Pharm Exam 2 Flashcards
Rhabdomolysis is a serious side effect of statin drugs what doesit cause
muscle aches that can lead to muscle disintegration & become fatal.
What drug category is digoxin?
Anti-dysrhthmia
What does HDL do
removes cholesterol and delivers it to the liver for escretion
Where is there an abundance of sodium in the filtrate
the loop of henley
What is the main difference between anticoagulants and antithrombolytics?
- Coags prevent the formation
- lytics disintegrates the clot
Orthostatic Hypotension is a problem mainly caused by dilation of the
veins, NOT arterioles
What is normal PTT balue (Partial Thromboplastin Time)
40 sec
Name food that are high in Vitamin K
- Mayonnaise, Canola Oil, Soybean Oil, Green Leafy vegetables, prunes
Name 4 Agents that can be used for Peripheral Vascular Disease
- Alpha 1 Antagonist (Minipress)
- Antiplatelets
- Antihypertensive (CCBs, ACE)
- Direct Acting Peripheral Vasodilateros (Vasodilan)
Why should statins be taken at night?
cholesterol syntheses increases at night
Name 5 advantages of Pradaxa?
- rapid onset
- fixed dosage
- lower risk of bleeding
- few drug interactions
- no blood monitoring necessary
Visual Illusions or halos around objects is a side effect of what drug?
Digoxin
This agent does not affect absoprtion of fat soluble vitamins
Selective Cholesterol Absorption Inhibitors
Exetimide (Zetia)
What are the most prevalent sonstiuents in the filtration from the kidneys
Sodium & Chloride
What are 4 main purposes of using Carbonic Anhydrase?
- Open Angle Glaucoma
- Epilepsy
- Alitude Sickness
- Metabolic Alkalosis
What do selective channel blockers end in?
dipine
What do peripheral vasodilators do?
- dilate vessels that have been narrowed by vasospasms
- treat atherosclerosis
- helps afterload.
- acts on vascular smooth muscles
Name the antidote for heparin
protamin sulfate
Name 3 Anti-platelet drugs
- Aspirin
- Clopidogrel
- Tirofiban
Name 3 Bile Acid Sequestrants
- Colesevelam (less GI side effects)
- Cholestyramine
- Fenofibrate
What are beta blockers most often combined with?
ACE or diuretics
This drug type is most effective at lowering triglyceride levels, but weak in LDL
Fibrates
What does grapefruit juice do to the metabolism related to CCB
greater than expected effects of the drug
How do bile acid sequestrants work?
decrease absorption of fat soluble vitamins (ADK)
What do non selective calcium channel blockers affect
Heart and blood vessels
should be used with caution pt w/ bradycardia, and HF
Name the five Categories of Antihypertensive Drugs
- Diuretics
- Sympatholytics
- Direct Arterial Vasodilators
- RAAS
- ACE, ARBs
- Calcium Channel Blockers
What is the goal lab value (PTT) for a patient taking heparin?
1-1/2 to 2 times normal value
>2x risk for hemorrhage
What should potassium sparing drugs be combined with?
Loop or thiaside diuretics, help maintain potassium balance.
Name 3 examples of potassium sparing drugs?
- Sprionolactone (Aldactone)
- Triamterene (Dyrenium)
- Amiloride (Midamor)
Thiazide relationship with calcium
reabsorbing
Beta blockers relationship with calcium
reduce entry into the cell
Name 4 Adrenergic Agents
- Alpha 1 Blocker (doxazosin)
- Alpha 2 Agonist (clonidine)
- Nonselective Beta Blocker
- Selective Beta Blocker (metropolol, atenolol)
What are contraindications with beta blockers?
sympatholytic drugs, can cause rebound hypertension
How do diuretics work?
interfere with reabsorption
What are the 2 main reasons for using diuretics
edema, hypertension
What drugs will increase risk of bleeding w/ anticoagulants?
antiplatelets
What drugs are used to treat stable angina?
