PHARM GROUP 7 Flashcards
WHAT ARE THE MAIN PHARMACOLOGIC CLASSES USED TO TREAT HTN ?
DIURETICS:
- PROMOTE SODIUM RETENTION, REDUCING ECF VOLUME
SYMPATHOLYTICS:
-AFFECT THE SNS TO LOWER BP
DIRECT-ACTING ARTERIOLAR VASODILATORS:
- RELAX VASCULAR SMOOTH MUSCLE, REDUCING BP
ACE INHIBITORS:
- INHIBIT THE CONVERSION OF ANGIOTENSIN 1 TO ANGIOTENSIN 2, REDUCING VASOCONSTRICTION
ARB’S:
- BLOCK ANGIOTENSIN 2 AT THE RECEPTOR, REDUCING VASOCONSTRICTION AND ALDOSTERONE SECRETION
CALCIUM CHANNEL BLOCKERS:
- REDUCE CALCIUM INFLUC INTO HEART AND VASCULAR CELLS, DECREASING CARDIAC CONTRACTILITY AND VASCULAR TONE
WHAT IS THE MOST COMMONLY USED DIURETIC FOR HTN ?
HYDROCHLOROTHIAZIDE
AVOIDED IN PATIENTS WITH RENAL INSUFFICIENCY
WHAT IS THE MOA OF INDIRECT ACTING CHOLINERGIC DRUGS ?
INHIBIT ACETYLCHOLINESTERASE, THE ENZYME THAT BREAKS DOWN ACETYLCHOLINE, THEREBY INCREASING THE AVAILABILITY OF ACETYLCHOLINE TO ACTIVATE RECEPTORS
WHAT ARE THE NONPHARMACOLOGIC MEASURES TO CONTROL HTN ?
STRESS REDUCTION:
- MEDITATION AND RELAXATION CAN LOWER BP
EXERCISE:
- REGULAR AEROBIC EXERCISE IMPROVES CV HEALTH AND DECREASES BP
SALT RESTRICTION:
- LIMITING SALT INTAKE TO <2G/DAY HELPS PREVENT WATER RETENTION AND LOWERS BP
ALCOHOL MODERATION:
- LIMITING ALCOHOL LOWERS BP BY REUDCING RENIN SECRETION
WEIGHT LOSS:
- DECREASE IN BODY WEIGHT HELPS DECREASE CARDIAC OUTPUT AND PERIPHERAL RESISTANCE, WHICH DECREASES BP
PURPOSES AND COMMON FORMS OF SYNTHETIC DERIVATIVES OF TESTOSTERONE
IMPROVE PHARMACOKINETICS AND PHARMACODYNAMICS
COMMON FORMS:
- TESTOSTERONE PROPIONATE
(OILY SOLUTION, LASTS 2-3 DAYS)
- METHYLTESTOSTERONE
(ORAL/BUCCAL FORM)
INDICATIONS FOR HYDROCHLOROTHIAZIDE (HYDRODIURIL)
HTN AND CHF
WHAT IS OXYBUTYNIN (DITROPAN) USED FOR AND WHAT ARE THE NURSING CONSIDERATIONS FOR ITS PATCH APPLICATION ?
USED TO TREAT OVERACTIVE BLADDER AND NEUROGENIC BLADDER CONDITIONS
NURSING CONSIDERATIONS FOR THE PATCH:
- REMOVING THE PREVIOUS DOSE
- APPLYING TO CLEAN, DRY, NONHAIRY SKIN
- ROTATING SITES TO PREVENT SKIN IRRITATION
WHAT IS OSTEOPOROSIS AND ITS KEY GOALS FOR TREATMENT ?
A CONDITION CHARACTERIZED BY A DECREASE IN BONE DENSITY AND AN INCREASE IN FRACTURE RISK DUE TO WEAKENED BONES
KEY GOALS OF TREATMENT ARE TO INCREASE BONE DENSITY AND DECREASE FRACTURE RISK
4 MAIN PARTS OF THE NEPHRON
- GLOMERULUS (FILTRATION)
- PROXIMA CONVOLUTED TUBULE
- LOOP OF HENLE
- DISTAL CONVOLUTED TUBULE
WHAT IS TOLTERODINE (DETROL) USED FOR AND WHAT IS A SIGNIFICANT INTERACTION TO AVOID ?
