Pharm Final 9 Flashcards
1
Q
3 CHF drugs
A
digoxin
digitoxin
milrinone
2
Q
CHF
A
inadequate cardiac output to provide the O2 needed by the body
3
Q
CHF symptoms
A
- pulmonary edema and shortness of breath
- decreased exercise tolerance with rapid muscle fatigue
- peripheral edema
- tachycardia
- cardiac hypertrophy
4
Q
Compensatory mechanisms during CHF include increased HR and increased
A
peripheral vascular resistance
5
Q
Compensatory mechanism for CHF is activating the __
A
RAAS
6
Q
The 2 main CHF drug categories
A
inonotrophic agents
non-ionotrophic agents
7
Q
category of CHF drugs that increase contractility of heart muscle
A
ionotropic
8
Q
category of CHF drugs that that includes digoxin
A
ionotropic
9
Q
Why are B-blockers questionable as a CHF drug
A
they slow the HR, which seems like it might increase congestion. But, the idea is that the slower rate will ease that demand on the heart
10
Q
digitalis glycosides include
A
digoxin and digitoxin
11
Q
pharmacologic effects of digoxin and digitoxin
A
increase cardiac contractility increase conduction velocity decrease heart rate decrease O2 needed by the heart decrease peripheral resistance
12
Q
pharmacologic effects of digoxin and digitoxin: increase cardiac
A
contractility
13
Q
pharmacologic effects of digoxin and digitoxin: increase conduction
A
velocity
14
Q
pharmacologic effects of digoxin and digitoxin: decrease heart
A
rate
15
Q
pharmacologic effects of digoxin and digitoxin: decrease O2 needed by
A
the heart
16
Q
pharmacologic effects of digoxin and digitoxin: decrease peripheral
A
resistance
17
Q
toxic effects of digoxin and digitoxin:
A
cramping bradycardia premature ventricular contractions atrial fibrillation ventricular tachycardia ventricular fibrillation
18
Q
toxic effects of digoxin and digitoxin: c___
A
cramping
19
Q
toxic effects of digoxin and digitoxin: b___
A
bradycardia
20
Q
toxic effects of digoxin and digitoxin: premature
A
premature ventricular contractions
21
Q
toxic effects of digoxin and digitoxin: atrial
A
atrial fibrillation
22
Q
toxic effects of digoxin and digitoxin: ventricular t___
A
ventricular tachycardia
23
Q
toxic effects of digoxin and digitoxin: ventricular f___
A
ventricular fibrillation
24
Q
treatment of digoxin and digitoxin toxicity:
A
stop the drug
give potassium
use lidocaine for antiarrhythmia
FAB (digoxin antibody)
25
treatment of digoxin and digitoxin toxicity: s__
stop the drug
26
treatment of digoxin and digitoxin toxicity: p___
potassium
27
treatment of digoxin and digitoxin toxicity: l___
lidocaine for antiarrhythmia
28
treatment of digoxin and digitoxin toxicity: F___
FAB (digoxin antibody)
29
Why is potassium used to treat digoxin toxicity
it completes for the same spots
30
clinical use of digoxin and digitoxin:
CHF
| Used to treat supraventricular arrhythmia
31
clinical use of digoxin and digitoxin: C__
CHF
32
clinical use of digoxin and digitoxin: s____
used to treat supraventricular arrhythmia
33
for digoxin and digitoxin the NI (besides monitor vitals) is monitor
electrolyte levels
34
group of HTN drugs that works by reducing Na and reducing blood volume
diuretics
35
2 HTN drugs that interfere with SNS
lols (beta blockers) doxazosin (a blockers)
36
3 HTN drugs that vasodilate
hydralazine (vasodilator), verapamil, nifedipine (CCBs)
37
3 HTN drugs that target RAAS
pril (ACE inhibitor), sartan (A2 antagonist), aliskiren (renin inhibitor)
38
doxazosin
a blocker
39
a blocker
doxazosin
40
doxazosin (a blocker) works by
decreasing peripheral resistance
41
doxazosin (a blocker) works by decreasing
peripheral resistance
42
doxazosin (a blocker) is not used for
first line, unless they have benign prostatic hyperplasia
43
doxazosin (a blocker) is not used for first line, unless
they have benign prostatic hyperplasia
44
doxazosin (a blocker) side effects are d___ and n___ c___
dizziness and nasal congestion
45
b blocker
lol
46
lol
b blocker
47
b 1 causes (3 things)
increase HR
increase renin
increase contractility
48
BLOCKING b 1 causes (3 things)
decrease HR
decrease renin
decrease contractility
49
b 2 causes (2 things)
bronchodilation and vasodilation
50
BLOCKING b 2 causes (2 things)
blocks bronchodilation and blocks vasodilation (bad for asthmatics)
51
effects B1 and B2, but mostly B1
lol
52
lol side effects:
conduction problems
bronchospasm
cold extremities
prolong duration of hypoglycemia
53
lol side effects: c___ p___
conduction problems
54
lol side effects: b___
bronchospasm
55
lol side effects: c___ e___
cold extremities
56
lol side effects: prolong
duration of hypoglycemia
57
```
side effects:
conduction problems
bronchospasm
cold extremities