Propranolol, Atenolol (Tenormin)
How do diuretics decrease the preload?
by decreasing the volume, and decrease venous return to the heart
What do Carbonic Anhydrase inhibitors end in?
-mide
This is an immune disorder that causes a rebound affect of heparin?
Heparin Induced Thrombocytopenia
This drug is an oral anticoagulant that is a Direct Factor Xa inhibitor?
Rivaroxaban
no antidote, dialysis will not remove b/c it is largely protein bound
What is angioedema
non-inflammatory swelling fo the skin, mucus membranes or organs (this is a side effect in ARBs and ACE)
Why are osmotic diuretics safe for diabetic patients and those with head injuries?
Decreases intracranial pressure, & intraocular pressure. Pulls water towards the vasculature, does not cause loss of major electrolytes
Name 2 examples of Nonselective Calcium Channel Blockers
- Verapamil (Calan)
- Diltiazem (Cardizem)
What value should be monitored while taking Warfarin
INR, normal is between 1.3 - 2
This causes steatorrhea
Bile Acid Sequestrants
inhibits free fatty acids from adipose tissue
Niacin (s.e. flushing)
What do ACE inhibitor end in?
-pril
This is an enzyme in cholesterol?
HMG Coa Reductase (Statin)
Name 3 Fibric Acid Derivative Drugs
Gemifibrozil,
Fenofibrate
fenofibric Acid
What drug type ends in -sartan
ARBS
How long is the half life for digoxin
36-48 hours
Why should mannitol be used with caused for heart failure patients
because pulmonary congestion can delveop
Name the antidote for Warfarin
Vitamin K
What is the drug of choice for hypertensive emergencies
nitroprusside (nitropress)- has a 2 min half life, IV only
direct acting vasodilator
What do selective calcium channel blockers affect?
blood vessels
CCB relationship with calcium
reduce influx
Why are CCB’s the drug of choice for “variant” angina?
because they relax the arterial smooth muscles. This is where the pain comes from.
What drug should digoxin not be taken with?
Diuretics
*note: dig holds on to calcium for heart contracion
What is the main difference between ARBs and ACE
- ARBs blocks angiotensin II from Receptors in the tissues
- will not cause hyperkalemia or dry cough
- ACE prevents the formation of Angiotensin II
What do most anti-coagulants end in?
-arin
If fluid retention occurs in direct acting vasodilators, what can correct it?
Diuretics
This is useful in the prevention of thrombosis in the arteries?
anti-platelets
This drug is a direct thrombin inhibitor and has less side effects than Warfarin
Dabigatran Pradaxa
no antidote except dialysis
Name 3 examples of Direct Acting Vasodilators?
- Hydralazine
- Minoxidil
- Nitroprusside
What is the target range Xa factor for a patient receiveing Heparin?
0.3 - 0.7
measures heparin concentration in the blood
Loop diuretics relationship with calcium
wast this
This is used adjunct with statin drugs
bile acid sequestrants
What does the inhibition of the carbonic anhydrase cause?
sodium, potassium, bicarb excretion
Characteristics of Zocor
- Lipid Lowering Agent
- HMG COA reductase inhibitor (statin)
- increases HDL
- decreases LDL, triglycerides
What are calcium channels?
Gates that regulate entry of caclium ions into the cell
calcium causes the heart to contract
What are drugs that are contraindicated with potassium sparing diuretics?
ACE inhibitors, Potassium supplements, salt substitues.
Side effects of alpha 1 blockers
interacts with NSAIDS, hypotension
If reflex tachycardia occurs with direct acting vasodilators what can prevent it?
Beta Blockers
What are the 4 main drug categories to treat Heart Failure?
- Diuretics
- ACE inhibitors/ ARBs
- Beta Blockers
- Cardiac Glycosides
If calcium entering the cell causes the heart to contract, what could that result in?
increase in the need for oxygen and workload
