & vWF
USES:
-Ruptured esophagus varix bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Conivaptan

A
  • Non peptide v1 & v2 adh rec antagonists

- ↑ urine output ↓ resorption water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cilostazol

A

Anti-platelt

  • PDE3 inhib → ↑ cAMP
  • TX intermittent claudication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Demeclocycline

A
  • Tetracycline antibiotic
  • Used to produce Diabetes Insipidus
  • Uncouple v2 receptor
  • Lower toxicity than lithium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Lithium

A

Uncouples v2 from adenylyl cyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Digitalis

Digoxin

A

-CardOut ↑ in CHF; Not in normal pt: ↓HR
-Use for atrial arrhythmias
-Inhibits Na/K ATPase
-↑ contractility, ↑ free Ca ↑intra Na
-K counters Digitalis;Digitalis counters K
-Mg and K ↓ toxicity
-Hockey Stick Config
-Narrow Marg of Saftey: L
ADV EFF: arrhythmias, CNS, and skin irrit
DO NOT USE CARDIOVERISON
C/I: WPW syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Digoxin

Drug Interactions

A

Enhance toxicity:

  • ↓ Renal Clearance & ↓ VD:
  • -(quinidine, amiodarone, verapamil, diltiazem, captopril)
  • ↑ GI Absorption

Reduce Toxicity:
-↓ GI absorption: Cholestyramine ↓ absorption

QUINIDINE: ↑ plasma levels displaces from protein
DIURETICS: cause hypokalemia= ↑toxicity
ELDERLY: ↑ levels b/c hypochloridia/↓ Clearance
INFANTS: ↑ Dose
Hypothyroid: ↓renal CL  ↑ plasma levels
Use: Lidocaine, Phenytoin or Propranolol for intox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Milrinone

A

-Inodilator or bipyridine
-Inhibit PDE, ↑ cAMP
-↑ Ca influx
-Vasodilatory
-ACUTE: ↑ CardOut CHRONIC: ↓ survival
Toxicites
-Arrhythmias, thrombocytopenia, nausea

    USE FOR ACUTE HEART FAILURE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Inamrinone

stop here

A

-Inodilator or bipyridine
-Inhibit PDE, ↑ cAMP
-↑ Ca influx
-Vasodilatory
ACUTE: ↑ CardOut CHRONIC: ↓ survival
Toxicites
-Arrhythmias, thrombocytopenia, nausea

    USE FOR ACUTE HEART FAILURE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Dopamine

A 
-Sympathomimetic
USE: Severe refractory CHF & Post op heart
-↑ Cardiac Output ↑ RBF
-↓ p. resistance
-↑ Na excretion
-Can treat shock
-IV Admin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Levosimendan

Pimobendan

A
  • Calcium Sensitizers
  • ↑ calcium sensitivity w/out ↑ tissue calcium
  • Inhibit PDE III
  • Sensitizes troponin-C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Dobutamine

A
  • Sympathomimetic
  • Selective B1
  • Less Tachycardia
  • ↑ O2 consumption
  • Reduced filling pressure
  • IV admin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Nesiritide

A
  • Analog of BNP
  • Acute Tx of decompensated CHF
  • Causes ↓ Pulm Wedge Press
  • Improves Dyspnea and Fatigue
  • Lack of tolerance (unlike Nitroglycerin)

MONITOR BP, hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Beta Blockers CHF

Bisoprolol, Carvedilol Metoprolol

A

-Dangerous in severe CHF
-↓ mortality rates class II and III CHF
USED in Diastolic Dysfunction & cardiomyopathy

Benefits

  • Attenuation catecholamines
  • ↑ beta receptors
  • ↓ HR ↓ Remodeling
  • Antiarrhythmic effect (UNIQUE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Sodium Nitroprusside

A
  • Used in CHF helps with preload after load
  • IV for HTN emergencies (↑ infusion = ↓ BP & visa versa)
  • Vasodilator Art and Veins (veins > arteries)
  • ADVERSE: Excessive Hypotension
  • Metabolized to thiocyanate: CYANIDE POISONING
  • Can cause metabolic acidosis
  • Sodium Nitrite → methemeglobin → Tx CN poisoning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Hydralazine

