Pharm Ex2- Call's Review Flashcards
Compelling indications to use ACE-I for HTN
Diabetic
CKD
Heart Failure (HFrEF)
Compelling indications to use B-blockers for HTN
Migraine (HA)
Post MI
Angina
HF (early only)
B blockers are best for
YOUNG white males
Enalapril
“pril” is DOC for
Heart failure
Do not stop suddenly
B-blockers!
B lockers are not good for
Those who exercise often
Contra in:
Thiazide diuretics are good for
Elderly African-American
Thiazide diuretics
Hydrochloroth
Metazoline
Indipamide
Metazoline (a thiazide diuretic)
Works well at reduced GFR (this is unique to thiazides)
Spironolactone tx for
Hyperaldosteronism
Do not use K-sparing diuretics with
ACE-I or ARBs
–> hyperkalemia
Indipamide (a thiazide diuretic) 3 unique things
Pronounced vasodilation
No threat to lipids
Good for renal insuff (bc its metabolized by both kidney AND liver)
Drugs dependent on Prostaglandins
ACE-I
Niacin
Loop & Thiazide diuretics
ACE-I/ARBs
most effective in young/middle aged white males (just like b-blockers)
CONTRA in Sulfa allergy
Thiazide
Loop
CA-inh
all diuretics
Contra in HF
Osmotic diuretics
B-blockers in Late HF
Verapamil & Diltiazem
Digoxin
HIP drugs
Hydralazine
Isoniazid
Procainamide
CYP450 interactions
Statins
CYP450 inhibitors (will cause Statin toxicity)
Macrolides (mycins) Ketoconazole (azoles) Cyclosporine Varapamil (CCB) Ritonavir (avirs)
CYP450 activators (will decrease Statin’s efficiency)
Phenytoin
Griseofulvin
Barbiturates
Rifampin
CYP2C19
Clopidogrel (Plavix)
Needs to be activated by CYP2C19
Using it with a drug that interacts with this will inhibit its conversion
i.e. Omeprazole
Nephrogenic Diabetes Insip
Thiazide
Central Diabetes Insip
Desmopressin (ADH agonist)
Lithium induced Diabetes Insipidus
Amiloride
Aldosterone antagonists (K sparing)
Spironolactone
Eplerenone
Direct Inh of Na flux
K Sparing
Amiloride (Li induced DI)
Triamterene
Osmotic diuretics
CONTRA in HF Mannitol Isosorbide Glycerin URea
Conivaptan
use IV in hospital for
Hyponatremic (euvelemic of hypervolemic)
i.e. SAIDH
Tolvaptan
take home! chronic use
Used in Pregnancy
Bile Acid Binding
Methyldopa
Labetolol
Nifedipine
Ranolazine
unique mechanism
PFox inhibitor
Last choice
Tx for Variant/Spastic Angina
Nitrates and CCB
Causes Torsades de Pointe
Quinidine
Sotalol
DOC to tx Torsades de Pointe
Magnesium, Mg
DOC for PSVT
Adenosine
DOC for Acute Ventricular Arrhyth
Class 1B
Lidocaine
DOC for Ventricular
Amioradone (jack of all trades)
treats both kinds
doesn’t cause Torsades
with the funny SE: yellow brown eyes, pulm fibrosis, blue-gray skin, thyroid dysfx
Class 4 CCBs
only effective in Atria
Class 1B Lidocaine
DOC for Acute Ventricular
only works for V arrhythmi
Clopidogrel
Ticagrel
irreversible block of ADP
Clopidogrel (Plavix) important characteristics
ADP receptor block
Use if person is allergic to ASA and has a STENT
Apciximab mechanism
GP2b/3a
Apciximab
Combine with Heparin
Used in surgeries
IV only
ASA
use prophylactically only in those with already established CVD
Lidocaine
only in Ventricles
CCBs
only in Atria
Heparin mechanism
mainly acts on Xa and Thrombin
LMWH mechanism
act mainly on Xa only
Direct thrombin inhibitor
Dabigatran (Pradaxa)
Main use for Dabigatran (Pradaxa)
Prevent stroke in those with non-valvular A-FIB
Black box warning for the Direct Oral Anticoags
DO NOT TAKE OFF SUDDENLY –> INC Clot Risk
Contra for Dabigitran
mechanical heart valves
What anticoag to use in Pregnant?
LMWH
Gemfibrozil (fibric acid)
do not use with Statin, but used to DECREASE triglycerides
Niacin’
“nice” increase HDL
but do NOT use in Diabetics
not nice to antibodies
PCSK9 antilipds
cutaneous injections
Class 1
block sodium channels
Class 2
beta blockers
Class 3
K channel blockers
Class 4
Calcium channel blockers
Quinidine
Class 1A
one of top 5 diarrhea Side effect drugs
Class 1b
Lidocaine blocks inactivated Na channels only in window current only Ventricular IV only (only given for Acute)
Esmolol shines
as beta blocker for Anti-arrhythmial
Class 2
Short 1/2 life
IV only
Amiorodone
can be used for Acute or Chronic