pharm exam 4

Question 1

what is the progestin in the vaginal ring and in the subdermal implant preparations?

Answer 1

etonogestrel

Question 2

the 3 antianginal classes?

Answer 2

organic nitrates, calcium channel blockers, beta blockers

Question 3

the 2 organic nitrates?

Answer 3

NTG, isosorbide dinitrate

Question 4

organic nitrate MOA

Answer 4

prodrug converted to NO by ALDH2. NO produces venous dilation in VSM. this reduces preload.

Question 5

what “load” does nitroglycerin decrease?

Answer 5

PREload

Question 6

adverse effects of nitroglycerin?

Answer 6

headache (can be severe), facial flushing, orthostatic HTN, reflex tachycardia

Question 7

drug interactions of organic nitrates?

Answer 7

vasodilator drugs for ED and with alcohol

Question 8

how does isosorbide dinitrate compare to NTG?

Answer 8

longer duration of action so can be added if angina is not controlled by NTG & Beta blockers or CCBs

Question 9

the 3 calcium channel blockers..

Answer 9

nifedipine, verapamil, diltiazem

Question 10

what “load” do the calcium channel blockers decrease?

Answer 10

AFTERload

Question 11

Calcium channel blockers MOA

Answer 11

bind alpha1 and block inward flow of calcium through voltage gated L type calcium channels which dilates coronary arteries and decreases afterload

Question 12

point of efficacy for calcium channel blockers

Answer 12

prophylaxis against angina attacks to reduce consumption of NTG

Question 13

where is nifedipine’s greatest inhibitory action?

Answer 13

VSM! not heart

Question 14

verapamil and diltiazem act to

Answer 14

decrease HR and contractility

Question 15

which is preferred: verapamil or diltiazem?

Answer 15

diltiazem! it produces less cardiac depression than verapamil and is better tolerated by most patients

Question 16

what would you use in a patient with CAD who presents with stable angina?

Answer 16

propranolol because of the survival benefit

Question 17

the vasodilator for ED

Answer 17

sildenafil

Question 18

sildenafil MOA

Answer 18

PDE5 inhibitor

Question 19

first-line agents for HTN

Answer 19

thiazide diuretics, ACE inhibitors, ARBs, CCBs

Question 20

the two diuretics

Answer 20

chlorthalidone, furosemide

Question 21

thiazide diuretic given in

Answer 21

(chlorthalidone) LOW DOSES bc shallow anti-HTN dose dependence

Question 22

loop diuretic

Answer 22

furosemide

Question 23

RAS blocking drug classes

Answer 23

ACE inhibitors, ARBs, aldosterone antagonists, direct renin inhibitors

Question 24

RAS blocking drug names

Answer 24

captopril, losartan, eplerenone, aliskiren

Question 25

ACE inhibitor name

Answer 25

captopril

Question 26

ARB name

Answer 26

losartan

Question 27

vasodilator with similar mechanism to NTG but tolerance does NOT develop

Answer 27

nitroprusside

Question 28

when would you use nitroprusside?

Answer 28

in HTN emergency or hypotensive surgery

Question 29

the 3 vasodilators

Answer 29

nitroprusside, hydralazine, minoxidil

Question 30

2 drugs used in combo for CHF/HTN in African-Americans?

Answer 30

hydrazaline and isosorbide dinitrate

Question 31

What is significant about hydrazaline and isosorbide dinitrate?

Answer 31

first drug used in combo specifically for a sub-pop! (CHF/HTN in African-Americans)

Question 32

dangerous drug but can be used topically for hair growth

Answer 32

minoxidil

Question 33

sympatholytics for anti-HTN

Answer 33

clonidine, methyldopa, propranolol, terazosin

Question 34

the 2 centrally acting alpha 2 adrenergic agonists

Answer 34

clonidine and methyldopa