A 
-ORAL: chronic HPT 
Tx-Vasodilator- peripheral (via NO)
-Relax ARTERIOLE smooth muscle (NO VEINS)
-↑ HR, Card Output, Left Vent Eject Fraction
-SAL: chronic HPT Tx
-given in combo w/ diuretics and BB
-Use for short term
-esp. effective w/ AFRICAN AMERICAN

-SLE in slow acetylators

**May induce ANGINA and MI in pts w/ CAD

39
Q

Procainamide

A

-Class IA antiarrythmic/ Like Quinidine
-Shorter Duration of Action & IV use
-Affected by slow/fast acetylators
-Same Adv Effect Quin: Torsdae de Pointes
ADV EFFECT: SLE & ↑ ANA
-DO NOT USE in complete AV block
-USE in ventricular and supraventric TACHY

40
Q

Quinidine

A

Class IA antiarrythmic–open & inactive Na chan

  • Myocardial Depress: ↓automaticity&response
  • ↑ Diastolic Threshold: slow Ca rise rate
  • ↑ APD & ERD: PREVENTS REENTRY
  • Block K+: ORAL; First pass
  • Block M Rec, ekg changes, ↑SA/AV block
  • LOW Ther INDEX: C/I- Av block,thrbocyto
  • Cardiac TOXIC;paradox tachy, SYNCOPE, Torsade de Pointes, Diarrhea Cinchonism
  • ↑ pt time, Phenytoin ↑ metab, ↑K=↑Toxicity
  • ↑ effect of paralyzing agents
41
Q

Disopyramide

A

-Class IA inhibitor, Different Structure than Quinidine
-Reduces Cardiac Index
-Use for premature ventricular & vent tach
-Increases ERP, elect threshold, decrease velocity
-Toxicity
-Torsdade de Pointes, Neg Inotropic effect
-Anticholinergic effect
DO NOT USE IN SICK SINUS SYNDROM

USE FOR VENTRICULAR TACHYCARDIA

42
Q

Lidocaine

A
  • Class Ib- antiarrhythmic & anesthetic
  • Binds inactivated channels
  • Decreases APD, Shortens ERP
  • Block slow Na Window Currents
  • NO depressant on contractility
  • NO VAGAL blocking
  • IV only, NO use for Supravent arrythmia
  • Toxicity
  • CNS Depression, Hypotension Convulsion
  • Bradycardia
  • *Least negative inotropic
43
Q

Mexiletine

A
  • Class Ib
  • Similar to lidocain
  • Also relieves pain in diabetic neuropathy
  • Toxicity
  • CNS
  • Tremor
  • Blurred
  • Lethargy

CAN BE USED ORALLY

44
Q

Phenytoin

A

-Class Ib
-Binds active and inactive NA channels
-Antiepileptic drug
-Used with digitalis toxicity
-Shortens ERP: depression myocar automaticity
Toxicity
-Nystagmus, ataxia, slurred speech, confusion
-Elevated glucose levels
-Fever Rash Blood dyscrasia
-Drug Interaction
-Warfarin, Disulfiram inhibit the metabolism
-Induces P450, inhibits folate dihydro reduct

45
Q

Flecainide

A

-Class IC- binds to ALL Na channels
-No effect APD, ANS
-QRS widening, shorten AP perkinje
-No first pass
Toxicity
-BLURRED VISION, Proarrythmic effect
C/I
-Pre ex AV block
-CHF or cardio genic SHOCK

*use for life threat ventric arrhythmias, prevent PSVT

46
Q

Propafenone

A

-Class IC similar to Flecainide
-Structurally similar to beta blockers
-Use in hospital with monitoring
RESERVED FOR LIFE THREATENING

47
Q 
Beta Blockers
(What type of Arrhythmic Drug)
A

Class II

48
Q

Amiodarone

A
  • Class III anti-arrhythmic
  • Life threat vent arrhythmia & atrial flutt/fib
  • Blocks K, Binds to inactivated Na, Calcium blocking,
  • Causes peripheral vasodilation (alpha block)
  • LARGE half life
  • Causes bradycardia, heart block, pulm fibrosis
  • Deposits in tissues cornea, Thyroid dysfunc
  • Ventricular Arrhythmias
  • ** NO TORSADES DE POINTES***
49
Q

