Pharmacology Flashcards
Atenolol, Metoprolol, Carvedilol, Labetalol, and Propranolol are all part of what drug class?
Beta blockers
T/F: Beta blockers inhibit the action of the SNS
T: SNS leads to (+) HR, (+) BP, vasoconstriction, and bronchodilation
Beta blockers lead to (-) HR, (-) BP, vasodilation, and bronchoconstriction
What conditions are beta blockers used for?
CAD, HTN, arrhythmia
Adverse effects of beta blockers
orthostatic hypotension, dizziness, lightheadedness, ringing in ears, venous pooling, bradycardia
Can beta blockers be used in patients with pulmonary issues like asthma and COPD?
Why/why not?
NO, beta blockers cause bronchoconstriction, which can be harmful to people with those conditions.
Beta blockers (increase/decrease) PR interval?
Increase due to slowing down conduction through the AV node/decreasing HR.
What is the reason beta blockers cause venous pooling?
beta blockers cause vasodilation, which leads to increased venous pooling
What do beta blockers do to preload and afterload?
No effect on preload
Decrease afterload
Medications ending in “pine” and “zem” are what type of medication?
CA Channel Blockers
“Think of the pine trees and the zem hippies in California.”
Amlodipine, Verapamil, and Diltiazem are all what type of medication?
CA Channel Blockers
Your cardiac rehab patient is taking CA Channel Blockers. What change in their EKG would you expect to find?
Prolonged QT interval, since CA channel blockers affect the cardiac action potential.
Why are CA Channel Blockers prescribed?
CAD, HTN, arrhythmia
Are CA Channel Blockers safe to use in people with pulmonary disorders like Asthma or COPD?
Why/Why not?
SAFE! Since CA channel blockers only really have their effect on the heart (not the whole SNS like beta blockers), they do not cause bronchoconstriction.
What are the effects of calcium channel blockers on:
Calcium levels (+/-)
Contractility (+/-)
HR and BP (+/-)
CA Channel Blockers decrease all of those
Calcium is (directly/indirectly) related to the contractility of the heart?
Directly: so, if you decrease calcium, you decrease heart contractility
Lasix, also known as Furosemide, is what type of medication?
Loop Diuretic
What do loop diuretics inhibit reabsorption of?
Water and all electrolytes
What conditions are loop diuretics prescribed for?
HTN, CHF, edema, pulmonary edema
How do loop diuretics affect preload and afterload?
Decrease both, which is why they’re good for CHF.
Side effects of loop diuretics
(hint: think of what they block absorption of)
Hypokalemia
Hypocalcemia
Hyponatremia
Dehydration
Orthostatic hypotension
Dizziness/lethargy
REFLEX TACHYCARDIA
What is reflex tachycardia?
What medications can cause reflex tachycardia?
Reflex tachycardia is when the HR reflexively increases in response to a decrease in BP.
This happens in diuretics.
Why does reflexive tachycardia happen in diuretics but not other drugs that affect BP?
Diuretics directly decrease BP through decreasing fluid/blood volume, which stimulates baroreceptors and triggers the increase in HR.
In other drugs, like CA channel blockers and beta blockers, blood pressure is indirectly decreased through means of decreased HR.
Spironolactone and aldosterone are what type of medications?
Potassium sparing diuretics
What are two unique side effects of potassium sparing diuretics?
Hyperkalemia
Gynecomastia
What are the three types of diuretics we learned about?
Loop diuretics
Potassium sparing diuretics
Thiazides
What are the unique side effects of thiazides?
“Hit my thigh and it made a big CLUG.”
HyperCalcemia
HyperLipidemia
HyperUricemia
HyperGlycemia
What populations should thiazides not be prescribed?
Elderly, DM, Renal dysfunction
(think of side effects like hyperuricemia and hyperglycemia)
T/F: Thiazides have a risk of hyperkalemia
F: hyperkalemia is a risk of potassium sparing diuretics
Hydrochlorothiazide (HCT) is what class of drug?
Thiazide: diuretic
Captopril, Enalapril, and Lisinopril are what type of medication?
ACE Inhibitors
April is allergy season.
Which drugs have side effects of hyperkalemia?
Potassium sparing diuretics
ACE inhibitors
ARB blockers
Cardiac Glycosides
What is a side effect unique to only ACE inhibitors?
Dry hacking cough: when you take ACE inhibitors for a long time, it increases nitric oxide production, which irritates the lungs.
“April is allergy season” so think of the cough side effect.
Losartan, Telmisartan, and Candesartan are what type of medication?
ARB Blockers
T/F: ARB Blockers can cause hyperkalemia
T
Digitalis, Digitoxin, and Digoxin (Lanoxin) are all what type of medication?
Cardiac Glycosides
ACE inhibitors and ARB blockers are beneficial for what conditions?
CHF, HTN
Cardiac Glycosides like Digoxin lead to (more/fewer) and better contractions/beats.
Fewer and better contractions/beats.
These meds are used for SYSTOLIC dysfunction, so they need to make the squeeze better.
What medication slows HR but increases the strength of contraction?
