Pharm for HTN, HF, Dysrrhythmias, and Blood clots Flashcards by Anna Shoolroy

Name three drugs in the alpha-1 antagonist drug class

1) doxazosin
2) terazosin
3) prazosin

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What is the MOA of alpha-1 antagonists

vasodilate blood vessels

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What is the MOA of beta-1 selective antagonists

decrease HR, decrease conduction velocity = decrease in stress placed on heart

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What is the common ending of beta-1 selective and non-selective beta antagonists

-olol

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What is the MOA of non-selective beta antagonists

decrease HR and conduction velocity and bronchocontrict

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drugs that end in -alol or -ilol are part of what drug class?

Alpha and beta antangonsits

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What is the MOA of alpha and beta antagonists?

decrease HR, conduction velocity, vasodilate blood vessels, bronchoconstrict, decrease sympathetic activity

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List three common alpha-1 antagonist drugs

1) doxazosin
2) terazosin
3) prazosin

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Give an example of a beta-1 selective antagonist drug.

Metoprolol

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Give an example of a non-selective beta antangonist drug.

Propranolol

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Give an example of an alpha/beta antagonist drug.

1) labetalol

2) carvedilol

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What is the MOA of alpha-2 agonists?

decrease sympathetic activity

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Give two examples of an alpha-2 agonist drug.

1) clonidine
2) methyldopa
3) guanfacine

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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

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What drug is 1st choice for severe hypertension in a pregnant patient?

Methyldopa

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What drug is 2nd choice for severe HTN in a pregnant patient?

Labetalol

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What drug is 1st choice treatment for severe pre-eclampsia in a pregnant patient?

Labetalol

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What drug is 1st choice in treatment for severe eclampsia in a pregnant patient?

Magnesium sulfate

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What antihypertension drug class(es) is/are contraindicated in patients w/ asthma and/or COPD?

non-selective beta antagonists & alpha/beta antagonists

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What antihypertension drug class is contraindicated in patients w/ DM?

alpha/beta antagonists

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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

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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

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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

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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

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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.