Sotalol

A
  • Nonselective beta blocker Class II l-isomer
  • Prolongs action potent Class III d-isomer
  • USED in ventricular and supraventricular
  • CAUSES torsades de pointes
50
Q

Ibutilide

A
  • Class III
  • USED: Rapid Conversion atrial fib/flutter
  • Promotes Na influx through hslow channels
  • Increases Length of action potential
  • DOES NOT alter bp, hr or QRS
51
Q

Dofetilide

A
  • Class III
  • USED: Conversion and Maintenance atrial fib
  • Effective supraventricular arrhythmia
  • Blocks Potassium channels
  • NO NEGATIVE INOTROPIC ACTIVITY
  • ORAL
  • Toxicity
  • Arrhythmias,TORSADE DE POINTES
  • Influenza Syndrome, Resp Tract Infect
52
Q

Calcium Channel Blocker

Anti-arrhythmic

A

-Class IV
Verapamil-
–Blocks slow cardia Ca, slows AV node,
–Supraventricular Tachycardia (Rentry Type)
–Minimal tox after ORAL
–Constipation avoid w/ beta blockers

Diltiazem

  • -Inhibits influx extracell Ca, reduces HR
  • -Increases exercise capacitance, improve perfus
  • -Treat paroxysmal supraventricular tach, atrial fib/flutter, Prinzmetal, follow ANGIOPLASTY

-affect arteries more than veins

53
Q

Adenosine

A

-DOC for PSVT and for WPW syndrome
-Slows conduction AV node, interrupts Rentry
-Atropine doesn’t affect but *Caffeine does
-Enhace K conductance, inhib of cAMP Ca
-SHORT ACTING: IV ONLY
-Flushing, loss of breath, burn chest, hypotension
C/I:
-Sick sinus syndrome
-AV Block

54
Q

Magnesium Sulfate

A

-Mechanism UNKOWN
-Effective even with normal Mg levels
USES:
-Digitalis induces arrhythmia
-TORSADE DE POINTES
-Management of Seizures

55
Q

Potassium

A
  • Careful b/c insufficient and excess are both PRO ARRHYTHMIC
  • Use to normalize K pool
  • Effects: Resting potential depolarization & membrane stabilization.
  • Hypokalemia=Increased risk of afterdepolarization
57
Q

Clonidine

A

-Central acting sympathomimetic
-↑medullary α2 stim -> ↓peripheral sympathetic
-Presynaptic ↓ transmitter release
-Postsynaptic ↓ inhibit neurons
-Lowers BP by ↓ vasoconst & ↓ renal renin
-Higher effect on HR & C. Outp > Methyldopa
Adverse
-CNS effects, Xerostomia,
-fast withdrawal = Hypertensive crisis
Drug Inter: TCA’s and Yohimbine

57
Q

Dexmedetomidine

A
  • Central acting sympathomimetic
  • Selective α2
  • Sedative and analgesic
  • ADMIN: IV
  • Anesthesiology and Post-op
58
Q

Methyldopa

A

-Central acting sympathomimetic
-Pro-drug
-↑medullary α2 stim -> ↓peripheral sympathetic
-Presynaptic ↓ transmitter release
-Postsynaptic ↓ inhibit neurons
-Lowers BP by ↓ vconst & ↓ renal renin
-can be used during pregnancy
Adverse:
-CNS effects (sedation, dizziness), Xerostomia
-**Hemolytic Anemia w/ + coombs test
-↑ prolactin: gynecomastia
Drug Interaction w/ TCA’s & Yohimbine

59
Q

Mecamylamine

A
  • Ganglionic Blocker
  • Tertiary amine: Goes to CNS
  • Promising in Tourettes syndrome

NOT typically used TONS side effects

60
Q

Reserpine

A

-Adrenergic Nerve Blocker
-Binds to vesicles: inhibits NE into vesicle (VMAT)
-Released NE metab by MAO enzyme
Adverse
-Sedation
-Psychic depression
-Stuffy nose
-GI

61
Q

Guanethidine

A

-Adrenergic Nerve Blocker
-Replaces NE in vesicles
-Inhibits exocytosis
Adverse
-Interaction w/ TCAs cocaine, indirect sympath

