pharm exam 3

Question 1

classes of diuretics

Answer 1

CA inhibitors
osmotic diuretics
loop diuretics
thiazide diuretics
K sparing diuretics

Question 2

diuretics for patients with normal kidney function

Answer 2

thiazides

Question 3

diuretics for impaired kidney function

Answer 3

loop

Question 4

loop and thiazide diuretics can cause:

Answer 4

hypokalemia and metabolic alkalosis

Question 5

2 types of K sparing diuretics

Answer 5

ENaC inhibitors and aldosterone receptor antagonists

Question 6

common loop diuretic/common ending

Answer 6

furoseMIDE

Question 7

Drugs used to treat HTN

Answer 7

diuretics, sympathoplegic agents, direct vasodilators, AT II blockers

Question 8

types of sympathoplegic agents used to treat HTN

Answer 8

CNS inhibitors (a2 agonists)
epi release inhibitors
selective adreno-receptor blockers (b1 blockers and a1 blockers)

Question 9

common beta blocker

Answer 9

metoprOLOL

Question 10

common a1 blockers

Answer 10

praZOSIN

Question 11

Types of vasodilators used for hypertension tx

Answer 11

NO stimulators
K channel activators (hyperpolarizing)
Ca channel blockers
dopamine agonists

Question 12

types of AT II blockers

Answer 12

ACE inhibitors
AT1 receptor blockers
renin inhibitors
aldosterone antagonists

Question 13

ACE inhibitor common ending

Answer 13

PRIL as in lisinopril

Question 14

AT receptor blocker common ending

Answer 14

SARTAN as in losartan

Question 15

positive inotropic drugs for CHF

Answer 15

cardiac glycosides (digoxin)
beta1 agonists
bipyridines (phosphodiesterase III inhibitors)

Question 16

drugs without inotropic effects for CHF

Answer 16

beta blockers
diuretics
ACE inhibitors
AT blockers
aldosterone blockers
vasodilators

Question 17

mechanism of cardiac glycosides (digoxin)

Answer 17

inhibit Na/K ATPase which slows Na/Ca exchanger; increased intracellular Ca increases contractility

Question 18

mechanism of bipyridine (phosphodiesterase III inhibitor)

Answer 18

cardiac cAMP levels are elevated, increased contractility and pacemaker automaticity

Question 19

mainstay tx of CHF

Answer 19

diuretics

Question 20

drugs for tx of angina

Answer 20

organic nitrites and nitrates
beta blockers
Ca channel blockers
ranolazine
aspirin, antiplatelets, and anticoagulents

Question 21

____ applied under the tongue for acute episodes of angina

Answer 21

nitroglycerin

Question 22

longer acting drug for angina and effective when taken orally due to stability against hepatic breakdown

Answer 22

isosorbide mononitrate

Question 23

all of the organic nitrates/nitrites used to treat angina are ____ that spontaneously produce ____; they act as _____

Answer 23

prodrugs; NO; vasodilators

Question 24

most common adverse effect of nitroglycerin is ____; contraindicated with ____

Answer 24

headache (potential hypotension, flushing, tachycardia); viagra

Question 25

effects of the drugs used for angina:

Answer 25

``` vasodilators (NO)- increase vasodilation, increase oxygen supply from coronary arteries; decreased BP and decreased myocardial oxygen demand cardiac depressants (beta blockers)- decrease contractility (vent. myocardium), decrease HR (SA node), and decrease oxygen demand calcium channel blockers- have both vasodilation and cardiac depressant effects ```

Question 26

anti-arrhythmia drugs

Answer 26

``` class I- Na channel blockers class II- beta blockers class III- K channel blockers class IV- Ca channel blockers ```

Question 27

dyslipidemia drugs

Answer 27

1. fibric acid derivatives 2. nicotinic acid (niacin) 3. bile acid sequestrants 4. HMG-CoA reductase inhibitors (statins) 5. cholesterol absorption inhibitors

Question 28

fibric acid derivatives mechanism

Answer 28

agonists of PPARa; stimulate catabolism of FA in the liver by beta-oxidation

Question 29

net effect of fibric acids:

Answer 29

reduce TG levels

Question 30

nicotinic acid (niacin) mechanism

Answer 30

agonist of GPR 109A receptor; inhibits adipose tissue lipolysis and subsequent delivery of FAs to the liver to produce TGs

Question 31

niacin is an inhibitor of _____ which blocks TG production

Answer 31

diacylglycerol acetyltransferase

Question 32

major benefits of niacin:

Answer 32

increase HDL and decrease TGs

Question 33

major side effect of niacin

Answer 33

flushing

Question 34

major actions of bile acid sequestrants

Answer 34

lower LDL, raise HDL, may increase TG (contraindicated with high TG levels)

Question 35

mechanism of the statins

Answer 35

by inhibiting HMG-CoA reductase, they inhibit cholesterol biosynthesis

Question 36

effects of the statins

Answer 36

lower LDL, reduce stroke, coronary HD and overall mortality

Question 37

cholesterol absorption inhibitor mechanism (ezetimibe)

Answer 37

inhibits NPC1L1- transport protein that reabsorbs cholesterol;

Question 38

cholesterol absorption inhibitors effect

Answer 38

lower LDL with no effect on HDL or TG

Question 39

lipolysis

Answer 39

occurs in adipose tissue; hydrolysis of TGs into glycerol and free FAs

Question 40

beta-oxidation

Answer 40

occurs in the liver; Fatty acids into acetyl-CoA