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Cardio/Renal 1 Final > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Loop Diuretics MOA

A

inhibits Na+/K+/CI- in ascending loop of henle which allows more water and CI- to travel to distal tubule

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2
Q

Loop diuretics MOA in HTN

A

Arteriolar vasodilator and diuretic effect (decreases peripheral resistance)

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3
Q

AE of loop diuretics

A

Orthostatic hypotension / Hypokalemia / hypomagnesemia / hypochloremia / hyponatremia / metabolic acidosis

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4
Q

What is Elperenone and its MOA

A

New aldosterone agent that selectively binds to mineralocorticoid receptors and blocks aldosterone

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5
Q

Feature of Elperenone

A

It has less affinity for steroid receptors compared to spironolactone

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6
Q

Canrenoate & Canrenone are…

A

metabolites of spironolactone

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7
Q

What do the 2 metabolites of spironolactone do and treat

A

they bypass hepatic metabolism and treat primary or secondary hyperaldosteronism / HTN / CHF / ascites due to hepatic cirrhosis

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8
Q

Which of the following are vasodilators ?

A

sodium nitropursside / nesirite / hydralazine / minoxidil

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9
Q

What is sodium nitroprusside and what does it do ?

A

It is a vasodilator and it decreases cardiac work + no reflux tachycardia + decreases pre load on heart

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10
Q

MOA of sodium nitroprusside

A

It makes RBCs convert nitropursside to NO - also relaxation by non-enzymatically to NO by glutathione

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11
Q

What are the AE of sodium nitroprusside ?

A

palpitation / abdomen pain / cyanide toxicity / lactic acidosis

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12
Q

What causes SE of sodium nitroprusside ?

A

the release of cyanide (thiocyanate)

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13
Q

Kinetics of nitroprusside

A

during biotransformation of nitroprusside. cyanice is produced which is then converted to thiocynate in the liver and excreted by the kidneys

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14
Q

What is Nesiritide

A

a recombinant form of human natriuretic peptide

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15
Q

Where does nesiritide release from and what does it do ?

A

it is secreted by the ventricles and increases cGMP

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16
Q

what does nesiritide cause ?

A

natriuresis

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17
Q

MOA of hydralazine

A

molecules combine with receptors in the endothelium of arterioles -> NO release -> relaxation of vascular smooth muscle -> fall in BP

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18
Q

How is hydralazine taken ?

A

combination with isosorbide dinitrate

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19
Q

What do beta blockers do for CHF

A

decrease reflux tachycardia + load on heart

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20
Q

What is an advantage of carvedilol ?

A

it reduces free radical induced lipid peroxidation and prevents cardiac and vascular smooth muscle mitogenesis

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21
Q

What is a SE of non-specific BB carvedilol ?

A

bronchoconstriction with higher doses

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22
Q

What are DI of carvedilol and what does the CYP one do ?

A

CCB / Cimetidine / CYP2D6 –> increases levels of carvedilol

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23
Q

What are the positive inotropes and what does inotrope mean ?

A

Digoxin, dopamine, dobutamine, milrinone / it means contraction

24
Q

What can positive inotropes lead to ?

A

Lusitrophy

25
Q

What does digoxin treat and what is the moa for each one ?

A

CHF -> increases calcium availability which reverses HF
Atrial fibrillation -> decrease HR / blocks A-V nodal conduction
Another MOA is the Na+/K+ ATPase
-> more Na+ in

26
Q

When Digoxin reverses HF, what does that lead to ?

A

CO returns to normal with dilated heart, with tachycardia / and also decreases peripheral edema + congestion

27
Q

Main ADRs of digoxin ?