63
Q

Prazosin
Terazosin
Doxazosin

A 
α1 selective BLOCKER
-↓ NE vasoconstriction in arteries & veins (equally)
-Less tachycardia no block of alpha 2
Adverse effects
-Postural Hypotension/ 1st dose effect
-↑ renin= sodium water retention
-Does not affect plasma lipids

veins have denser alpha 1 concentrations

63
Q

Drugs that can cause SLE in slow acetylators

A

Hydralazine
Isoniazid
Procainamide

64
Q

Betablocker

*Nebivolol

A

-Reduce CO, ↓ Renin, ↓ SNS vasomotor tone
-Preferred: angina, migraines, after M.I.
-Least preferred: high physical activity, black, DM, ↑ cholesterol, peripheral vascular disease
-Most effective in Young, and Caucasians
(thiazide: elderly and blacks)
-**Combine w/ other Rx to prevent tachycardia and ↑ renin from other drugs
**Nebivolol ↑ endogenous NO production= ↑vasodilation
ADVERSE: Heart, Lung, GI, CNS
-↑ exercise tolerance,
-predispose atherogenesis ↑ VLDL ↓ HDL
-Mask symptoms of hypoglycemia
**C/I: Diabetes, sever CHF, heart block, asthma

66
Q

Carvedilol

A

-Alpha1 and beta blocker
- ↓ BP w/o causing tachy
-Lower BP in hypertensive emergency
Adverse:
-Orthostatic hypertension
-Bronchospasm
-HEPATOTOXIC

Lipid Neutral

66
Q

Fenoldopam

A

-IV for HTN emergencies
-Specific D1 receptors agonist (no tachy from B1)
-Postsynaptic relax arteriolar smooth muscle
Toxicity
-Reflex tachycardia
-Headache
-Flushing

67
Q

Diazoxide

A

-IV for HTN emergencies
-Vasodilator and hyperglycemic (ARTERIES only)
-Is a thiazide but not diuretic effect
-Activates ATP/K+ channels (inhibit insulin release)
-Used with INSULINOMA patients
Adverse
-Hyperglycemia
-Sodium retention
-Hyperuricemia (b/c its a Thiazide)
-Excessive Hair growth

69
Q

Minoxidil

A
  • ORAL for chronic HTN tx
  • dilates ARTERIES (via open K+ channel)
  • given in combo w/ diuretics and BB
  • *May induce ANGINA and MI in pts w/ CAD
  • inhibit insulin release
70
Q

drugs that inhibit insulin release

A
  • Diazoxide (K channel → hyper polarize)
  • Minoxidil (K channel → hyper polarize)
  • CCB (Ca channel → no Ca induced exocytosis)
71
Q

Least preferred HTN drugs for:

1) 65+ yrs
2) African american
3) Pregnant
4) Angina
5) Asthma
6) Diabetic (?)

A

1) centrally acting alpha2 agonist (clonidine, methyldopa)
2) BB
3) ACEI, ARB
4) Hydralazine, Minoxidil
5) BB
6) Propanolol can mask symptoms of hypoglycemia, inhibit insulin release, and increase blood lipids

72
Q

1) Classic or Atherosclerotic angina (angina of effort) Tx

2) Variant or angiospastic angina (Prinzmetal’s)

A

1) ANGINA OF EFFORT
- Beta Blockers
- CCB
- Ranolazine (partial Beta-ox inhib)
- do NOT use Hydrazine or Minoxidil w/ CAD

2) VARIANT ANGINA
- DOC: Nifedipine
- nitrates relieve spasm
- CCB (Diltiazam)
- do NOT use BB → ↓ HR → ↑ ejection time → ↑ LVEDV → ↑ o2 req.