prolong duration of hypoglycemia
```
lol
58
abrupt lol withdraw can cause
unstable angina and MI
59
pril
ACE inhibitor
60
ACE inhibitor
pril
61
prils work by inhibiting ACE which causes
decreased peripheral resistance
62
prils inhibit ACE which blocks production of
A2
63
in addition to blocking A2, prils (ACE inhibitors) retain
bradykinin
64
in addition to blocking A2, and saving bradykinin, the prils
decrease aldosterone
65
bradykinins decrease
BP
66
the dose of prils (ACE inhibitors)
is only once or twice daily
67
really common prils (ACE inhibitors) side effects
rash and cough
68
rash and cough very common
prils (ACE inhibitors)
69
rash and cough are common for prils (ACE inhibitors), but the more serious side effects are
hyperkalemia, renal failure, angioedema, and proteinuria
70
prils (ACE inhibitors) are contraindicated
during pregnancy
71
prils (ACE inhibitors) interact with
K-sparing diuretics and NSAIDs
72
prils (ACE inhibitors) mixed with K-sparing diuretics can cause
dysrhythmia
73
sartan
A2 antagonist
74
A2 antagonist
sartan
75
doesn't give such a bad cough because it doesn't effect bradykinin
sartan (A2 antagonist)
76
useful for people who can't tolerate ACE inhibitors (prils)
sartan (A2 antagonist)
77
just as effective as ACE inhibitors (prils)
sartan (A2 antagonist)
78
sartan (A2 antagonist) dose
once daily
79
random sartan (A2 antagonist) side effects
tooth pain and alopecia
80
aliskiren
renin inhibitor
81
renin inhibitor
aliskiren
82
not popular for HTN yet
aliskiren (renin inhibitor)
83
aliskiren (renin inhibitor) contraindicated
during pregnancy
84
aliskiren (renin inhibitor) most common side effects
diarrhea
85
when aliskiren (renin inhibitor) are used with prils (ACE inhibitors) you can get
hyperkalemia
86
the 2 CCBs
verapamil and nifedipine
87
the major effect of verapamil is on the
heart
88
the major effect of nifedipine is on the
smooth muscle
89
verapamil is more useful for
decreasing HR and contractility
90
nifedipine is more useful for
AV conduction abnormalities
91
hydralizine
vasodilator
92
vasodilator
hydralizine (vasodilator)
93
between arteries and veins, hydralizine (vasodilator) effects
arteries
94
hydralizine (vasodilator) are used in combination with
b-blockers and diuretics
95
hydralizine (vasodilator) are only used when
HTN is really bad
96
side effect of hydralizine (vasodilator)
reflex tachycardia
97
4 diuretic prototypes
acetazolamine
furosemide
hydrochlorothiazide
spirono
98
4 classes of diurects
carbonic anhydrase inhibitor
loop
thiazide
K sparing
99
carbonic anhydrase inhibitors works at the
proximal tube
100
thiazides work at the
distal tube
101
k sparing work at the
distal and collecting tubes
102
not effective diuretic, not used for HTN
acetazolamide (carbonic anhydrase inhibitors)
103
acetazolamide (carbonic anhydrase inhibitors) gets rid of
bicarbonate
104
acetazolamide (carbonic anhydrase inhibitors) retains
H+
105
acetazolamide (carbonic anhydrase inhibitors) uses
altitude sickness
glaucoma
alkalinize urine
106
acetazolamide (carbonic anhydrase inhibitors) side effects
metabolic acidosis
| tingling extremities
107
furosemide works by getting rid of these 4 electrolytes
sodium, potassium, chloride, calcium
108
furosemide prevents the reabsorption of water from the
collecting ducts
109
diuretic that increases venous capacitance
furosemide
110
diuretic that's especially good for people with renal failure
furosemide
111
diuretic used for:
| PE, cirrhosis, renal disease
furosemide
112
furosemide treats 3 "hypers"
hypertension, hyperkalemia, hypercalcemia
113
diuretic that causes ototoxity
furosemide
114
long term use of furosemide can cause
hyperglycemia
115
diuretic of choice for HTN
thiazide
116
thiazide mechanism
block chloride pump and inhibits sodium
117
diuretic used for PE and nephrogenic diabetes insipidus
thiazide
118
long term use of thiazide can cause
hyperglycemia
119
hyperglycemia can happen from long term use of
furosemide and thiazide
120
thiazide side effects
hyperuricemia (gout)
| increased cholesterol
121
thiazide contraindication
sulfur
122
diuretic that's an aldosterone antagonist
spirono
123
not that best diuretic, but might use it for someone with K problems
spirono
124
diuretic used to treat hyperaldosterone and nephrogenic diabetes insipidus
spirono
125
side effects hyperkalemia and gynecomastia
spirono
126
spirono side effects
hyperkalemia and gynecomastia
127
NI diuretics monitor for
anorexia (which can be caused by electrolyte imbalance)
128
the 6 hemostasis drugs
```
Heparin
Warfarin
Dabi
Clopi
Strepto
Vit K
```
129
the 4 angina drugs
nitro
verapamil
nifedpine
lol