TREATS URINARY FREQUENCY, URGENCY, AND URGE INCONTINENCE
PATIENTS SHOULD AVOID GRAPEFRUIT JUICE BECAUSE IT CAN ENHANCE THE TOXICITY OF THE DRUG THROUGH THE CYTOCHROME P-450 3A4 LIVER PATHWAY
WHAT IS ESSENTIAL HTN AND HOW COMMON IS IT ?
AKA PRIMARY HTN
HAS NO IDENTIFIABLE CAUSE AND IS THE MOST COMMON TYPE, ACCOUNTING FOR ABOUT 90% OF ALL HTN CASES
ADVERSE EFFECTS OF SPIRONOLACTONE
- HYPERKALEMIA
- GYNECOMASTIA
- HEADACHE
- DIZZINESS
- CRAMPS
PERI-MENOPAUSE
THE TRANSITIONAL PERIOD LEADING UP TO MENOPAUSE. CHARACTERIZED BY FLUCTUATING HORMONE LEVELS
SYMPTOMS
- CYCLES BECOME IRREGULAR
- INSOMNIA
- HOT FLASHES
- IRRITABILITY
- HEADACHES
- MEMORY LAPSES
- DECREASED LIBIDO
- VAGINAL DRYNESS
- JOINT ACHES AND PAINS
PREMARIN (CONJUGATED ESTROGEN)
INDICATIONS:
- HRT FOR MENOPAUSE SYMPTOMS
- MODERATE TO SEVERE VASOMOTOR SYMPTOMS OF MENOPAUSE, VAGINAL DRYNESS, AND ATROPHY
MOA:
- DEVELOPS AND MAINTAINS FEMALE GENITAL SYSTEM, BREASTS, AND SECONDARY SEX CHARACTERISTICS
CONTRAINDICATIONS:
- KNOWN DRUG ALLERGY
- ESTROGEN DEPENDENT CANCERS SUCH AS BREAST CANCER
- UNDIAGNOSED ABNORMAL VAGINAL BLEEDING
- PREGNANCY AND LACTATION
- ACTIVE THROMBOLYTIC DISORDERS (STROKE, THROMBOPHLEBITIS, HYPERCOAGULABLE STATES)
HOW DOES HTN VARY AMONG DIFFERENT ETHNIC GROUPS ?
BLACKS:
- DEVELOP HTN EARLIER WITH HIGHER MORTALITY RATES. THEY HAVE LOW- RENIN HTN WHICH MAKES BETA BLOCKERS AND ACE INHIBITORS LESS EFFECTIVE. ALPHA-BLOCKERS, DIURETICS AND CALCIUM CHANNEL BLOCKERS ARE MORE EFFECTIVE
ASIANS:
- HAVE A HIGHER SENSITIVITY TO BETA-BLOCKERS AND OTHER ANTIHYPERTENSIVE MEDS, SO LOWER DOSES ARE OFTEN REQUIRED
INDIANS:
- SHOW RESISTANCE TO BETA BLOCKERS, NECESSITATING THE USE OF OTHER CLASSES OF HYPERTENSIVES
WHY IS ADRENERGIC STIMULATION NOT SUITABLE FOR PATIENTS WITH GLAUCOMA ?
ADRENERGIC STIMULATION CAUSES PUIL DILATION (MYDRIASIS) WHICH INCREASES INTRAOCULAR PRESSURE AND CAN EXACERBATE GLAUCOMA
WHAT ARE THE NOTICEABLE EFFECTS OF SYMPATHOMIMETICS ?
- PUPILS DILATE
- MOUTH GETS DRY
- NECK AND SHOULDER MUSCLES TENSE
- HEART PUMPS FASTER
- CHEST PAINS AND PALPITATIONS
- SWEATING
- MUSCLES TENSE FOR ACTION
- HYPERVENTILATION
- INCREASED OXYGEN DEMAND FOR MUSCLES
WHAT DO DOPAMINERGIC RECEPTORS DO WHEN STIMULATED ?
DILATE THE BLOOD VESSELS OF RENAL, MESENTERIC, CORONARY, AND CEREBRAL ARTERIES, INCREASING BLOOD FLOW TO THESE TISSUES
SSRI’S
REDUCE SEVERITY OF VASOMOTOR SYMPTOMS AND DEPRESSION
MAY RELIEVE IRRITABILITY AND MOOD CHANGES
EXAMPLE)
SERTRALINE AND FLUOXETINE
4 COMMON ANTICHOLINERGIC SIDE EFFECTS
DOCU
D - DRY MOUTH
O - ORTHOSTATIC HYPOTENSION
C - CONSTIPATION
U - URINARY RETENTION