73
Q

Niacin

A

Class: Hyperlipidemia
MoA: Inhibits VLDL secretion, hepatic chol-genesis
- ↓ VLDL & LDL
- ↑ HDL
USE: heterozygous familial hypercholesterolemia, combined hyperlipopreteinemia, when STATINS INEFFECTIVE

ADV/EFF: 
Vasodilation (from PG → aspirin prevents it)
Nausea
Elevate aminotransferases
Impairs glucose tolerance
Hepatotoxicity
74
Q

Gemfibrozil

A

Class: Hyperlipidemia: Fibric Acid Derivative
MoA: Ligand TF for ppar-α ↑LPL activity
- ↓ VLDL → ↓ TAG (may ↑ LDL)
- ↓Cholesterol
USE: Fam Dysbetalipoproteinemia & Hypertriglycemia
Do NOT USE prim chylomicronemia & Fam Hypercholesterolemia

ADV/EFF
Skin Rashes, Gi, Hypokalemia
↑ aminotransferases & ALP
↑ cholelithiasis/gallstones
**Inhibits metabolism of statins, ↑LDL
Potentiate anticoagulay
75
Q

Fenofibrate

A

Class: Hyperlipidemia: Fibric Acid Derivative
MoA: Ligand TF for ppar-α ↑LPL activity
- ↓ VLDL → ↓ TAG (may ↑ LDL)
- ↓Cholesterol
USE: Fam Dysbetalipoproteinemia & Hypertriglycemia
Do NOT USE prim chylomicronemia & Fam Hypercholesterolemia

ADV/EFF
Skin Rashes, Gi, Hypokalemia
↑ aminotransferases & ALP
↑ cholelithiasis/gallstones
**Inhibits metabolism of statins, ↑LDL
Potentiate anticoagulay
76
Q

Colestipol

A

Class: Hyperlipidemia: Bile Acid Resin
MoA: Diver Chol from VLDL to synth of Bile Aci
↑ expression of LDL receptor, ↑ LDL uptake
↓ LDL
Take with Meals
USE: LDL elevated HETEROzygous hyperlipidemia
DO NOT USE: homozygous hyperlipidemia (no LDL receptors) & hypertriglyceridemia

ADV/EFF:
Constipation & gallstone (less than fibric acid)
Hypoprthrombinemia poor vit K absorption
Impair absorption: Digitalis, thiazides, tetracycline, thyroxine, aspirin

77
Q

Cholestyramine

A

Class: Hyperlipidemia: Bile Acid Resin
MoA: Diver Chol from VLDL to synth of Bile Aci
↑ expression of LDL receptor, ↑ LDL uptake
↓ LDL
Take with Meals
USE: LDL elevated HETEROzygous hyperlipidemia
DO NOT USE: homozygous hyperlipidemia (no LDL receptors) & hypertriglyceridemia

ADV/EFF:
Constipation & gallstone (less than fibric acid)
Hypoprthrombinemia poor vit K absorption
Impair absorption: Digitalis, thiazides, tetracycline, thyroxine, aspirin

78
Q

Colesevelam

A

Class: Hyperlipidemia: Bile Acid Resin
MoA: Diver Chol from VLDL to synth of Bile Aci
↑ expression of LDL receptor, ↑ LDL uptake
↓ LDL
Take with Meals
USE: LDL elevated HETEROzygous hyperlipidemia
DO NOT USE: homozygous hyperlipidemia (no LDL receptors) & hypertriglyceridemia

ADV/EFF:
Constipation & gallstone (less than fibric acid)
Hypoprthrombinemia poor vit K absorption
Impair absorption: Digitalis, thiazides, tetracycline, thyroxine, aspirin

79
Q

Lovastatin

A

Class: Hyperlipidemia, Comp inhibitor HMG CoA reduc
MoA: Analogs metabolites inhibit HMG CoA, ↓ LDL,
↑ LDL receptors, ↓TAGs ↑ HDL
USE: When LDL is elevated GIVE IN EVENING
BENEFITS: ↓CRP, ↑NO, ↑plaque stability, ↓ LDL oxid
↓ platelet aggregation

ADV/EFF:   
Liver damage &↑ aminotransferase
↑ creatine kinase activity
Rhabdomyolysis Myoglobinuria plugs kidney
C/I in PREGNANCY
Grapefut juice ↑ bioavailability,
80
Q

