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DMD 5247 > pharmacology (all) > Flashcards

pharmacology (all) Flashcards

1
Q

what is the first drug therapy that should be used with patients with hypertension

A

thiazide diuretics (hydrochlorothiazide)

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2
Q

how can hypertension be resolved without drug therapy

A

diet
stop smoking
less salt
exercise

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3
Q

after thiazide diuretics, what is the next logical pharmacuetical option for hypertension

A

ACE inhibitors

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4
Q

how do ACE inhibitors work

A

they inhibit angiotensin converting enzyme from synthesizing angiotensin 2, a potent vasoconsrictor. angiotensin 2 also causes aldosterone to be secreted. which is an antidiuretic. increasess blood volume and pressure

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5
Q

what do ACE inhibitors end in

A

-pril

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6
Q

what do angiotensin 2 receptor blockers end in

A

-sartan

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7
Q

what is the benefit of angiotensin 2 blockers over ACE inhibitors

A

they don’t cause a dry cough

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8
Q

what is the adrenergic drug for hypertension that can be used in pregnancy

A

clonidine (catapres)

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9
Q

how do beta blockers work

A

they reduce heart rate by blocking beta receptors in the heart. they also reduce renin secretion, thus aldoseterone II and angiotensin
decrease blood pressure

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10
Q

can patients abruptly stop taking antihypertension medication

A

no because it can cause a rebound hypertensive effect, which can lead to a stroke

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11
Q

what do calcium channel blockers end in

A

ipine

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12
Q

what drug is used for a hypertensive emergency

A

sodium nitropresside (nitride) and IV diazoxide (they are peripheral vasodilators

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13
Q

what causes angina pectoris

A

insufficient oxygen to the heart

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14
Q

what are the three types of angina

A

chronic stable (classic or effort) angina
unstable (preinfarction) angina
vasospastic (prinzmetals) angina

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15
Q

what are the characteristics of stable angina

A

no pain while resting
pain starts by exercise, stress, emotion or heavy metals
caused by atherosclerotic plaques

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16
Q

what are the characteristics of unstable angina

A

unpredictable even at rest
more intense pain longer lasting
risk MI and death
caused by atherosclerotic plaque rupture/blockage

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17
Q

what are the characteristics of vasospastic angina

A

caused by intense coronary arterial spasms
pain may come at rest
smoking, hyperinsulinemia, and insulin resistance are factors

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18
Q

what are nitrates for

A

they are used to prevent angina, since they cause potent dilation of coronary arteries. they are used for acute angina, and prevention of angina

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19
Q

what is the main side effect of nitrates

A

headaches (also orthostatic hypotension)

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20
Q

what is the most common calcium channel blocker

A

niphedipine (procardia)

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21
Q

what is the most common side effect of niphedipine

A

constipation (tell them to eat fiber)

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22
Q

what is nitroglycerine for

A

it is a vasodilator that decrease bp and helps with angina

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23
Q

what is the process for taking nitroglycerine with angina

A

when angina occurs, sit down and take one sublingually. wait five minutes, take another if angina persists. call 911 get an ambulance. take third 5 minutes later if angina persists

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24
Q

when should you not give someone nitroglycerine

A

with someone who has a systolic blood pressure below 90

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25
Q

what type of drugs are used for long term management of angina

A

beta blockers and calcium channel blockers

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26
Q

what type of drugs are used for acute angina management

A

nitroglycerines

27
Q

what is a mild diuretic

A

thiazide

28
Q

what is a powerful diuretic

A

forosimide (lacic)

29
Q

what should be instructed of patients taking diuretics

A

increase electrolytes, especially potassium

30
Q

what are potassium sparing diuretics

A

spirolactone and aldolactone

31
Q

what shouldn’t be done with potassium sparing diuretics

A

you shouldn’t increase potassium (can lead to hyperkalemia)

32
Q

when should diuretics be taken

A

in the morning (don’t wake up to pee)

33
Q

what is the drug of choice for ventricular dysrhythmias

A

lidocaine,xylicaine

34
Q

why is a beta blocker a bad idea for a women with a slow heart beat

A

because they slow down the heart rate

35
Q

what is a dysrhymia

A

any deviation from the normal rhythm of the heart

36
Q

what causes dysrhythmias

A

ischemia/MI
toxicants
drugs
hypokalemia

37
Q

what is the normal level of digoxin

A

.5-2 ng/dl

38
Q

what are the effects of digoxin

A

positive ionotrope
negative chromotrope
negative dronotrope

39
Q

what are the side effects of digoxin overdose

A 
nausea
diarrhea
vomiting
seeing halos
hypokalemia
40
Q

what happens with digoxin and a diuretic

A

hyperkalemia

41
Q

what things shouldn’t someone on warfarin/coumadin do

A

anything that can cause bleeding

shaving, flossing

42
Q

what tests are used to test the effects of warfarin

A

prothrombin time and INR

PT-INR

43
Q

what are the signs and symptoms of serious side effects of warfarin

A 
bleeding
skin rashes
fever
nausea
diarrhea
dermatitis
alopecia
urticaria
abdominal cramps
anorexia
44
Q

what pain killer should be taken with warfain/coumadin

A

tylenol/acetometaphen

45
Q

what is the antidote for warfarin/coumadin

A

vitamin K

46
Q

what is the mechanism of action for anticoagulants

A

prevent clot formation, don’t break down current clots

47
Q

why would LMWH be administered

A

because it has a more predictable anticoagulant response
it doesn’t require prolonged aPTT
it doesn’t require prolonged lab tests

48
Q

what is LMWH

A

low molecular weight heparin

49
Q

what is the lab test used to monitor heparin effects

A

aPTT activated partial thromboplastin time

50
Q

what is the first choice antiplatelet drug

A

aspirin, because it is the least powerful

51
Q

why do we use clopdogrel

A

its a powerful antiplatelet that we use so we don’t have to use an anticoagulant

52
Q

at what point do we call a doctor if on antihypertensive drugs and we are in hypotension

A

if systolic is less than 90

53
Q

what must we caution our patient about antihypertensive drugs,

A

they need to watch for orthostatic hypotension

54
Q

what is primary hypertension

A

idopathic, cause unknown

55
Q

what is secondary hypertension

A

hypertension due to a secondary cause, it goes away once the other problem is fixed

56
Q

concerning pulse, when should we call the doctor

A

if its less than 60 or more than 100

57
Q

when taking calcium channel blockers what tests do we check to observe renal function

A

BUN and creatinine

58
Q

what is verapamil

A

calcium channel blocker

59
Q

ways to reduce cholesterol

A

diet

exercise

60
Q

what is the first line drug of choice for hypercholesterolemia

A

statins

61
Q

what are ideal LDL values

A

less than 100 (190 is very high)

62
Q

what are ideal HDL values

A

more than 60 (less than 40 is bad)

63
Q

what are ideal total cholesterol values

A

less than 200 (more than 240 is bad)

64
Q

treatment for digoxin overdose

A

digoxin immune fab (digibind) therapy

DMD 5247 (11 decks)

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