Pharm for HTN, HF, Dysrrhythmias, and Blood clots Flashcards
Name three drugs in the alpha-1 antagonist drug class
1) doxazosin
2) terazosin
3) prazosin
What is the MOA of alpha-1 antagonists
vasodilate blood vessels
What is the MOA of beta-1 selective antagonists
decrease HR, decrease conduction velocity = decrease in stress placed on heart
What is the common ending of beta-1 selective and non-selective beta antagonists
-olol
What is the MOA of non-selective beta antagonists
decrease HR and conduction velocity and bronchocontrict
drugs that end in -alol or -ilol are part of what drug class?
Alpha and beta antangonsits
What is the MOA of alpha and beta antagonists?
decrease HR, conduction velocity, vasodilate blood vessels, bronchoconstrict, decrease sympathetic activity
List three common alpha-1 antagonist drugs
1) doxazosin
2) terazosin
3) prazosin
Give an example of a beta-1 selective antagonist drug.
Metoprolol
Give an example of a non-selective beta antangonist drug.
Propranolol
Give an example of an alpha/beta antagonist drug.
1) labetalol
2) carvedilol
What is the MOA of alpha-2 agonists?
decrease sympathetic activity
Give two examples of an alpha-2 agonist drug.
1) clonidine
2) methyldopa
3) guanfacine
Name the 5 drug classes that decrease HR via a direct action.
THEY ARE ALL SYMPATHOMIMETICS
1) alpha-1 antagonists
2) beta-1 selective antagonists
3) non-selective beta antagonists
4) combo alpha/beta antagonists
5) alpha-2 agonists
What drug is 1st choice for severe hypertension in a pregnant patient?
Methyldopa
What drug is 2nd choice for severe HTN in a pregnant patient?
Labetalol
What drug is 1st choice treatment for severe pre-eclampsia in a pregnant patient?
Labetalol
What drug is 1st choice in treatment for severe eclampsia in a pregnant patient?
Magnesium sulfate
What antihypertension drug class(es) is/are contraindicated in patients w/ asthma and/or COPD?
non-selective beta antagonists & alpha/beta antagonists
What antihypertension drug class is contraindicated in patients w/ DM?
alpha/beta antagonists
Name the 3 antihypertensive drug classes that are contraindicated in patients w/ heart failure.
1) alpha-1 antagonists
3) non-selective beta antagonists
4) alpha-2 agonists
Name two antihypertensive medications that can also be used to treat hyperthyroidism, glaucoma, migraines, heart failure, and adrenertic overload
1) labetalol
2) carvedilol
BOTH ARE ALPHA/BETA ANTAGONISTS
What are the 4 antihypertensive drug classes that are the first choice of treatment for DM patients?
1) ACE-Is
2) ARBs
3) Thiazide/Thiazide-like
4) DHP CCBs
What are the 4 antihypertensive drug classes that are the first choice treatment for HTN?
1) ACE-Is
2) ARBs
3) Thiazide/Thiazide-like
4) DHP CCBs
What are the 3 antihypertensive drug classes that are the first choice treatment of HTN in those of African decent?
1) Thiazide/Thiazide-like
2) DHP CCBs
3) loop diuretics (furosemide)
What are the 2 antihypertensive drug classes that are the first choice treatment of HTN in those w/ CKD (chronic kidney disease)?
1) ACE-Is
2) ARBs
What are the 2 antihypertensive drug classes that are the second choice treatment of HTN in those w/ CKD?
1) DHP CCBs
2) Thiazide/Thiazide-like
What class of hypertension medications has a common side effect of a dry, unproductive cough?
ACE-Is
Name the 4 drug classes that are used to treat HTN & Heart Failure
1) ACE-Is
2) ARBs
3) beta blockers
4) MRAs (spironolactone)
What medication is an MRA and also a potassium sparing diurectic?
Spironolactone
What drug class is the most potent potassium wasting?
Loop diuretics
What medication can be used to treat HTN, BPH, and pheochromocytoma?
Doxazosin
What three HTN drug classes are also useful in treatment of patients who are post-MI?
beta-1 selective antagonists
ARBs
MRAs (spironolactone)
What two drug classes have angioedema as a serious side effect?
ACE-Is and ARBs
Name 4 antihypertensive drug classes that should be used to treat HTN in patients w/ a Hx of stroke.
1) ACE-Is
2) ARBs
3) Thiazide/Thiazide-like
4) DHP CCBs
What is the common ending for ACE-I medications?
-pril
What is the common ending for ARB medications?
-sartan
What is the common ending for the DHP CCBs?
-dipine
Name two 5th choice medications for the treatement of HTN.
1) hydralazine
2) minoxidil
What antiHTN drug class should NOT be Rx’d to patients with a severe allergy to SULFA drugs?
Thiazide/Thiazide-like
Name three sympatholytic drugs that may cause ED?
Metoprolol, clonidine, methyldopa
Name two antihypertensive medications that list acute kidney injury as a side effect.
1) lisinopril
2) aliskiren
Name a direct renin inhibitor medication.
Aliskiren
Name the two antihypertensive drug classes that reduce chronic kidney disease in T2DM.
ACE-Is & ARBx
What three classes of drugs are used to treat angina and HTN?
Beta-blockers, CCBs, and nitrates
Which sub class of calcium channel blockers (DHP CCBs or non-DHP CCBs) can be used as monotherapy for the treatment of angina?
non-DHP CCBs
Which drug class that treats angina cannot be combined with ED medications w/in 24-48 hours?
nitrates
What medication in the nitrate family relieves the SYMPYOMS of angina and is short acting
nitroglycerine
All of the RAAS drug classes cause hyperkalemia EXCEPT:
MRAs (spironolactone)
What two RAAS drug classes can also be used as stroke prophylaxis?