Cardiac Glycosides: Digitalis, Digitoxin, Digoxin (Lanoxin)
What EKG changes would you expect to see in a patient who takes Digoxin?
Digoxin = Cardiac Glycoside
Prolonged PR interval, shortened QT interval.
Cardiac Glycosides are used for what health condition?
Systolic dysfunction in patients with CHF.
Digoxin is usually a (short/long) term drug.
Short due to digoxin toxicity: arrhythmia, palpitations, fatigue, GI disturbances, visual disturbance, hyperkalemia, confusion, delirium
What’s the main difference between selective and non-selective NSAIDs?
Non-selective NSAIDs cause GI disruption due to targeting inflammation (COX2) and also healthy prostaglandins in the gut (COX1).
Selective NSAIDs have adverse cardiovascular effects.
Why do people use NSAIDs?
(3 reasons)
Anti-inflammatory
Antipyretic
Analgesic
What are some side effects of non-selective NSAIDs?
Gastric ulcers, bleeding, nausea, vomiting
Aspirin, Ibuprofen, and Naproxen are all what type of medication?
Non-selective NSAIDs
Celecoxib (Celebrex) is what type of medication?
Selective NSAIDs
Tylenol is what type of medication?
Acetaminophen
T/F: Tylenol has anti-inflammatory effects
F: Tylenol/Acetaminophen is not an anti-inflammatory.
IT IS: antipyretic, analgesic, and can help with headaches
What are the uses of Acetaminophen?
(3 uses)
Antipyretic
Analgesic
Headache pain
What is one side effect of overuse of acetaminophen?
Liver damage
Morphine, Oxycodone, Hydrocodone, Fentanyl, and Methadone are all under what type of drug?
Opioid Analgesics
What are the uses of Opioid Analgesics?
Severe pain
Post-op pain
Antitussive (cough medication)
What are the side effects of Opioids?
Everything SLOWS DOWN:
Respiratory and CNS depression
Bradycardia
Constipation
Slowed breathing
Dizziness
Drowsiness
Slowness
Addiction
What is the antidote for overdose?
Naloxone/Narcan
Your patient just got a knee replacement and is taking Hydrocodone for pain relief.
How much time before your physical therapy session should your patient take the medication?
Opioid: 30 mins prior to therapy
Diazepam (Valium), Clonazepam (Klonopin), and Alprazolam (Xanax) are what type of medication?
Benzodiazepines
Benzodiazepines (increase/decrease) inhibitory effects of GABA in the CNS.
Increase GABA!
Your patient informs you that they have recently started taking Xanax for their anxiety. You noticed they drove to the clinic. What should you say?
Patients should not drive while on benzodiazepines.
What are Benzodiazepines used for?
Muscle spasms, anxiety, insomnia, alcohol withdrawal, acute epileptic attacks
Cyclobenzaprine (Flexeril), Baclofen, and Botox are what type of medication?
Skeletal Muscle Relaxant
Patients with spasticity problems seen in MS and SCI can commonly have pumps with this medication in it
Baclofen (muscle relaxant)
Botox is commonly used in this condition with muscle spasticity
Cerebral palsy
Beta-2 agonists, Antimuscarinic (Cholinergic), and Corticosteroids are all what type of medication?
Bronchodilator Drugs
Corticosteroids carry what side effects?
Delayed wound healing
Osteoporosis
Cushing’s disease
Budesonide and prednisolone are what type of drug?
Corticosteroids
What is the difference between short acting and long acting bronchodilator drugs?
Short acting: acute asthma attack
Long acting: daily dose
Penicillin, Cephalosporin, Vancomycin, and Gentamicin are all what type of drug?
Antibacterial Drugs
Ototoxicity is a side effect specific to what drug?
Gentamicin (antibacterial drug)
Statins like Lipitor and Zocor are used for what?
High cholesterol
What are some side effects of statins?
Rhabdomyolysis
Muscle achiness
Tea-colored urine
Increase in creatine kinase
Barbiturates are used for what?
Epilepsy
Phenobarbital (Phenytoin) is what type of drug and what is it used for?
Barbiturate: anti-epilepsy drug
Sinemet is another name for what popular drug?
Levodopa
Levodopa (Sinemet) is used to treat what disease?
Parkinson’s
What should patients avoid consuming when taking Levodopa?
Protein
What are some side effects of Levodopa?
Restlessness, dyskinesia, hallucinations
Warfarin (Coumadin) and Heparin are what type of drug?
Anticoagulants/Blood thinners
What is a normal INR?
0.9-1.1
What foods should patients avoid while on anticoagulants?
Leafy greens, cranberry juice, and grapefruit juice.
When a patient is on anticoagulants like Coumadin, their INR can be in this range and it is still acceptable:
2-3
You should be extra careful about guarding a patient to prevent falls if their INR is ___
> 2.5
Patients have a higher risk for hemarthrosis if their INR is ___
> 3
An INR of ___ calls for bed rest until it is corrected.
> 6
Are anticoagulants or antiplatelets stronger medications?
Anticoagulants; they’re used to treat conditions like DVT, MI, and Stroke so they need to be stronger and more fast-acting.
Aspirin and Clopidogrel are what type of medication?
Antiplatelets
