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Pharmacology II-Final > Pharmacology I > Flashcards

Pharmacology I Flashcards

1
Q

Phase 1 clinical trials

A

the drug is administered to a small number of healthy volunteers

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2
Q

Phase 2 clinical trials

A

are controlled trials with a limited number of patients with the condition to be treated

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3
Q

Phase 3 clinical trials

A

involve hundreds to a few thousand patients

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4
Q

Phase 4 trial

A

are studies that are conducted after the drug is marketed to the public

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5
Q

Angina is a symptom of?

A

ischemic heart disease. Ischemia is caused by loss of blood suuply to a region of the body

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6
Q

risk factors for angina?

A

Peoplewho have heart disease, high blood pressure and diabetes
smoking, overacting, a diet high in cholesterol and salt, excessive alcohol intake, obesity, stress and lack of excercise

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7
Q

prolonged ischemia can result?

A

in tissue leading to myocardial infaction or stroke

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8
Q

3 types of angina?

A

stable angina, unstable angina and variant angina.
In all types there is an imbalance between blood supplied to the heart muscle and the need for blood and oxygen

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9
Q

Symptoms of stable angina?

A

physical exertion is the most common reason
rest and antianginal medications treat the acute symtoms of stable angina

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10
Q

unstable angina?

A

requires medical evaluation because it may precede a myocardial infarction
it may occur at rest and result when ane embolus partially or completly blocks an artery
Symptoms are not relieved by rest or antianginal medicines

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11
Q

Variant angina?

A

caused by vacospasm of the coronary arteries. Spasms decrease the opening of the artery reducing the blood suuply and oxygen to the heart. relieved by nitrates and calcium channel blockers

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12
Q

why are drugs given to treat angina?

A

given to increase the blood and oxygen supply to the heart and or decrese the heart’s demand for oxygen. They produce their effects by dilating blood vessels, decreasing heart rate, reducing cardiac contractilility or reducing vasospasms.

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13
Q

Nitrates?

A

reduce oxygen demand and increase oxygen supply. They dilate blood vessels and increase supply of oxygen to the heart. Some dosages are designed to deliver nitroglycerine quickly and are used to treat acute symtoms such injections, sublingual tablets and lingual spray.

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14
Q

why should sublingual nitroglycerine be packaged in amber glass bottles?

A

because nitroglycerin is volatile and loses its potency on exposure to air, light and moisture.

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15
Q

Nitrates drugs:

A

Isosorbide dinitrate
Nitroglucerine

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16
Q

isosorbide dinitrate brand name?

A

Isordil

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17
Q

Patients using nitrates can develop?

A

tolerance to their effects and is more common with long-acting products

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18
Q

what do beta-adrenergic blockers do?

A

reduce the heart’s demand for oxygen by decreasing the heart rate and thereby reducing the workload of the heart. They decrease the frequency and severity of stable angina.

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19
Q

when would you use beta-adrenergic blockers cautionly?

A

can produce bronchospasm so person with asthma and people who have diabetes because decrease heart rate is one of the signs of hypoglycemia in diabetes

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20
Q

Atenolol brand name?

A

Tenormin

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21
Q

Metoprolol brand name?

A

Lopressor

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22
Q

Propranolol brand name?

A

Inderal LA

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23
Q

What do calcium channel blockers do?

A

used in the treatment of variant and stable angina because their ability to reduce vasospasm that restrict the flow of blood and oxygen.
can be used in combination with nitrates or beta blockers.
block L-type voltage-dependent calcium channels, suppress depolarization and reduce contraction of the heart muscle.

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24
Q

what are the two classes of calcium channel blockers?

A

Dihydropyridines (amlodipine, nifedipine): selective for blood vessels so they are ableto increase blood oxygen supply without slowing heart rate or contractions
Non-dihydropyridines (verapamil and diltiazem): myocardial selective and tend to reduce the heart rate

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25
Q

Amlopipine brand name?

A

Norvasc

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26
Q

Dilitiazem brand name?

A

Cardizem CD, Tiazac

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27
Q

Verapamil brand name?

A

Isoptin SR

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28
Q

Nifedipine brand name?

A

Adalat XL

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29
Q

What is th one adverse effect caused by all calcium channel blockers?

A

Hypotension

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30
Q

What is cardiac output?

A

Volume of blood ejacted from the left ventricle in 1 min

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31
Q

Systolic blood pressure?

A

is a measure of the pressure when the heart’s ventricles are contracting (systole)

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32
Q

diastolic blood pressure?

A

is a measure of the heart at rest (diastole)

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33
Q

risk factors of high blood pressure

A

metabolic syndrome, hyperlipidemia, diabetes and dyslipidemia and drugs may cause high blood pressure.

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34
Q

elevated blood pressure is defined as ?

A

120-129/ 80

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35
Q

Gestational hypertension?

A

Hypertension during pregnancy

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36
Q

What can hypertension cause?

A

cause damage to the kidneys, heart, brain, arteries and eyes. called silent killer (can kill without any symtoms)

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37
Q

Hypertension poses a serious public health why?

A

the risks for death and long-term disability

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38
Q

Lifestyle modification is an important strategy for preventation and management of hypertension but why?

A

chronic disease of lifestyle due to its association with obesity, excess dietary sodium intake, physical inactivity, excessive alcohol intake and inadequate intake of fruits and vegatables.

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39
Q

what do diuretics do?

A

exert their effects on the kidneys. They lower pressure by decreasing blood volume, peripheral resistance in blood vessels and cardiac output.

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40
Q

3 types of Diuretics?

A

-thiazide diuretics
-loop diuretics
-potassium-sparing diuretics

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41
Q

Thiazide diuretics?

A

are the first-line therapy for hypertension.
They act at the distal convoluted tubule decreasing vasoconstriction, lowering peripheral resistance along with blood pressure.
-dosed once a day
-promote elimination of water, sodium, potassium that can cause dehydration, hyponatremia, hypokalemia, hypomagnesemia, hypochloremia and hyperuricemia( excess uric acid)

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42
Q

caution use in what patient when using thiazide diuretics?

A

diabetes

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43
Q

adverse reactions of thiazide diuretics?

A

gastrointestinal upset, impotence and photosensitivity

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44
Q

Chlorthalidone brand name?

A

generics

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45
Q

indapamide brand name?

A

lozide

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46
Q

metolazone brand name?

A

Zaroxolyn

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47
Q

loop diuretics?

A

most potent diuretics
-they increase potassium excretion so need to give potassium supplement
-increase calcium excretion as well
-absorded from the GI tract
-they can cause dehydration, severe hypotension, hypokalemia, hyperuricemia and photosensiticty.

48
Q

Furosemide brand name?

A

Lasix

49
Q

What does potassium-sparing diuretics do?

A

inhibit sodium reabsorption while avoiding potassium loss.
less effective than loop and thiazide diuretics
Hyperkalemia is the most serious adverse reaction and te risk increases if they are prescribed concurrently with ACE inhibitors

50
Q

What patients should you use potassium-sparing dirutics cautionly?

A

heart failure who are on Digoxin
patient should be advised to avoid salt substitute because they contain potassium chloride

51
Q

Amilorde-HCTZ brand name?

A

Moduret

52
Q

Triamterene-HCTZ brand name?

A

Dyazide

53
Q

what do aldosterone recetor antagonists do?

A

Block the effect of aldosterone
Aldosterone is released when the kidney percevies a drop in blood flow and blood pressure
it causes sodium and water reabsorption to increase blood pressure

54
Q

what is spironalactone?

A

is an aldosterone antagonist and sometimes classified as a postassium-sparing diuretic
also used to treat primary aldosteronism, hypokalemia and heart failure. work immediately and take several weeeks to see max effects.

55
Q

why can spironolactone only be dosed once a day?

A

because of its long half-life

56
Q

Spironolactone brand name?

A

Aldactone

57
Q

what do Angiotensin-Converting Enzyme inhibitor (ACEI) do?

A

block the action of angiotensin-converting enzyme and hence prevent the conversion of angiotension I to angiotensin II (Which is a potent vasoconstrictor, stimulates release of aldosterone and promotes the release of norepinephrine from sympathetic neurons.

58
Q

First-line therapy for the treatment of hypertension with chronic kidney disease, diabetes and coronary artery disease?

A

ACEI

59
Q

what do ACEI do that lowering blood pressure?

A

cause accumlation of bradykinins (produce dilation of arteries) which reduces peripheral resistance

60
Q

what ACEI are already active?

A

Captopril and Lisinopril

61
Q

what ACEI drug is good for patients with decreased kidney function?

A

Fosinopril since only 50% is eliminated by kidney and 50% by liver

62
Q

ACEI’s side effects?

A

Dry cough, hyperkalemia, lightheadness, hypotension, diarrhea and skin rashes.

63
Q

ACEI contraindicated?

A

in pregnancy and salt subsitutes should be avoided to reduce risks of hyperkalemia

64
Q

Brand name of Enalapril, lisinopril, perinodopril, Quinapril, Ramipril, Trandolapril, enalapril/HCTZ, lisinopril/HCTZ, Quinapril/HCTZ.

A

Enalapril-Vasotec
lisinopril-Prinivil
perinodopril-Coversyl
Quinapril:Accupril
Ramipril-Altace
Trandolapril: Mavik
enalapril/HCTZ: Vaseretic
lisinopril/HCTZ: Zestoretic
Quinapril/HCTZ: Accuretic

65
Q

What do Angiotensin II Recetor Antagonists do?

A

lower blood pressure by blocking the binding of angiotensin II. They also inhibit angiotensin II-stimulated growth of smooth muscle, reducing ventricular and arterial hypertrophy that is associated with chronic hypertension. produce less cough

66
Q

ARB’s are contrindicated..

A

is the second and third trimesters of pregnancy.

67
Q

Candesartan brand name?

A

Atacand

68
Q

irbesartan brand name?

A

Avapro

69
Q

Losartan brand name?

A

Cozaar

70
Q

Telmisartan brand name?

A

Micardis

71
Q

Valsartan brand name?

A

Diovan

72
Q

how do Beta-Adrenergic Blocker (Beta blocker) work?

A

They block the effect of norepinephrine and epinephrine on the heart and blood vessels to reduce heart rate and reduce blood pressure.

73
Q

selective and nonselective beta blockers?

A

selective are less likely to produce bronchospasm

74
Q

Beta blockers should not be stopped abruptly why?

A

may cause the onset of arrhythmias or angina

75
Q

Propranolol brand name?

A

Inderal LA

76
Q

Acebutolol brand name?

A

Sectral

77
Q

Atenolol brand name?

A

Tenormin

78
Q

metoprolol brand name?

A

Lopressor

79
Q

Alpha 1-Blockers what do they do?

A

produce vascular relaxation, which reduces peripheral vascular resistance and lowers lood pressure. reduce low-density lipoprotein cholesterol levels

80
Q

Doxazosin brand name?

A

Cardura

81
Q

Prazosin brand name?

A

Minipress

82
Q

Terazosin brand name?

A

Hytrin

83
Q

Calcium Channel Blockers what do they do?

A

The dihydropyridines (Amlopidine & felodipine ) are selective for blood vessels and are effective at lowing blood pressure because of their ability to relax blood vessels.
The phenylalkylamines (Verapamil) and benzothiapines (Diltiazem) decrease cardiac workload, heart rate, and heart contractions.

84
Q

Amlodipine brand name?

A

Norvasc

85
Q

Dilitiazem brand name?

A

Cardizem CD, Tiazac

86
Q

Felodipine brand name?

A

Plendil

87
Q

Nifedipine brand name?

A

Adalat XL

88
Q

Verapamil brand name?

A

Isoptin SR

89
Q

Central-acting alpha2-Agonists two drugs?

A

Methydopa and clonidine

90
Q

what does Methydopa do?

A

binds to recetors it minicks the autoinhibitory effect of norepinephrine, blood vessels dilate, and peripheral resistance is decreased.

91
Q

what does clonidine do?

A

inhibits norepinephrine release from the CNS and peripheral sites

92
Q

Clonidine brand name?

A

Catapres, Dixarit

93
Q

what do direct vasodilators do?

A

decrease peripheral resistance and reduce blood pressure by relaxing vascular smooth muscle.

94
Q

what do direct vasodilators do?

A

decrease peripheral resistance and reduce blood pressure by relaxing vascular smooth muscle.

95
Q

Hydralazine is recommended for…

A

hypertensive emergencies (parenteral use) and is safe for the treatment of preeclampsia in pregnant women.

96
Q

Hydralazine brand name?

A

Apresoline

97
Q

Minoxidil brand name?

A

Loniten

98
Q

Direct Renin inhibitors what do they do?

A

act to block the conversion of angiotensinogen to angiotensin I which is the first step in the Renin-Aldosterone-Angiotensin system cascade.

99
Q

Aliskiren brand name?

A

Rasilez

100
Q

When is Aliskiren contraindicated?

A

Concurrent use of ACE inhibitors and ARBs are contraindicated.
in patients with diabetes because of risk of renal impairment, hypotension and hyperkalemia.
contraindicated during pregnacy due to risk of fetal toxicity.

101
Q

Antithrombotic

A

Drug that inhibits clot formation by reducing the coagulation action of blood protein thrombin

102
Q

Ischemic strokes?

A

are caused by oxygen deprivation
blood clots are the most common cause of strokes

103
Q

nonmodifiable risk factors for stoke and mi?

A

Age, gender, family history and chronic disease (such as hypertension, ischemic heart disease and diabetes)

104
Q

Modifiable risk factors for stroke and mi?

A

SMOKING, ALCOHOL, DIET

105
Q

Drugs used to treat heart disease?

A

drugs that control the buildup of lipids and plaque and drugs that reduce the formation of blood clots are administered to prevent stroke, myocardial infaction and acute coronary syndrome.

106
Q

Cardioglycosides are the..

A

oldest class of drugs used in the treatment of heart failure.

107
Q

what does cardioglycosides do?

A

increases cardiac output and slows the heart rate.

108
Q

Digoxin affects on the body?

A

food can decrease absorption
has a narrow therpaeutic index; therefore patients should watch for sings of digitalis toxicity such as arrhythmia, dizziness, headache, convulsion, delusions and coma

109
Q

Digoxin brand name?

A

Lanoxin, Toloxin

110
Q

Other drugs to treat heart failure?

A

diuretics, aldosterone antagonists, beta blockers, ACE inhibitors, ARBs, vasodilators.

111
Q

Antiplatelet drugs what do they do?

A

produce their effects by interfering with steps in the clot formation process

112
Q

How does Aspirin work?

A

blocks the enxyme cyclooxygenase which reduces plaque formation and inhibits prostaglandin synthesis which decreases thromboxane A2

113
Q

drug interactions of antiplatelets?

A

NSAIDS, vitamin supplement, and herbs can increase the risk for bleeding

114
Q

Aspirin brand name?

A

Entrophen and Novasen

115
Q

Clopidogrel brand name?

A

Plavix

116
Q

Dipyridamole brand name?

A

Persantine

117
Q

Dipyridamole inhibits?

A

platelet aggregation and is a coronary vasodilator

Pharmacology II-Final (14 decks)

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