A

Hallucination, disturbed vision

28
Q

What are digoxins digital toxicities

A

Narrow therapeutic index / depends on electrolytes

29
Q

What are the non-digital positive inotropes that resemble NE

A

Dopamine / dobutamine / amrinone / milrinone

30
Q

What type of drugs are amrinone and milrinone

A

Theophylline drugs that inhibit phosphodiesterase and have positive inotropic activity and are inotropic vasodilators

31
Q

Whats the MOA of non-inotropic drugs

A

inhibit peak III cAMP phosphodiesterase isoenzyme in cardiac + vasculature

32
Q

Whats a DI of non-inotropic drugs

A

forms precipitate with IV furosemide

33
Q

Whats the ARNI + ARB combination

A

Sacubtril + valsartan = entresto

34
Q

What kind of drug is entresto ?

A

nephrylism inhibitor

35
Q

what is nephrylism ? and what amplifys its effect

A

endopeptidase that has naturetic + vasodilatory effects
valsartan amplifies the effects

36
Q

is sacubitril a pro-drug or not and if it is what is is activated by

A

it is a pro drug and it is activated by esterase hydrolysis

37
Q

what does entresto do for patients with CHF

A

reduces risk of cardiovascular death + hospitalization with reduced ejection rate for patients with reduced ejection fraction

38
Q

what kind of drug is Ivabradine and its MOA

A

1) HR lowering drug
MOA - selectively inhibits the “funny” channel pacemaker in SA node -> HR + more blood flow to myocardium

39
Q

What kind of patients is ivabradine good for ?

A

patients with ejection rate of < or equal to 35% and has less SE

40
Q

Which ones are the OD and what are OD and hypertonic solutions used for

A

mannitol, sorbitol, and isosorbital and used for cerebral edema and acute renal failure

41
Q

What are features of ODs

A

LMW + hydrophilic and pass through bowmans capsule into renal tubules

42
Q

What does mannitol decrease

A

intraocular + intracranial pressure

43
Q

what is used to treat metabolic acidosis

A

sodium bicarbonate

44
Q

what are examples of hyperkalemia agents

A

calcium chloride/gluconate, sodium bicarbonate, dextrose-insulin infusion, albuterol nebulizer, furosemide, kayexalate

45
Q

What can hyperkalemia drugs lead to

A

cardiac arrest

46
Q

What are drugs that treat hyperphosphotemia

A

calcium carbonate/acetate, sevelamer & lanthanum, aluminum hydroxide gel

47
Q

What kind of disease is sevelamer used for and what does it do

A

used in patients with chronic renal disease and binds directly to phosphate

48
Q

Lanthanum MOA

A

Breaks down in acid environment of the GI tract -> release lanthanum ions bind to dietary phosphate which is why its taken with food

49
Q

Everything about erythropoietin stimulating agents

A
  • used for anemia of chronic renal failure
  • 2 types -> erythropoietin alpha and darbepoetin alpha
  • recombinant human erythropoietin
50
Q

MOA of desmopressin and what is it used for

A
  • increase cyclic AMP in renal tubular cells which lead to retention of water in the body
  • bleeding and diabetes insipidus
51
Q

Everything about potassium chloride

A

1) slows down HR
2) used for hypokalemia because it increases K+

52
Q

What are the DIs of potassium chloride and why are they an interaction

A

ACE inhibitors and K-sparing diuretics (Sprinolactone, Traimetene, Amilornone) and because they elevate a persons K+ levels

53
Q

What does calcium gluconate do and treat ?

A

increase calcium levels + treats hyperkalemia

54
Q

What is Cinacalet and what does it do ?

A

it is a calcium sensitizer that decreases PTH in patients with renal failure

55
Q

What is Doxercalciferol ?

A

It is a vitamin D2 analog that undergoes metabolic activation in vivo to 1a,25-dihydroxyvitamin D2, a naturally occurring, biologically active form of vitamin D2

56
Q

Everything about vaptans

A

1) Tolvapatan (1st one) / Conviaptan
2) Hyponatremia is defined as serum sodium concentration <135
3) Vaptans are nonpeptide vasopressin receptor antagonists (VRA)
4) VRAs offer a novel therapy for water retention
5) Conivaptan is a V1 a/V2 nonselective VRA approved for euvolemic and hypervolemic hyponatremia

Cardio/Renal 1 Final (1 decks)

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