ACE-Is & ARBs
When treating stage I HF, what 2 drug classes are your first choice?
ACE-Is, specifically enalapril
ARBs, specifically valsartan
When treating stage I HF, what two medications are your first choice for treatment?
enalapril & valsartan
When treating stage II HF, what 2 drug classes are your 1st choice?
ACE-Is, specifically enalapril
ARBs, specifically valsartan
When treating stage II HF, what 2 drug classes can be combined w/ ACE-Is or ARBs as a treatement choice?
Beta-blockers (metoprolol or carvedilol)
MRAs (spironolactone
When treating stage III HF, ACE-Is/ARBs + what drug class is your 1st choice?
Beta-blockers (metoprolol or carvedilol)
What medication can be combined w/ ACE-Is/ARBs + beta blockers to treat additional symptoms of stage III HF?
Digoxin
What drug is used to treat stage IV HF?
Digoxin
What is the common ending for drugs that are alpha-1 antagonists?
-zosin
What is the common ending for drugs that are loop diuretics?
-semide
Name the 4 drugs classes that list reflex tachycardia as a side effect.
1) alpha-1 antagonists
2) dihydrapine CCBs
3) Direct vasodilators (hydralazine & minoxidil)
4) nitrates
What is the common ending for drugs that are dihydrapine CCBs?
-dipine
What is the common ending for drugs that are Direct Renin Inhibitors (DRIs)
-kiren
What two nitrate medications reduce anginal episodes?
1) isosorbide mononitrate
2) isosorbide dinitrate
What are the two “classes” that are your 1st choice for controlling RATE in dysrhythmias?
Class 2 (beta blockers) Class 4 (non-DHP CCBs)
What are the two most prevelant drugs in the non-DHP CCB drug class?
verapamil & diltiazem
What other medications, other than metoprolol, diltiazem, and verapamil also control RATE in dysrhythmias?
amiodarone, sotalol, digoxin
What three medications provide RHYTHM control in the treatment of dysrhythmias? HINT: one is off-label.
amiodarone (off-label), dronedarone, flecainide
What medication provides RATE & RHYTHM control in the treatment of dysrhythmias?
Sotalol
What antihypertension drug class can also be used to treat A-Fib?
Non-DHP CCBs
Name two medication that treat HTN that are contraindicated in patients w/ gout.
Aliskiren & hydrochlorothiazide
What antiHTN drug class can also be used to treat addtional symptoms in stage III HF?
Thiazide/Thiazide-like
Hypokalemia increases this medications toxicity
Digoxin
What antiHTN drug class is also useful for the treatment of angina, A-Fib, PSVT, and atrial arhythmias?
non-DHP CCBs (verapamil & diltiazem)
What class of antidysrhythmics is known to cause Torsades de Pointes?
Class 1c
What three classes of anidysrhythmics are negative inotropes and should not be used in patients w/ HF.
Class 1a
Class 3
Class 4
What medications are part of the 1a Class of antidysrhythmics?
quinidine
procainamide
disopyramide
What medications are part of the 1b class of antidysrhythmics?
lidocaine
phenytoin
mexiletine
What medications are part of the 1c class of antidysrhythmics?
flecainide
propafenone
What medications are part of the class 2 antidysrhythmics?
Beta blockers (metoprolol tartrate)
What medications are part of the class 3 antidysrhythmics?
amiodarone dronedarone sotalol dofetilide ibutilide
Which antidysrhythmic drug class is used to treat life threatening V-Fib?
Class 3 (amiodarone, sotalol)
Which anydysrhythmic medication is used to treat Torsades de Pointes?
Magnesium Sulfate (Class 5)
What medications are part of the class 4 antidysrhythmics?
Non-DHP CCBs (verapamil & diltiazem)
What medications are part of the class 5 antidysrhythmics?
Adenosine, digoxin, magnesium sulfate
Which antidysrhythmic drug class is used to treat supraventicular tachycardia, PSVT, and A-Fib?
Class 1c (flecainide)
Which antidysrhythmic medication is used for long term treatment and prophylaxis of ventricular arrhythmias?
Amiodarone
Which antidysrhythmic medication can cause liver and lung toxicity?
amiodarone
Which antidysrhythmic medication can cause Torsades de Pointes?
amiodarone
Name two medication that can be used for stroke prevention due to their antiplatelet capacity.
Aspirin & clopidogrel
Name the medication that is used to prevent clots during cardiac catheterization.
acbixmab
What medication is a antithrombolytic and known as a “clot buster”?
alteplase/activase
What medication can be used in the treatment of a non-hemorrhaging CVA?
Warfarin
What is the name of the drug class that can be used to treat and provide prophylaxis for DVT, PE, and strokes?
anticoagulants
Name one medication that is a LMWH?
enoxaparin
What does HIT stand for?
Heparin Induced Thrombocytopenia
What factors does Warfarin inhibit?
X, IX, VII, II
What proteins does warfarin inhibit?
protein S & C
What is the time to onset of warfarin?
3-5 days
What is the time to onset of heparin?
immediate
Name three DOACs
dabigatran, rivaroxiban, apixaban
What are three advantages of Xa factor inhibitors (rivaroxiban & apixaban) over warfarin
1) no need for routine lab tests
2) very few drug interactions
3) rapid onset + short wash out = no bridging
What are three disadvantages of Xa factor inhibitors (rivaroxiban & apixaban) over warfarin?
1) cost
2) adherence is critical
3) not effective for stroke prevention in patients w/ prosthetic heart valve.