pharm exam 3 Flashcards
classes of diuretics
CA inhibitors osmotic diuretics loop diuretics thiazide diuretics K sparing diuretics
diuretics for patients with normal kidney function
thiazides
diuretics for impaired kidney function
loop
loop and thiazide diuretics can cause:
hypokalemia and metabolic alkalosis
2 types of K sparing diuretics
ENaC inhibitors and aldosterone receptor antagonists
common loop diuretic/common ending
furoseMIDE
Drugs used to treat HTN
diuretics, sympathoplegic agents, direct vasodilators, AT II blockers
types of sympathoplegic agents used to treat HTN
CNS inhibitors (a2 agonists) epi release inhibitors selective adreno-receptor blockers (b1 blockers and a1 blockers)
common beta blocker
metoprOLOL
common a1 blockers
praZOSIN
Types of vasodilators used for hypertension tx
NO stimulators
K channel activators (hyperpolarizing)
Ca channel blockers
dopamine agonists
types of AT II blockers
ACE inhibitors
AT1 receptor blockers
renin inhibitors
aldosterone antagonists
ACE inhibitor common ending
PRIL as in lisinopril
AT receptor blocker common ending
SARTAN as in losartan
positive inotropic drugs for CHF
cardiac glycosides (digoxin)
beta1 agonists
bipyridines (phosphodiesterase III inhibitors)
drugs without inotropic effects for CHF
beta blockers diuretics ACE inhibitors AT blockers aldosterone blockers vasodilators
mechanism of cardiac glycosides (digoxin)
inhibit Na/K ATPase which slows Na/Ca exchanger; increased intracellular Ca increases contractility
mechanism of bipyridine (phosphodiesterase III inhibitor)
cardiac cAMP levels are elevated, increased contractility and pacemaker automaticity
mainstay tx of CHF
diuretics
drugs for tx of angina
organic nitrites and nitrates beta blockers Ca channel blockers ranolazine aspirin, antiplatelets, and anticoagulents
____ applied under the tongue for acute episodes of angina
nitroglycerin
longer acting drug for angina and effective when taken orally due to stability against hepatic breakdown
isosorbide mononitrate
all of the organic nitrates/nitrites used to treat angina are ____ that spontaneously produce ____; they act as _____
prodrugs; NO; vasodilators
most common adverse effect of nitroglycerin is ____; contraindicated with ____
headache (potential hypotension, flushing, tachycardia); viagra
effects of the drugs used for angina:
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
anti-arrhythmia drugs
class I- Na channel blockers class II- beta blockers class III- K channel blockers class IV- Ca channel blockers
dyslipidemia drugs
- fibric acid derivatives
- nicotinic acid (niacin)
- bile acid sequestrants
- HMG-CoA reductase inhibitors (statins)
- cholesterol absorption inhibitors
fibric acid derivatives mechanism
agonists of PPARa; stimulate catabolism of FA in the liver by beta-oxidation
net effect of fibric acids:
reduce TG levels
nicotinic acid (niacin) mechanism
agonist of GPR 109A receptor; inhibits adipose tissue lipolysis and subsequent delivery of FAs to the liver to produce TGs
niacin is an inhibitor of _____ which blocks TG production
diacylglycerol acetyltransferase
major benefits of niacin:
increase HDL and decrease TGs
major side effect of niacin
flushing
major actions of bile acid sequestrants
lower LDL, raise HDL, may increase TG (contraindicated with high TG levels)
mechanism of the statins
by inhibiting HMG-CoA reductase, they inhibit cholesterol biosynthesis
effects of the statins
lower LDL, reduce stroke, coronary HD and overall mortality
cholesterol absorption inhibitor mechanism (ezetimibe)
inhibits NPC1L1- transport protein that reabsorbs cholesterol;
cholesterol absorption inhibitors effect
lower LDL with no effect on HDL or TG
lipolysis
occurs in adipose tissue; hydrolysis of TGs into glycerol and free FAs
beta-oxidation
occurs in the liver; Fatty acids into acetyl-CoA