Orlistat

A

Inhibits pancreatic lipase → ↓ TAG breakdown

used for weight loss

81
Q 
Lab findings:
↑ Cholesterol → 
↑ TAG → 
↑ Cholesterol and TAG → 
↓  HDL →
A

Cholesytamine, colestipol, ezetimibe

Gemfibrozil

Statins and niacin, ezetimibe

Niacin

82
Q

Heparin sodium

A
  • Anticoagulant, prophylaxis against thrombosis
  • Binds ATIII → mainly inactivates Xa & thrombin (XII, XI, IX )
  • IV ONLY (onset immediate)
  • can cause HIT
  • CI: renal or hypatic dysfunction
  • inactivated by protamine sulfate
  • monitored by PTT
83
Q

Ezetimibe

A

Class: Hyperlipidemia: Inhibits cholesterol absorption
MoA: Blocks absorption of cholesterol & phytosterols
USE: to lower LDL & Cholesterol

Synergistic with STATIN to lower Cholesterol

Enterohepatic circulated

Metabolized by glucoronidation

No significant adverse effects

84
Q

Enoxaprin

  • -Dalteparin
  • -Danaparoid
A
  • Anticoagulant (LMW heparin)
  • Binds ATIII → mainly inactivates X
  • Sub-Q injection
  • ↓ chance of HIT
  • not completely reversed by protamine sulfate
  • monitored by PTT
  • used during PREGNANCY instead of warfarin
85
Q

Fondaparinux

A
  • Synthetic pentasaccharie
  • Anticoagulant (LMW heparin)
  • Binds ATIII → mainly inactivates X
  • Sub-Q injection
  • ↓ chance of HIT
  • not effected by protamine sulfate
  • monitored by PTT
86
Q

Lepirudin
Bivalrudin
–Argatroban

A

DIRECT THROMBIN INHIBITOR

  • doenst require ATIII
  • given as alternative in HIT
  • IV ONLY
  • Lepirudin → kidney
  • Bivalrudin → liver
  • monitored by PTT
  • -Argatroban → liver
87
Q

Dabigatran

A

ORAL direct inhibitor of Thrombin

88
Q

Rivaroxaban

–Apixaban

A

ORAL inhibitor of Xa

Tx: DVT, PE, and FUTURE CLOTS

89
Q

Warfarin

A
  • ORALLY, chronically
  • ↓ reduction of vit K →
  • → ↓ synthesis of VII, IX, X, II, protein C**
  • rapid ↓ protein C → transient hypercoag
  • -give w/ heparin @ initiation
  • delayed onset
  • delayed disappearance of effect
  • PREVENT emboli
  • reverse w/
  • -VIT. K → slow
  • -FROZEN PLASMA → immediate
  • cant use during pregnancy (use Enoxaprin)
90
Q

Warfarin drug interactions

A

Drugs that affect:

  • vitamin K
  • clotting factors (estrogen pregnancy)
  • platelet aggregation/function
  • Inhibit microsomal liver enzymes
  • Induce microsomal liver enzymes
90
Q

Aminocaproic acid

–Tranexamic acid

A

ANTIFIBRINOLYTIC

  • Inhibits plasminogen activation
  • Treatment of bleeding disorder
  • reversal of fibrinolytic therapy
  • oral or IV
  • ADVERSE: can cause intravascular thrombosis
91
Q

Alteplase

  • -Reteplase
  • -Tenecteplase
A

FIBRINOLYTIC

  • IV or intra-arterially
  • convert plasminogen → plasmin
  • lysis of already formed clots → re-establish perfusion
  • -Higher affinity for FIBRIN-BOUND plasminogen → clot selective

-Tenecteplase more fibrin specific and resistant to PAI-1

92
Q

Aspirin

A

ANTIPLATELET Inhibitor of thrombogenesis
-irreversible inhibition of COX → ↓ TXA2
-USED secondary prevention of cardiovascular events
in patients with ESTABLISHED CV disease

94
Q

Clopidogrel

  • Ticlopidine
  • Prasugrel
A

Inhibitor of ADP-induced platelet aggregation
-Irreversibly block ADP receptor on platelets
-Given ORALLY
DOC: prevent thrombosis in pt getting CORONARY STENT

95
Q

Abciximab

A

Inhibitor of GPIIb/IIIa receptor

  • ↓ platelet aggregation by inhibiting GPIIb/IIIa receptor from binding FIBRINOGEN
  • given IV** →↑↓

year 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions